MDK Nord

What MDK Nord does

Medizinischer Dienst Nord (MD Nord), legally Medizinischer Dienst Nord, Körperschaft des öffentlichen Rechts, is the independent medical and nursing assessment service for statutory health insurance (GKV) and social nursing care insurance (SPV) funds in the German federal states of Hamburg and Schleswig-Holstein. The organization operates under statutory mandates set out in SGB V and SGB XI and is supervised by the Hamburger Behörde für Gesundheit, Soziales und Integration pursuant to § 280 Abs. 4 SGB V. Approximately 725 staff, the majority medical and nursing expert assessors, deliver the service portfolio from headquarters in Hamburg (Hammerbrookstr. 5) and regional Beratungs- und Begutachtungszentren (BBZ) and Beratungsstellen (BS) in Kiel, Lübeck, Pinneberg, and Flensburg.

Core services include nursing care assessments (Pflegebegutachtung) for care-level determinations under SGB XI, social-medical assessments covering rehabilitation, work disability, medical aids, and treatment errors under SGB V, hospital billing reviews (DRG/PEPP), quality inspections of ambulatory and inpatient care facilities under §§ 112-114a SGB XI, and — newly under the federal hospital reform — Leistungsgruppen- and OPS-Strukturmerkmale-Prüfungen for hospital planning. Supporting digital infrastructure includes the MD-Portal for healthcare providers, a Tracking-Tool for insurance funds to monitor assessment status, and the IGeL-Monitor evidence-rating platform for self-pay medical services. MD Nord also hosts the nationwide Kompetenz-Centrum Geriatrie and participates in the Kompetenz-Centren Onkologie and Psychiatrie/Psychotherapie networks.

The business model is non-commercial: as a public-law corporation, MD Nord is funded via statutory insurance contributions and does not publish revenue or pricing. Services are commissioned exclusively by GKV and SPV funds; in 2025 the organization completed over 400,000 expert opinions and statements, including 72,900 hospital billing reviews (46% found overbilled, identifying €460M in annual savings potential across the MD system), 202,000 nursing assessments, and 1,302 quality inspections. Insured-person satisfaction reached 85.7% for home-visit nursing assessments and 83.5% for structured telephone interviews, based on more than 1,500 anonymous questionnaires.

Name

MDK Nord

Legal name

Medizinischer Dienst Nord, Körperschaft des öffentlichen Rechts

Website

https://mdk-nord.de

Company type

Private

Operating status

Operating

Headcount range

11–50 employees

Short description

Medizinischer Dienst Nord is a German public-law corporation that performs independent medical and nursing care assessments for statutory health and nursing care insurers in Hamburg and Schleswig-Holstein under SGB V and SGB XI, covering roughly 4.2 million insured persons with approximately 725 staff.

Ownership category

akta.pro rank

Product category

Medical Assessment and Advisory Services

NAICS

Health Care and Social Assistance (62)

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

Medicare Quality, Risk Adjustment & Stars Analytics/Services (FSAIAGAJ)

akta.pro secondary industries

Medigap Fraud, Waste & Abuse (FWA) & Payment Integrity (HLAEADAI), Medigap Member Support & Care Navigation (Advocacy/Concierge) (HLAEADAH)

Keywords

• Medical assessment services
• Nursing care reviews
• Hospital billing audits
• Healthcare quality inspections
• Statutory health insurance

Headquarters

HQ city

Kiel, Schleswig-Holstein

HQ country

Germany

HQ region

Europe

Offices5 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Infrastructure, Technology or R&D, Others

Revenue model

1. Statutory funding: As a public corporation under public law (Körperschaft des öffentlichen Rechts), MD Nord is funded through statutory health and nursing care insurance contributions. The organization does not generate commercial revenue but fulfills statutory mandates.

