Welcome to the latest update on what is happening in the Dutch commercial healthcare market. In this update we cover:

• Buurtzorg closes multi-year contract with one of the large Dutch healthcare insurance companies. Is Menzis changing the financing of Dutch healthcare?
• MC Groep saga is finalized. What does this mean for the sector?
• In our snapshot we give an overview of CCN, a company that was interested in taking over key activities at both MC Groep hospitals

Welcome to the latest update on what is happening in the Dutch commercial healthcare market. In this update we cover news about the Dutch hospital sector:

• I must admit that I have been very wrong in my appraisal of the future of the hospitals belonging to the MC Groep;
• BDO publishes analysis of the financial situation of Dutch hospitals;
• I give my initial thoughts on what the consequences are for the sector?

If you have any specific questions related to this week’s update do not hesitate to get in touch with me directly.

Welcome to the latest update on what is happening in the Dutch commercial healthcare market. In this update we cover:

• Real estate associated with European Care Residences sold to Aedifica. Who is the seller?
• MC Groep 2017 annual report shows another loss. Bad news for private hospitals in the Dutch market?
• In our snapshot we give an overview of the Alexander Monro Hospital, which is totally focused on patients with breast cancer.

If you have any specific questions related to this week’s update do not hesitate to get in touch with me directly.

It has been relatively quiet here in the Netherlands the last few weeks, but as always, there are interesting things going on. In this latest update on private healthcare in the Netherlands we cover:

• Hot off the press: Orpea buys two more companies in the Netherlands
• Little news related to the healthcare sector in the latest budget presentation by the government. Is this good or bad news?
• The disabled care sector has done well in 2017. Are there opportunities for international investors?
• In our snapshot we give an overview of Annotommie, a chain of independent clinics focusing on orthopedic care.

All the schools have started up again her in the Netherlands and life (and traffic jams) are starting to go back to normal. In this latest update on private healthcare in the Netherlands we cover:

• Increased revenues and improved profitability for the ten largest Dutch mental healthcare providers. Is the mental healthcare sector becoming attractive for international investors?
• Independent clinics increasing market share in hospital market. When will the first acquisitions by international groups take place?
• In our snapshot we give an overview of Vitadent, a provider of dental care services for the elderly.

It has been summer vacation here in the Netherlands and not much has been going on these last few weeks. In this latest update on private healthcare in the Netherlands we cover:

• Dutch insurance company moves to system to base part of payments for treating depression based on results. Local providers are very unhappy and other insurance companies say that they have no plans for similar initiatives. Will this make the Dutch market more interesting for organizations with experience with similar payment systems from other countries?
• In our snapshot we give an overview of Zuster in de Buurt, a franchise organization providing home care.

The wonderful weather here in Holland is continuing, and there are no signs that it is going to change in the short-term. Even with hot temperatures and summer vacations there are still interesting things happening in the market. In this latest update on private healthcare in the Netherlands we cover:

• European Care Residencies finally finds a buyer. What will be the next step in the consolidation of the Dutch elderly-care sector?
• Large and growing shortage of assisted-living apartments in the Netherlands. Opportunity for international elderly-care companies?
• Government likely to relax rules related to dividend payments for Dutch healthcare sector. How much will really change?
• Privately owned hospitals in trouble. Storm in a tea-cup?
• In our snapshot we give an overview of De Herbergier, the largest commercial provider of elderly care in the Dutch market.

Here in Holland we have had great weather the last few weeks, and there have been several interesting announcements in the press. In this latest update on private healthcare in the Netherlands we cover:

• Consolidation of Dutch dentistry sector continues, but sector is still very fragmented. Who will take the next steps in the expected consolidation?
• Financing for long term psychiatric care in process of being moved back to central government. What does this mean for international companies interested in the Dutch disables sector?
• Profitability up in Dutch elderly care sector. Is the improvement structural?
• In our snapshot we give an overview of Kies Mondzorg, the largest privately-owned dentistry chain in the Dutch market.

In the last few weeks there has been a couple of announcements from the government that must be seen as very good news for international healthcare companies interested in the Dutch market. In this latest update on private healthcare in the Netherlands we cover:

• Public statement from the Minister of Healthcare regarding the recent acquisition of Dagelijks Leven by Orpea. What does this mean for international operators interested in the Dutch market?
• The Dutch Healthcare Authority announces changes to the financing of long-term care. Why is this good news for operators with experience in competitive markets?
• In our snapshot we give an overview of Senior Service, a company helping the elderly live longer at home.

