Healthcare three times as strongly bound into groups as the rest of the economy

Hospitals, medical care centres and care homes are far more often bound into groups than the rest of the economy. 7.7% of the 24,140 corporations in healthcare are bound to a parent company through a domination or profit transfer agreement, compared with 2.6% in the total population. This is the result of an analysis by HDH Group Research.

The affiliation is strongest among medical care centres at 16.7%, in inpatient care at 13.8% and among hospitals at 12.0%. In addition, there is concentration in management: 27.2% of medical care centres are run by a management in which at least one person manages five or more medical care centres. Outpatient care, by contrast, with 2.6% of companies contractually bound, remains a domain of independent owners.

Dental care centres since 2015

Medical care centres are a creation of legislation. Admitted since 2004, they experienced their second surge of incorporations when centres with only one specialty were also permitted in 2015. Dentistry above all has changed since then: before 2015 hardly more than five dental care centres were founded a year; in 2021 there were 83. Today, 688 dental care centres exist as corporations.

Insolvencies in waves

Each segment had its own year of crisis. In inpatient care, the insolvency rate rose from 2.9 ‰ in 2022 to 14.0 ‰ in 2023, when the obligation to pay collectively agreed wages, rising energy costs and a lack of staff coincided. Outpatient care followed in 2024 with 15.4 ‰. Among hospitals, the number of cases is small, but it is rising: in the first half of 2026, 14 insolvencies of hospital companies were recorded, after 6 in the first half of 2025.

Method

The analysis covers corporations in healthcare as of 23 October 2026 in six segments: hospitals, medical care centres, practices, inpatient and outpatient care, and diagnostics and therapy. Facilities run by churches, municipalities or non profit operators in other legal forms are not included.

The report

This item is based on the report “Hospitals, medical care centres and care services” by HDH Group Research. It contains all figures and tables, the definition of the population and a section on method and limitations: Hospitals, medical care centres and care services, also as PDF.