MEDIAN & Waterland

Creating Europe’s Leader in Rehabilitation and Mental Health Services

MEDIAN’s history goes back to 2011 when Waterland acquired the rehabilitation services provider, RHM, with 20 facilities and revenues of ca. € 75m. In 2015, Waterland merged RHM with Median Kliniken and created MEDIAN. With the vision of building a company that offers the highest quality of services based on a strong base of hospitals, best-in-class operating model and digital capabilities, Waterland pursued a Buy- & Build strategy with >20x acquisitions thereby creating Europe’s leading provider of rehabilitation and mental health services with ca. 430 facilities and € 2bn in Revenues (>25x since inception).

MEDIAN at a glance

MEDIAN is a leading provider of value-based rehabilitation in Germany with broad geographic coverage, primarily focusing on neurology, post-acute care as well as mental and addiction care, which represents ca. 85% of its revenues. MEDIAN is the clear private market leader in the c.€10bn German inpatient rehab market with more than 10% market share by beds. The company holds #1 market positions in Germany across its main service lines, namely neurology, post-acute orthopedics & cardiology, mental as well as addiction rehabilitation & sociotherapy.

In January 2021, Waterland acquired Priory, one of the largest providers of behavioral healthcare services in the UK, in order to combine it with MEDIAN to create the leading rehabilitation and mental health services provider in Europe, with undisputed leadership in its core markets. Priory is specialized in mental and addiction care, which represents ca. 75% of its revenues. Priory is the largest independent mental healthcare provider as well as largest residential adult care provider in the UK measured by bed capacity.

The Group operates over 430 facilities across Germany and the UK with over 30,000 employees generating ca. € 2bn in Revenues.


The Group’s goal is to help patients and service users to participate in life by providing the highest quality services, starting from a strong base of hospitals to a continuum of selected outpatient and digital aftercare services managed all out of one hand.

The management team aims to partner with the healthcare system of each country it operates in. The Group aims to offer top quality therapy to patients and service users, maintaining its focus in its strongest areas, sharing best practices and developing innovative medicine and care across the Group based on its integrated research database.

Management envisions the measured outcomes of all facilities to be in the top quartile in their relevant markets through continually focusing on quality by measuring and communicating the Group’s standard of care along the whole pathway.

An important goal of the Group is to become a leader of digital after care. The company aims to offer every patient a digital follow-up program paid by insurances in order to expand the services along the recovery process.

In order to establish itself as the employer of choice for the best medical professionals in the sector, the Group is offering employees and staff the best working environment and professional development opportunities.

By further expanding its geographic footprint the Group intends to grow and actively consolidate its relevant markets.

Buy-and-build strategy

Since Waterland became a shareholder, MEDIAN has acquired and integrated >25 clinics and clinic groups. While doing so, MEDIAN is aiming to achieve the highest of quality standards in terms of medical rehabilitation and is making significant investments in treatments, additional staff, digitalizing processes and modernizing clinic buildings.

With the support of Waterland, MEDIAN plans to continue the consolidation of the European rehabilitation market, both in terms of the development of its regional presence and the provision of additional medical specialty services. In addition, MEDIAN aims to further integrate patient pathways and to implement evidence-based medicine even more as part of its treatment services.

Reducing CO² emissions by 25% by 2025

MEDIAN has launched CO2 reduction initiatives in both Germany and the UK. From 2021, MEDIAN will reduce its direct and indirect CO2 emissions by 5 ppts per year.
Key initiatives to achieve the CO2 reduction targets include:

  1. Installation of combined heat and power plants (25 are already installed and in operation, with a further 20 planned by 2025)
    Installation of photovoltaic systems on roofs
  2. Replacement of half of MEDIAN’s vehicle fleet with electric vehicles
  3. Replacement of conventional lighting with LED
  4. Site-related energy refurbishment of building shells (e.g. façade insulation, window replacement)
  5. Various technical measures (e.g. installation of intelligent heating control, pump control and ventilation)

In addition, MEDIAN is currently developing the concept for a CO-2-emission-free clinic.

Better healthcare by improving medical quality

Quality is at the heart of all activities at MEDIAN. Continuous quality measurements, ongoing improvement initiatives and a strong quality culture ensure that MEDIAN continues to deliver above-market quality in both countries.

In Germany, MEDIAN uses the pension fund quality measurement for therapy quality and delivers on the average 95 out of 100 possible quality points in 2021. This is significantly above market average. All quality data is automatically generated and reflected in dashboards that are used on all levels of the organization for continuous quality improvement.

Priory similar to MEDIAN has a culture of continuous quality improvement, which is recognized in the being above the national benchmark with regulators by 4.3% in the hospitals (82.3% Good/Compliant or better), 5.5% in the specialist care homes (90.5% Good/Compliant or better) and 15% in Supported Living which is 100% Good or compliant. Quality is measure across a number of KPIs and reviewed monthly.

In recent years, MEDIAN has already introduced the use of medical scores to measure patient outcomes for all indications. The MEDIAN app enables indication-specific measurement of patient-reported outcomes, which is used for quality improvement in the medical boards. While Priory has already had a strong focus on quality in the past and does some outcome measurement in the mental health and social care setting, this will be further strengthened in the coming years.

Contribution to society in times of crisis

When Covid hit the German health system, MEDIAN was the first healthcare provider to develop post-Covid and long-Covid rehabilitation to make sure that those affected worst by the disease find their way back to good health. With more than 5.000 patients treated, MEDIAN is the largest post-/long Covid rehabilitation provider in Europe.

Beyond medical expertise, MEDIAN also offered accommodation to those hit hardest by the flood catastrophe in 2021. Similarly, MEDIAN offers 100 therapy places for free to Ukrainian wounded in war and children that lost their parents. Numerous local initiatives are supported with logistics and material. Last but not least, MEDIAN offers beds for refugees from Ukraine.

Good governance means good compliance

MEDIAN stands for integrity and fair play in the market. In both countries, UK and Germany, MEDIAN creates yearly compliance reports that transparently list all challenges and solutions.