By: Steffen Bayer, TNECD Director of Business Development, Germany, Austria, Switzerland, Belgium, Netherlands and Luxembourg
A little local knowledge can go a long way.
Sometimes in life, you hope for certain things for quite some time, and then you’re all the more delighted when they actually happen.
When I was growing up in Erlangen, just north of Nuremberg, Germany, I often passed the Siemens buildings. My father spent his entire career with the company; I completed my first summer internship during high school at one of the facilities and several members of my family still work there. Erlangen is home to Siemens’ largest location in the world, as well as Siemens Healthineers’ headquarters.
Decades later and 4,500 miles from Germany, I proudly stood outside another Siemens Healthineers facility in East Tennessee. Moments like these make my role as director of the State of Tennessee Germany Office especially meaningful.
On September 9, 2026, TNECD announced that Siemens Healthineers plans to invest $43.6 million and create more than 90 new jobs over five years at its campus in Rockford, Tennessee. The Blount County site houses the company’s Molecular Imaging PET Detector Center, which focuses on research and development and materials production.
The decision to expand in Tennessee was made right next to my old doorstep, while the resulting project is in an East Tennessee county of 140,000 people. That connection is what I find most fascinating about my work.
It is also important to consider the type of investment Siemens Healthineers is making. Production can be located in many places, but research and development follows talent. Engineers do not move easily, and companies commit R&D operations to a location when they see the potential for long-term growth.
Why German Medtech Companies are Looking to the U.S.
Germany has one of the largest medtech markets in the world. Approximately 1,500 manufacturers, most of them small and midsized companies, employ more than 210,000 people. The industry reinvests roughly 9% of its revenue in research and development and exports approximately two-thirds of its products.
It is an industry built on engineering depth rather than scale, and Germany leads Europe in medtech patent filings.
Several critical economic, regulatory and strategic factors are now encouraging German companies to establish a presence in the United States.
The first is market weight. The United States is the world’s largest and best-reimbursed medtech market. For companies focused on imaging, diagnostics and implantables, the revenue potential can justify local production in a way that may not be possible in other markets.
U.S. healthcare providers and hospitals often view new technology as an opportunity to boost revenue and show a higher willingness than their European counterparts to adopt innovative tools and devices quickly.
The second factor is regulation. Since the European Union’s Medical Device Regulation took effect, many German manufacturers have found the U.S. Food and Drug Administration (FDA)’s clearance process to be faster and more predictable than obtaining a European CE mark.
The new regulation has created additional bureaucratic hurdles and intense compliance costs, which can disproportionately affect small and midsized companies without the administrative resources to manage them.
The third factor is cost. German medtech companies are facing high domestic costs for energy, raw materials, transport and labor. In many cases, rising producer prices are outpacing sales growth and putting significant pressure on profit margins.
A recent survey of approximately 3,100 German companies by the German Chamber of Industry and Commerce found that 20% had moved capacity abroad or were considering doing so. That figure rose to 40% among industrial companies.
Tennessee has been attracting and supporting companies of exactly this type for decades.
Why Tennessee
International medtech companies are increasingly considering Tennessee because the state offers a powerful combination of established healthcare infrastructure, logistical advantages and access to talent from leading research institutions.
Tennessee ranks third in the nation for medtech production and exports. The industry supports more than 18,000 jobs across the state through a combination of established clusters and specialized manufacturing hubs.
Established Medtech Clusters
International companies do not have to build an ecosystem from scratch; they can plug into already thriving regional hubs:
- Memphis and West Tennessee
Memphis is home to one of the world’s largest orthopedic and medical device clusters. Major global companies, including Smith+Nephew, Medtronic and Stryker, have commercial and manufacturing operations in the region.
- Nashville and Middle Tennessee
Nashville is widely recognized as the healthcare services capital of the United States. The region is home to major hospital systems, including HCA Healthcare, Community Health Systems and Ardent Health Services.
This concentration of healthcare providers gives medtech companies access to potential customers, clinical partners, investors and advisers in a centralized market.
- Knoxville and East Tennessee
The Knoxville region supports a robust advanced manufacturing sector and offers proximity to leading research institutions. It is also home to a growing concentration of medtech and life sciences companies, including Siemens Healthineers, DeRoyal, Scapa Healthcare, ChoiceSpine and ProNova.
A Logistical Advantage
Medical devices often require rapid and temperature-sensitive shipping. Memphis International Airport, the second-busiest cargo airport in the world, is home to the FedEx World Hub.
That logistical advantage allows Memphis-based companies to ship time-sensitive medical devices, implants and biological materials to hospitals across the country and to major international markets overnight, often faster than from almost anywhere else in North America.
It is no surprise that medical devices are Tennessee’s leading export category, accounting for $2.7 billion in annual exports.
Access to Talent and Research Institutions
Leading research institutions such as Vanderbilt University and the University of Tennessee continuously strengthen Tennessee’s talent pipeline and collaborate with medtech companies.
Purpose-built partnerships between industry and universities create a collaborative environment for next-generation medical device innovation. Students gain access to internships and hands-on learning opportunities, while researchers gain direct access to industry equipment, expertise and market insights.
Japan’s Nissha Medical Technologies relocated its engineering operations to Nashville and opened an Innovation Center of Excellence on Vanderbilt University’s campus, bringing engineering and development expertise closer to academic research and clinical applications.
Swiss medtech company Medacta International relocated its U.S. headquarters to Middle Tennessee, approximately 30 minutes south of Nashville, and expanded its manufacturing operations there. The project represents an investment of $85 million and will create more than 200 jobs.
Tennessee is already home to more than 115 German companies that employ nearly 20,000 people. Much of that investment has been built around engineering and manufacturing, but the Siemens Healthineers announcement demonstrates the opportunity to attract additional investment in research, development and healthcare innovation.
If you are a German medtech company considering establishing operations in the U.S. market, or if you simply want to understand Tennessee’s medtech ecosystem from the inside, I would be glad to connect.
I look forward to continuing these conversations at MEDICA, the world’s largest trade show for medtech, healthcare and clinical diagnostics, in Düsseldorf, Germany, November 16-19, 2026.
For me, few opportunities would be more meaningful than helping another German company find its place in Tennessee.