I hope that you have all had a good transition to 2021. We all hope that 2021 will; be a better year than 2020, but the shocking happenings in Washington last week and the explosive growth bin COVID-19 infections in many countries has not been a good start. Let us hope that the ongoing vaccination programs will quickly get up to speed and allow us to move back to a “new normal”.

In the meanwhile, there have been several new developments in the Dutch healthcare sector. In this update we cover:

• Apax France to acquire Mentaal Beter. Will investors look at other Dutch mental care operators?
• Process related to Mediq is in the end phase. Who will be the new owner?
• Largest Dutch provider of disabled care with innovative financing program. Will other organizations follow?
• New report from insurance companies highlights need for large investments. Where will the financing come from?
• Bergman continues growth in Dutch market. What is happening to the sales process?

The daily number of reported COVID infections here in the Netherlands has been increasing during the last few weeks and as of today the Netherlands is in lockdown for the next five weeks. Christmas this year will be celebrated in small gatherings.

For this update we cover:

• Second corona wave leads to lower capacity utilization in Dutch nursing homes. What will be the financial consequences?
• Mediq up for sale. What is the current situation?
• Profits up in the mental healthcare sector in 2019. What will happen in 2020?

The number of COVID infections here in the Netherlands are still bouncing up and down and it does not look like we will have a fast and structured decline in time to enable less restrictions for Christmas. Bad news for those of us looking forward to the celebrations but even more reason to look forward to the vaccines.

For this update we cover:

• Specialty clinics stay open in the second COVID wave. Good news for Bergman Clinics?
• Strong growth in 2019 revenues in the disabled sector but profits are flat. What will happen in 2020?
• Changes to be made to the financing of youth care. Bad news for Mentaal Beter?
• Traditional operator loses court case for “fair tariffs”

Here in the Netherlands it appears that the measures taken a few weeks ago are starting to work. Number of COVID infections are down as are the number of people in the hospitals and in intensive care units with corona. Hopefully, the trend will continue. We should be very happy about the news from Pfizer and hopefully the corona-situation will improve in your country as well.

For this update we cover:

• Mental healthcare operator puts in place “patient stop” for patients from major healthcare insurance company. What are the effects of complicated contracting processes on the valuation of acquisition targets?
• Study suggests that additional controls on dividend payments from healthcare companies will have negative effects. Good news for investors?
• Courts disallow general reductions in tariffs for non-contracted operators What will be effects on innovation and investments?

Here in the Netherlands we are now in a “lock-down” similar to the one we had before the summer. Not as strict as in many other countries, but restaurants and cafes are closed and there are restrictions on the size of groups for events. Hospitals are starting to fill up again, so, hopefully, the restrictions will help. Even with corona dominating the headlines there is still other news regarding the Dutch healthcare sector. For this update we cover:

• Investors found for Sanquin Plasma Products. How will the governance work?
• Insurance companies suggest steps to build 25.000 nursing home beds by 2025. Good news for the sector?
• Large traditional healthcare organization to be split up. Who will be next?
• Insurance companies will continue to support healthcare sector in 2021. Who else will step up?

The mornings and evenings are getting darker and there is only bad news regarding the resurgent spread of COVID-19. Luckily, there are still interesting things happening in the Dutch healthcare sector. For this update we cover:

• Leading commercial mental healthcare provider with innovative financing. Will others follow?
• Dutch chain rebrands clinics under one name. Is it following in the footsteps of Bergman?
• Specialist in organ transplantations sold. Are there other hi-tech pearls at Dutch universities?
• Leading maternity care company saved from bankruptcy (again). Will it survive this time around?

Here in the Netherlands we are enjoying an Indian Summer. Wonderful sunny days, but with a fresh feel. Quite nice after a long hot summer. For this update we cover:

• Bergman (finally) makes acquisition in Germany. Will the sales process also start up again?
• Specialized home nursing operators does not accept new clients from a major insurance company. Why is this happening?
• Different views regarding how banks see Dutch healthcare providers post-corona. Who is right?
• In our snapshot we give an overview of ExperTcare, a provider of specialized homecare for children and adults

Officially summer is now over. I hope that you have all enjoyed it and are fully prepared for the opportunities and challenges of autumn. For this update we cover:

• Commercial mental healthcare provider signs multi-year contract with major health insurance company. Is this good news for ongoing M&A activities?
• Strong growth in nursing home capacity is required, but municipalities and laws make growth difficult. How can this be changed?
• Revenues up but profitability decreases for Dutch elderly care sector. How is he sector positioned for 2020?
• Banks prepared to finance investments in nursing homes but worries about cross subsidies between housing and healthcare activities. Are operators building sufficient reserves for upcoming investments?