Go-to-market motion1 record

Distribution channels4 records

Marketing channels7 records

Core offering

Medizinischer Dienst Nord is the independent assessment and advisory service for statutory health and nursing care insurance funds in Hamburg and Schleswig-Holstein. It performs legally mandated medical and nursing assessments — including nursing care level determinations, social-medical expert opinions, hospital billing reviews, quality inspections of care facilities, and Leistungsgruppen/OPS structure assessments under the German hospital reform — on behalf of statutory health (GKV) and long-term care (SPV) insurance funds. The organization operates regional Beratungs- und Begutachtungszentren and provides digital tools (MD-Portal, Tracking-Tool) to coordinate and process assessment mandates.

Product overview

MDK Nord operates as a unified assessment and advisory service (Körperschaft des öffentlichen Rechts) serving statutory health and nursing insurers in Hamburg and Schleswig-Holstein. The organization offers a portfolio of assessment services including Pflegebegutachtung (nursing care assessments), social-medical assessments (rehabilitation, work disability, aids), hospital billing reviews, quality inspections of care facilities, and Leistungsgruppen/OPS structure assessments under hospital reform. Supporting digital infrastructure includes the MD-Portal for healthcare providers, a tracking tool for insurers, and the IGeL-Monitor public information service. Specialized competence centers (Kompetenz-Centren) for geriatrics and oncology provide expert referral services. The organization completed approximately 400,000 assessments and expert opinions in 2025, with roughly 202,000 in the nursing insurance sector alone.

Differentiator

Problem solved

Functional benefit

Products and services

• Pflegebegutachtung (Nursing Care Assessment) Assessment of nursing care needs for determining care levels (Pflegegrade) under SGB XI, conducted through home visits or structured telephone interviews on behalf of statutory long-term care insurance funds. Used by SPV to determine benefit eligibility for ~4.2 million statutory insured persons in Hamburg and Schleswig-Holstein.
• Sozialmedizinische Begutachtungen (Social-Medical Assessments) Medical expert assessments covering rehabilitation, work disability, aids and medical equipment, and treatment errors for statutory health insurance funds. Used by GKV to support coverage decisions for insured persons.
• Krankenhausabrechnungsprüfung (Hospital Billing Review) Review of hospital invoices (DRG/PEPP) for correctness and compliance with regulations. Performed on behalf of insurance funds to identify incorrect billing and protect the solidarity-based insurance system.
• Qualitätsprüfungen (Quality Inspections) Inspection of nursing facilities and outpatient care services for quality standards compliance under §§ 112-114a SGB XI. Conducted on behalf of the Landesverbände der Pflegekassen to ensure care quality.
• Leistungsgruppen- und OPS-Strukturmerkmale-Prüfungen (Performance Group and OPS Structure Assessments) Hospital structure and quality criteria assessments under the German hospital reform, evaluating OPS codes and Leistungsgruppen for hospital planning. Determines whether hospitals qualify for specific performance groups and reimbursement.
• MD-Portal Online portal for healthcare providers and hospitals to submit documents, track assessment requests, and access services digitally. Direct sales channel for institutional customers to initiate engagements with MD Nord.
• Auftragsnachverfolgung (Tracking-Tool) Web-based tracking tool for statutory health and nursing insurers to monitor the status of commissioned assessments. Provides real-time order status visibility to insurance fund clients.
• Kompetenz-Centren (Competence Centers) Expertise centers including Kompetenz-Centrum Geriatrie (geriatric medicine, based in Hamburg), Kompetenz-Centrum Onkologie (oncology), and Kompetenz-Centrum Psychiatrie und Psychotherapie (psychiatry) providing specialized consulting and expert reference services across the nationwide Medical Services community.
• Stationäre Abrechnungsprüfung (Inpatient Billing Review) Statutory review of inpatient hospital billing for statutory health insurance funds, provided to hospital and insurance fund clients.
• Außerklinische Intensivpflege (Outpatient Intensive Care Assessment) Assessment of outpatient intensive care needs and services for statutory nursing care insurance funds, including benefit eligibility determinations for intensive home care.
• IGeL-Monitor Scientific evaluation and rating of individual health services (IGeL, Individuelle Gesundheitsleistungen) offered to insured persons as self-pay services. Provides evidence-based assessments to support informed patient decisions.

