Abstract

With demographic ageing ranking high on the agenda in many European countries, there are, in theory, potential opportunities for care home providers to expand their markets across borders. However, in practice, cultural and language barriers, as well as regulations may hinder expansion. In this study, we aim to explore the role that national regulations play in the provision of care across borders by care home providers. In particular, we seek to gain insights on how different public reporting mechanisms in long-term care (LTC) impact German care home providers’ decisions to expand their operations to Austria.

Austria and Germany have been selected as they share similar cultures and a common language, yet they have different regulatory and public reporting systems. In Germany a compulsory public reporting is part of the quality assurance framework, whereas in Austria a voluntary public reporting mechanism is still in its early stages. For the purpose of the study, semi-structured interviews were carried out with senior representatives of German care home provider organisations that have expanded to Austria, as well as with managers of the new care homes. Austrian public officials involved in the tendering or procurement process of care homes were also interviewed. This presentation will report the preliminary findings of the study.

Representatives from German care home provider organisations were asked about the role that regulations and in particular public reporting mechanisms played in their relocation process. Questions included to what extent public reporting is seen as a useful tool to signal commitment to quality and successfully challenge the position of incumbent providers, whether it is viewed as a tool for benchmarking against similar organisations or alternatively, as a barrier to entry. Care home managers were questioned on how different public reporting mechanisms might impact the way in which the care homes are run. In addition, the organisations were questioned on the extent to which experience gained with public reporting in one country is transferable or forms an advantage when faced with a different public reporting mechanism. Cross-border movement of care providers could be seen as an important allocation tool to mitigate local or regional care shortages in the European Union, particularly along border regions that share similar languages and cultures. It seems plausible to assume that as public reporting mechanisms become more established, this will make the regulatory framework of LTC even more differentiated among European countries.

This presentation will therefore inform the policy debate on how public reporting mechanisms may affect the movement of providers within the European Union and on the desirability of a common minimum quality framework. This is particularly relevant in the context of the discussion on Social Services of General Interest (SSGI) and on the feasibility of having an internal market of in the LTC sector. It also highlights how different regulatory systems may constitute an additional barrier to entry and thus affect competition in the care market.

Slides