After a wet and relatively cool July summer seems to have finally arrived in August. Summer is relatively quiet but there is always some news. For this update we cover:

• Decline in healthcare real estate investments. Will investments return to earlier levels?
• ODG stops sale of home-care business. Will it look for a new buyer?
• Middin stops with elderly care. Will other traditional operators also review their portfolios?
• In our snapshot we give a review of Mentaal Beter, a national provider of outpatient mental healthcare

Here in the Netherlands we have had a record-breaking heat wave with eight days of day-time temperatures higher than 30 degrees. However, the hot weather has not stopped activities in the Dutch healthcare sector: For this update we cover:

• Acquisition of dentist chain is a “fiasco”. Will this put a damper of further consolidation in the sector?
• Bergman Clinics sales process starting up again. Who will be the buyer?
• M&A activity in Dutch healthcare sector picking up. Is this the start of a new trend?

I hope that you are all enjoying the summer even in these strange times. If you are on vacation you are probably relatively close to home, which I find has its own charms. For this update we cover:

• Orpea and Korian continue to grow in the Dutch market  through acquisitions. Who will be next?
• Bergman rebrands Dutch ophthalmology locations to Memira. What does this mean for their international strategy?
• FocusCura is acquired by Assa Abloy. Is this the start of more consolidation in the Dutch personal alarm sector?
• Tariffs for maternity care are increased substantially. Will this make the sector attractive for foreign investors?

Here in the Netherlands we now have (almost) tropical weather. I hope that you are also able to enjoy summer weather and all its associated pleasures and not be too troubled by less nice aspects such as bugs. It seems that summer also entails less news. In this update we cover:

• Bergman opens new clinic and seems to be back in business. When will the sales process be restarted?
• Health minister moves financing from home care to long-term care. Is this contrary to government strategy and policy?

One of the stranger effects of the corona-crisis for me personally is that I have become much more interested in my garden. In addition to buying plants, this involves worrying whether the plants have enough water. I am therefore quite happy that we have had a couple of days of rain recently. In this update we cover a wide range of news from the Dutch healthcare sector:

• Lower results for Buurtzorg in 2019. What does the future look like?
• Only half of independent clinics have made use of the “continuation payments” for supporting the Dutch healthcare sector through the corona-crisis. Why not the rest?
• Yet another hospital-merger is called off. Who will be next?
• Correction: Location to be refurbished by Cofinimmo will fit within the housing component of the traditional Dutch nursing home financing

More good news from the Netherlands. When the cafes are opened on June 1 and you decide to go out for a beer with friend (or on a first date, as may be the case with my daughters) you are now allowed to sit together at the same table and closer than 1.5 meters from each other. Even more good news is that it is possible to write this update and only indirectly touch on corona-related issues:

• Consolidation continues in nursing home sector. Which company will be acquired next?
• Cofinimmo investment will lead to high rental costs. Is there a trend away from direct government financing of housing costs for nursing home clients?
• Corona not expected to have a long-term effect on Dutch nursing home sector. Is the Dutch market more attractive than other countries?

Here in the Netherlands Corona-restrictions are now starting to be eased. Among other things we are now allowed to fix our corona-hair and from 1 June cafes will be allowed to serve customers on terraces (let us hope that the nice weather stays). Another sign of the changing times is that it is getting easier to find news that is not corona-related:

• Yet another hospital merger is called off. Will this trend towards smaller, regionally based organizations continue?
• A new long-term contract between healthcare insurer and mental healthcare provider. What will be the next step in changing the financing of psychiatric care in the Netherlands?
• Dutch healthcare organizations will be compensated for corona-related losses but are still deeply worried about their financial situation. What are consequences for investments?