Private healthcare in European markets continues to undergo significant expansion. Constrained public systems, long waiting lists and a rising appetite for better, faster access are pushing more patients to consider, and actively opt for, privately funded care.
L.E.K. Consulting’s recent multi-country survey of over 3,500 patients across five European markets confirms this trend, with demand growing not only for traditionally private-pay services like dental care, but also for more complex specialities such as cardiology, oncology and orthopaedics.
Patients are willing to pay, even for complex specialities
More than half of surveyed patients indicated a greater likelihood of paying for private healthcare in the next five years across 11 out of 14 treatment areas (see Figure 1). Notably, this includes complex and traditionally publicly funded specialities — such as cardiology (45%), orthopaedics (44%) and oncology (39%) — where willingness to pay has historically been lower.
This indicates a fundamental shift in patient expectations and behaviour. Where private care was once limited to non-essential or supplementary services, it’s now increasingly seen as a necessary route to access timely treatment, especially in systems under pressure.
The data shows this trend is most pronounced in Southern and Eastern Europe, where public infrastructure challenges are more acute and out-of-pocket models are already more normalised.
This shift suggests a structural change in consumer expectations. Private care is no longer seen solely as a convenience or an upgrade; for many, it is becoming a necessary alternative to access timely and quality care.
Demand driven by public system constraints and quality perceptions
Patients are motivated by both push and pull factors when opting for private care (see Figure 2). On the push side, limited access, long wait times and lack of public coverage were among the most frequently cited reasons. At the same time, the pull factors are equally compelling — a sizeable portion of patients are choosing private care due to perceived or actual quality differences.
For example, in Germany and Romania, over one-third of patients indicated that they associate better clinical outcomes, service levels or doctor availability with private healthcare providers. This reinforces the importance of quality differentiation as a commercial strategy — it’s not just about faster access, but also about offering a superior experience and outcome.
Providers that can build strong reputations around excellence in care, outcomes data and patient-centric design will likely capture greater market share, especially in higher-income segments or underserved urban areas.
Out-of-pocket and self-funded insurance uptake on the rise
Crucially, this demand is backed by patient willingness to pay. Across markets, more than half of respondents said they expect to increase out-of-pocket spending on healthcare in the next five years (see Figure 3). This includes countries with strong public systems, like the UK and Germany, highlighting a shift in mindset from entitlement to empowerment and choice.
At the same time, self-funded private medical insurance is also on the rise (see Figure 4). In our survey, nearly 1 in 3 patients had taken out private insurance independently (not through an employer), indicating that individuals are actively seeking ways to guarantee access to care on their own terms.
This presents a dual opportunity:
- For insurers to create more flexible, accessible and modular products that appeal to self-pay customers
- For providers to design offerings that integrate with or complement these insurance models, especially in ambulatory and specialist care settings
Out-of-hospital settings gaining traction
Patients are also increasingly open to nontraditional care settings. Nearly half of respondents (45%) indicated a preference for outpatient or standalone clinics, such as polyclinics or ambulatory surgical centres, for minor procedures.
This reflects a growing consumer preference for convenience, proximity and efficiency. Instead of navigating large, impersonal hospitals, patients are seeking care closer to home, often in settings that feel less clinical and more user-friendly.
From a commercial standpoint, this shift supports lower-cost, higher-throughput operating models. Providers that can deliver safe, high-quality care in community-based settings stand to benefit from:
- Reduced overhead and infrastructure costs
- Higher patient satisfaction and retention
- Greater geographic reach into suburban or second-tier cities
In most European markets, operators have already begun expanding urban polyclinic formats, offering general practitioner, diagnostic, specialist and day surgery services under one roof, with growing traction among both patients and insurers (see Figure 5).
Implications: A structural demand shift with provider upside
Taken together, the survey data points to a structural shift in European healthcare consumer behaviour that is not a temporary post-Covid-19 spike or an isolated national trend. The combination of rising out-of-pocket spending, self-funded insurance adoption, willingness to pay in complex specialities and openness to out-of-hospital delivery represents a transformational opportunity for private providers.
The playbook is clear:
- Expand into high-value specialities where wait times or quality gaps are severe
- Invest in scalable, polyclinic-style formats that align with patient preferences
- Differentiate through service design, clinical outcomes and experience
For investors and operators, now is the time to shape networks that are fit for this new, more consumer-driven reality.
How can L.E.K. help?
We regularly engage with leading providers and payors across European markets to develop high-impact strategies for private healthcare, including:
- Defining the right payor mix
- Designing digitally enabled delivery models
- Building out a pan-regional care network
Our teams bring the data, insight and on-the-ground perspective to help businesses navigate complexity and scale with confidence.
If you’re looking to define your strategy in this evolving space, get in touch. We’d love to share what we’re seeing and help take your healthcare business to the next level.
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