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In 2004, the German Legislature approved medical centers – or MCCs for short (German: MVZs) for statutory-health-insurance-accredited Original Article 51 Original Articles Clinical Social Work and Health Intervention Vol. 8 No. 2 2017 Introduction On 01/01/2014, the German Legislature approved Medical Care Centers (in short: MCCs) for statutory health insurance medical care. As a result, changes regarding the healthcare system in Germany have taken place the effects of which are far from being clarified. A clear type identification of this new healthcare/economic field has not been available up until this point, even if the topic of MCCs has been dealt with by various authors, for example Frielingsdorf (3), Distler (1), Blümm (2) and Sörensen (15), to name but a few. In his Dissertation, Medizinische Versorgungszentren in Deutschland: Entwicklung einer Typologie unter Unternehmensführungsaspekten [MCCs in Germany: The (short: SHI) medical care. This resulted in fundamental changes to the German Healthcare System the effects of which are far from being clarified. The Legislature expects the structural changes to result in improved interconnections between the In-patient and Out-patient Sectors. Object of enquiry: Growth will also be recorded by those types of MCC which are managed by other SHI service providers, because the synergy effects from these forms of cooperation can be clearly seen. Aims: The aim of the study is to show that there exist three different types of MCCs in Germany and what the concrete characteristics of these types are. Methodology: A semi-standardized questionnaire was assessed on the MCCs to receive the relevant data. Results: There are three types of MCCs in Germany: the usual MCC/partnership, the usual MCC/corporation, the company MCC. Through the developments in the medical field it has become noticeable in the last few years that the MCC in Germany has definitely attained a particular position of importance. Conclusion: The following paper on the classification of MCCs in Germany shows the results of the study carried out in December 2011, the results of which are presented in an empirical classification of MCCs. The structure of the German MCC is an excellent type for the medical field and has very good prospects for the future. 52 Clinical Social Work and Health Intervention Clinical Social Work and Health Intervention Vol. 8 No. 2 2017 development of a typology under company management perspectives], Renger shows approaches for a clear typology of MCCs. This study shows the first results Hulkova, Renger and Czirfusz were able to achieve within the scope of forming a typology according to Kluge’s method. Material and Methods Objects of investigation are to include all MCCs in Germany in order to come to a compre-hensively and empirically validated typology to the furthest extent possible. As a scientific method, a semi-standardized questionnaire was used. It was distributed to the MCCs in Germany via e-mail and supported by conducting telephone surveys. It is evident that despite a response rate of 5.33% (usual for this type of survey), an initial typology was definitely able to be formed using the examination material. Three MCC Types/Empirical MCC Type classification/Devising Relevant Comparative Dimensions In order to typify MCCs based on various aspects, first a differentiation can be established according to member types: • Freelance Doctor/Panel Doctor • Hospital • Affiliated Group/Management Company (4–5). Furthermore, a differentiation can be made with regard to what status the Doctors have that work at the MCC: • the MCC works exclusively with Panel Doctors, • the MCC works with Panel Doctors and Employed Doctors, • the MCC works exclusively with Employed Doctors. Since three characteristic features are involved here, initially a “feature space” is established consisting of nine combination options (5). Since it has been shown within the scope of literature that there are preferences in terms of this (for example, that Management Companies that operate MCCs almost always only work with Employed Doctors, something which also frequently concerns hospitals that operate an MCC (1)), the feature space is classified in the form of a typological reduction (5-7) in such a way that the empirical types adequately correspond to the majority of MCCs existing in Germany (see Figure 1 on the following page). By forming the feature space, seven Basic Types of MCCs form in Germany: • Basic Type, Freelancer MCC • Basic Type, Hospital MCC • Basic Type, Affiliated Group MCC • Basic Type, Freelancer MCC with EmployedDoctors • Basic Type, Hospital MCC with Panel Doctors • Basic Type, Affiliated Group MCC with the involvement of Freelance Doctors • Basic Type, Affiliated Group MCC involving a Hospital The two Basic Types/the one Basic Type that is still conceivable Freelancer/Hospital MCC is not sensible since this would mean that the majority of the partnership shares are not taken into consideration. Although this is basically also the case for types 6 and 7 it seems difficult to imagine that a Freelancer MCC would involve a Hospital in the minority and then only work with Employed Doctors or, in other words, that a Hospital would involve a Freelancer in the minority and then only work with Panel Doctors. 53 Original Articles Clinical Social Work and Health Intervention Vol. 8 No. 2 2017 Grouping of Cases and Analysis of Empirical Regularities In the following, the MCCs in Germany are grouped based on the KBV 2008 MCC Survey (8) and classified using the legal-form criteria (see Figure 2). The results are revealed from the Internet survey that was conducted during from December 2011 to January 2012. The typology-forming method type is orientated on the method presented by Kluge. (4–5) The Basic Type Freelancer MCC with Employed Doctors is the most prevalent, exclusively in the legal form GmbH (37.5%). The Basic Type Freelancer MCC follows with a company distribution of the legal form GbR being 25% and partnership companies being 12.5%. Figure 1: Feature space of empirical MCC Types MCC types Doctor status Member Type Panel Doctor Panel Doctor / Employed Doctor Employed Doctor Freelancers Basic Type, Freelancer MCC Basic Type, Freelancer MCC with Employed Doctors Hospital Basic Type, Hospital MCC with Panel Doctors Basic Type, Hospital MCC Affiliated Group Basic Type, Affiliated Group MCC with the involvement of Freelance Doctors Basic Type, affiliated Group MCC involving a hospital Basic Type, Affiliated Group MCC Figure 2: Distribution of the basic MCC types in Germany with regard to their legal form Legal form of MCC types Legal form MCC Basic Type GbR PartG GmbH AG KG GmbH&CoKG 1 Freelancers 2 25% 1 12.5% 2 Hospital 1 12.5% 3 Affiliated Group 1 12.5% 4 Freelancers + Employed Doctors 3 37.5% 5 Hospital + Panel Doctors 6. Group + Involvement of Freelance Doctors 7. Group + Involvement of a Hospital 54 Clinical Social Work and Health Intervention Clinical Social Work and Health Intervention Vol. 8 No. 2 2017 The Basic Type Hospital MCC has the legal form GmbH (12.5%); as does the Basic Type Affiliated Group MCC (12.5%). (11–13) Figure 3 shows these aspects:

Typology of Three Types of Medical Care Centers in Germany