Things are changing in the health care landscape: competition has been discovered. Tentative, yet concrete practical economic options in the health care system were created in the new health care system modernisation act. On the one hand, under special conditions, physicians and providers of medical services may be under direct contract with health insurances. On the other hand, the traditional structures and relationships between health insurances and registered doctors and clinics still exist. Therefore we currently have a very complex situation. This article sheds light on the new legislation on integrative health care and medical service centres involving occupational medicine. For some time this medical branch has been in economic competition. Additionally, occupational medicine is established in its sector and cross-sectionally oriented. Therefore, it is predestined to play an important role in integrated health care systems.