Quantifiable outcome

• 85.7% satisfaction rate among insured persons for nursing care assessments in home visits
• +3 more outcomes

Named customers5 records

Segments5 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature4 records

Partnerships

Six partnerships are on record, tiered core.

• Gemeinschaft der Medizinischen Dienste (Community of Medical Services)coreStrategic or Co-development PartnerMD Nord is part of the nationwide Community of Medical Services, a federation of medically assessment services organized under public law. This association ensures standardized assessment practices across Germany and enables knowledge sharing among regional medical services.
• Kompetenz-Centrum Geriatrie (KCG)coreStrategic or Co-development PartnerThe Competence Center for Geriatrics is a joint institution of all Medical Services with its seat at MD Nord in Hamburg and nationwide responsibility. It serves as the reference center for geriatric questions within the Medical Services community, supports complex assessments, and ensures consistent quality-assured assessment practices.
• Kompetenz-Centrum Onkologie (KCO)coreStrategic or Co-development PartnerCompetence Center for Oncology providing specialized expertise for cancer-related assessments across the Medical Services network.
• Kompetenz-Centrum Psychiatrie und Psychotherapie (KCPP)coreStrategic or Co-development PartnerCompetence Center for Psychiatry and Psychotherapy supporting complex psychiatric assessments within the Medical Services community.
• Medizinischer Dienst BundcoreStrategic or Co-development PartnerThe national Medical Services association that establishes unified guidelines, directives (such as LOPS-Richtlinie), and quality standards for all regional Medical Services across Germany.
• Behörde für Gesundheit, Soziales und Integration Hamburg (Social Authority Hamburg)coreOthersRegulatory authority overseeing MD Nord as the responsible supervisory authority under § 280 Abs. 4 SGB V.

Scale indicators12 records

Recent moves6 records

Expansion highlights5 records

Broad incumbents

• MAXIMUS: US-listed provider of operational services to government health and human services programs, including independent medical examinations and disability assessments. Comparable as an independent, mandated assessment services provider, though operating across broader human services verticals.
• Cotiviti: US healthcare payment accuracy and quality analytics firm. Comparable to MD Nord's hospital billing review and quality inspection services, with overlap in payment integrity analytics and quality measurement.
• Performant Healthcare Solutions: US payment integrity and healthcare claims review vendor. Comparable to MD Nord's hospital billing review function (DRG/PEPP verification) and the FWA-related portion of its mandate, though operating under different statutory framework.

Direct peers

• MDK Baden-Württemberg: Regional MDK serving Baden-Württemberg with the same statutory mandate. Comparable in offering nursing assessments, hospital billing review, and quality inspections under SGB V/XI.
• MDK Westfalen-Lippe: Regional MDK providing medical and nursing assessments, hospital billing review, and quality inspections for statutory health insurers in Westfalen-Lippe. Operates under identical statutory framework as MD Nord.
• MDK Nordrhein: Regional MDK serving North Rhine with the same statutory mandate. Comparable service portfolio (Pflegebegutachtung, hospital billing review, quality inspections) and headcount scale.
• Medizinischer Dienst Bund (MDS): National umbrella of the German Medical Services that sets guidelines, directives, and quality standards for all regional MDs/MDKs. Directly comparable as the parent coordination body in the same statutory assessment framework (SGB V/XI).
• MDK Hessen: Regional MDK in Hessen providing identical medical and nursing assessment services under SGB V/XI. Directly comparable in mandate, service mix, and operating model.
• MDK Berlin-Brandenburg: Regional MDK covering Berlin and Brandenburg with the same mandate under SGB V/XI. Directly comparable in service mix including nursing assessments, hospital billing review, and quality inspections.
• MDK Bayern: Largest regional Medical Service in Germany. Operates the same statutory mandate for medical and nursing assessments as MD Nord, with a comparable portfolio (Pflegebegutachtung, hospital billing review, quality inspections) at greater scale.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks5 records

Key highlights6 records

Customer concentration

• LinkedInlinkedin.com/company/mdk-nord

Revenue estimate

Valuation estimate

Number of profiles

Profiles7 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about MDK Nord