The growing absolute number of the elderly causes an increase in the number of patients suffering from not only chronic diseases and multimorbidity, but also higher usage of the health care system. In the German Federal State of Mecklenburg-Western Pomerania (MW), the effects of demographic change will be more pronounced than in other regions. The objective of this article is to show the consequences of the changing population structure for the health care system. Using examples from MW, innovative models to secure high quality health care at the population level are presented. Examples include the establishment of subsidiary practices, multidisciplinary ambulatory health care centers, delegation models, ambulatory health care managers, telemedicine, and intensified and improved interdisciplinary networking. In the context of the demographic change, assisted care, adequate symptom control, maintaining personnel competence, preservation of an independent lifestyle with a high quality of life, and stimulation of social participation become priority objectives of medical care. Besides the effectiveness and the quality of results with regard to these objectives, innovative health care models should be economically evaluated at the population level under real life practice conditions.