Introduction: Demographic change poses significant challenges for medical care in Germany. Structurally weak regions are already suffering from gaps in healthcare provision, which are being worsened by the increasing demand for healthcare services and the simultaneous shortage of healthcare professionals. Regional healthcare networks that follow the integrated care approach offer a promising solution by improving care and making it more efficient through greater cooperation between healthcare stakeholders. Healthcare networks are often specific to regional contexts, resulting in solutions that are typically isolated and lack broader applicability. To enhance the transferability of potential solutions, this study aims to identify key factors contributing to the success of healthcare networks and to examine the barriers hindering their development.

Methodology: A multi-case interview study was conducted to analyze regional health networks' success factors and barriers. Data collection involved semi-structured expert
interviews with the managers of seven exemplary networks in Germany. The structured interview guidelines included questions on the motivation for founding, financing,
success factors and barriers, operation, and successful network elements. In addition, a comprehensive literature review was conducted to contextualize the empirical findings.

Results: Healthcare networks have the potential to significantly stabilize medical care in structurally weak regions, mainly when coordination is managed by a professio-
nal management entity, there is close collaboration with non-medical health professionals, and well-functioning digital infrastructure is in place. However, existing legal and financial frameworks hinder the further development of these networks. Many networks rely heavily on the personal commitment of their founders, which can lead to
instability if sustainable refinancing models for core and cross-functional activities are not established. The transition from initial project-based funding to regular operational
financing proves to be particularly challenging. Additionally, interpersonal factors, such as prejudices and mistrust among actors, can create resistance and hinder cooperation
within the network.

Conclusion: Regional healthcare networks have the potential to sustainably improve medical care in structurally weak regions. However, to ensure their long-term success,
political measures are needed to overcome legal and financial barriers, as well as to promote preventive measures, nursing professions, and the integration of civil society
initiatives