After the very warm days in May it is now a more typical summer here in the Netherlands with rain and wind. In this latest update on private healthcare in the Netherlands we cover:

• Orpea purchase of WoonZorgNet is official. Why has Orpea waited for such a long time in announcing this deal?
• Research company estimates that the Netherlands will require 82.000 more nursing home beds. Who will develop the required new capacity?
• Co-payments for home-care services standardized and limited to €17,50 per four weeks. Will this make the home care sector more attractive?
• In our snapshot we give an overview of Pro Senectute, a different elderly care organization.

In this update a focus on the increasing international interest in the Dutch commercial elderly care sector and a company that appears to be in play.

As reported earlier, Orpea is building a position in the Dutch healthcare sector through the acquisition of a provider of long-term psychiatric care (WoonZorgNet) and the recent acquisition of Dagelijks Leven. Dagelijks Leven operates a chain of 29 nursing homes with a total of 580 apartments.

Another company operating in the elderly care sector is European Care Residencies (ECR). ECR was started several years ago by the current owners Maria Scholts and Paul Bijleveld (who are a married couple). ECR currently operates nine elderly care locations with a total of 458 apartments. In addition, ECR also has approximately 100 short-stay studios where rehabilitation services are offered. The company is divided into a holding company, a company providing healthcare services (RAZ), and individual real estate companies per location.

ECR has been profitable until 2015 (the last year with published results) but appears to be going through a bit of a rough patch. In the last few years there have been severe quality issues with RAZ receiving several warnings from the healthcare authorities. RAZ also appears to be structurally loss-making, with all profits coming from other services. ECR has also been selling off real estate (to Confinimo among others), with a large share of profits in 2015 coming from one-off extraordinary results (probably profits from sale of real estate).

ECR is currently in the process of selling more real estate and according to rumors on the street several international operators have looked at ECR but not necessarily liked what they have seen. ECR is one of the largest commercial providers of elderly care in the Dutch market and should represent an interesting market entry opportunity. Will ECR be the next operator to be sold to an international operator? Who will be the buyer and the next entrant to the Dutch market?

For those of you in north-west Europe, I hope that you have been enjoying the great weather. In this update on private healthcare in the Netherlands we cover:

• For the first time a private chain of clinics has signed a multiyear contract with one of the leading Dutch insurance companies. Are the insurance companies starting to understand the value that private healthcare operators bring to the market?
• Ongoing change in the dentistry sector. Will this increase the speed of consolidation in the sector?
• Turkish hospital chain expands beyond Amsterdam. Are they developing a national organization?
• Further consolidation in the diagnostics and laboratory sector. Has the dam broken?
• In our snapshot we give an overview of Atalmedial, the private company who has acquired the laboratory activities of MC Slotervaart.

For those of you who were in London at the HBI conference: I hope you had a great time and wish that I could have attended. In this update on private healthcare in the Netherlands we cover:

• Orpea enters Dutch elderly care market through acquisition of Dagelijks Leven, a chain of 29 elderly care locations with 580 beds. Will other international elderly care companies now also enter this market?
• Government clarifies requirements for promised extra financing of nursing homes. Will the requirements stifle innovation in the sector?
• In our snapshot we give an overview of Dagelijks Leven, the elderly care chain acquired by Orpea.

In a separate email I am attaching the presentation I have made for my roundtable discussion on investment opportunities in the Dutch healthcare market at the HBI conference last week in London. Please take a look. If you have any specific questions related to the presentation or this week’s update do not hesitate to get in touch with me directly.

In my previous update I said that I was looking forward to meeting you at the Healthcare Business International conference in London this week where I was to host a roundtable discussion on investment opportunities in the Dutch healthcare market.

Unfortunately, at the moment I am quite limited in my mobility due to an accident that has resulted in a couple of fractures. Due to this, I will not be able to make it to London this time. If you are going, I hope that you have a useful and nice time at the conference.

I will send you the presentation I was planning to use at the Roundtable discussion at a later date. If you have any immediate questions regarding the Dutch healthcare sector, do not hesitate to get in touch.

Welcome to the newest update on private healthcare in the Netherlands. In this update we cover:

• Unilabs acquisition of Medlon is finalized after acceptance by authorities. Is this the start of the consolidation of the Dutch diagnostics sector?
• Careyn, troubled Dutch healthcare conglomerate, sells maternity care business to Naviva. Is this the first step in a further portfolio restructuring for Careyn?
• Rumors on the street say that Bergman Clinics are preparing themselves for a sale. Is this an interesting target for an international chain of clinics?
• In our snapshot we give an overview of Zorg voor de Zaak, a privately-owned group of companies providing a wide range of health-care related services.