"Buy one hundred doctors' practices in a year." That is the tall order that Mediclinic, the Czech primary care operator, backed by Penta Investments, has set for itself.
Marketing Director Petra Kopecka won't say how close Mediclinic is to the target, but the website says that they had 30 doctor employees by August. Kopecka says Mediclinic is well past that now.
Mediclinic is not alone; Moje Ambulance is planning a similar network and, so far, has ten practices. Kopecka says there are other regional players who are also consolidating fast.
What is the hurry? Well, there is growing resistance to private groups in the Czech Republic, following the victory of the social democrats in October's regional elections. These victories are likely to halt the privatisation of hospitals, which has led to the formation of chains Agel, PP Hospitals and Mediterra.
That doesn't really explain why Mediclinic is in such a hurry. After all, over 95% of primary care practices, the first port of call for most Czech patients, are already private. But there is a difference between tens of thousands of small practices, owned by their doctors, and a chain of 100 in which the doctors are employees and managed for profits
Political pressure is likely to grow, and the professional association is opposed to doctors selling their practices. The Czech Doctors' Chamber is concerned that doctors are selling their practices for unfairly low prices: "We recommend not selling until a law is passed allowing a sale combined with a contract from a health insurance company. This will double the price," said ČLK spokesman, Michal Sojka.
There are differences between the two main contenders. Mediclinic has plenty of private equity backing, whilst Moje Ambulance does not. Moje Ambulance is setting up practices in shopping centres with lots of bright branding, whilst Mediclinic is not looking to change where doctors practice from.
Kopecka says that many doctors are keen to sell: "About 40% are over 60, and many do not have anyone to take over the practice," she told HealthcareEuropa. She would not reveal multiples, but said that Mediclinic was paying anything from Kč 400,000 to Kč 10m.
The hope is that, by building networks, these companies can make big back office efficiencies and offer a better service, typically 12 hours a day. Just about all the work carried out in practices is paid from state-backed social insurance funds.
Our Analysis: At first sight, the Czech republic is not attractive to private medicine. Private healthcare insurance is outlawed, there is huge resistance to hospital privatisation and Czechs kicked up one hell of an uproar over a recently introduced charge of just Kč30 per visit. The system is fairly inefficient, with the social insurance funds failing to police payments, and the regions and state in direct conflict over healthcare policy. It will be intriguing to find out more.
