Bundeskartellamt clears acquisition of eye and eye laser clinics in Central Germany by SmileEyes group

The Bundeskartellamt has granted the eye clinic chain “SmileEyes”, which is owned by financial investor Trilantic, permission to acquire MVZ Augen- und Laserzentren Mitteldeutschland GmbH, Augen- und Laserzentren Berlin MVZ GmbH and Augen- und Laserzentren Hamburg MVZ GmbH, all headquartered in Leipzig.

Andreas Mundt, President of the Bundeskartellamt: “Ultimately, the acquisition does not raise any serious competition concerns, because both companies have been operating in different areas so far. Patients’ options thus remain unaffected by the merger. There is a minor overlap of catchment areas in Berlin, which does not raise concerns in view of the many options to choose other eye clinic chains or independent clinics in that particular area.”

The SmileEyes group operates eye clinics in Munich, Trier, Luxemburg and Berlin. It also operates a number of conventional ophthalmic practices, mainly in Bavaria. In addition, the group licences the “Smile Eyes” brand to further practices, among them the Leipzig-based eye clinic group which it can now acquire. The chain operates eye and eye laser clinics, especially in eastern Germany, and various ophthalmic practices in greater Leipzig.

Andreas Mundt: "Over the last few years, we have been witnessing a growing number of acquisitions of and participations in medical practices, health centres and clinics by financial investors. Unfortunately, the statutory regulations only allow us to control a small part of these transactions under competition law. An acquisition is not subject to merger control unless the target company has achieved a minimum turnover of 17.5 million euros. There is a risk of concentrated power structures arising underneath the Bundeskartellamt’s radar."

The mere fact that clinics and practices are taken over by financial investors does not give rise to competition concerns. Financially strong investors can stimulate competition, for example by investing in expensive medical devices. However, the situation changes if clinic and practice chains obtain market power in certain geographic areas. Once dominant, health care providers are no longer forced to consider the needs of patients, other health care providers or cost bearers.

In addition, structures could become entrenched to the detriment of younger doctors working in the outpatient sector. The right to bill the statutory health insurance funds remains with the investor’s medical care centre, even after the contract physicians employed there retire. This is one of the reasons why the coveted accredited practices are particularly valuable to capital investors. Young doctors wishing to take over a practice on their own find themselves at a disadvantage in the competitive bidding with financially strong capital investors.