Mar10

Update 10 March 2026

Update 10 March 2026

At the time of writing we are enjoying an early spring here in the Netherlands. Day-time temperatures are high (ten degrees centigrade higher than the average for the time of year), and terraces are full of people enjoying the sunshine and a glass of beer or wine. Other parts of Europe are seeing rain and cold, and March can be fickle so we will see what happens. In any case, there is still news to report from the Dutch healthcare sector. In this update we cover:

  • FYEO sold to EuroEyes. What is the background to the deal?
  • Chipsoft is as profitable as ever. Will it ever lose its almost-monopoly on hospital EPD systems?
  • Bergman Clinics signs new multi-year contract. What are implications for the position of commercial specialized clinics in the Dutch market?
  • Mental healthcare provider enters receivership. What went wrong?
  • More than half of independent physiotherapists want to sell. What are consequences for consolidation?

FYEO sold to EuroEyes

FYEO (For Your Eyes Only) is a major player in the Dutch refractive surgery sector. We describer FYEO in a snapshot in 2019, but since then the company has developed an even stronger position in the Dutch market. In 2019 FYEO had revenues of €12 million and 40 employees. Today FYEO has 15 clinics and more than 300 employees. FYEO has an interesting strategy. Most of its competitors in the Dutch market focus on refractive surgery paid by the healthcare insurance companies. FYEO is entirely focused on out-of-pocket care for patients who see refractive surgery as an alternative to wearing glasses or using contact lenses. Their entire patient journey from websites and other marketing to the patient experience in the clinics is focused on providing a high-end experience

FYEO is being acquired by EuroEyes that was founded in 1993 and now has thirty clinics in Germany, other countries in Europe and in China. For EuroEyes FYEO probably represents an interesting entry into the Dutch market, but also will provide an opportunity to gain experience about consumer-directed marketing and the development of a high-end brand in the ophthalmology sector.

 

Chipsoft has another profitable year and increases domination of Dutch market

In earlier updates we have written about the domination of Chipsoft in the Dutch hospital EPD-market and its position with Microsoft as launching partner for AI solutions in the healthcare sector. Recently Chipsoft has published its 2024 (!) annual accounts. Revenues for the year were €175 million, and the company booked net profits of €67 million. This is a growth of 18% in revenues and a six percent-point improvement in profit margin to 38%. The owners (father and son Mulder) received dividend of €80 million, but still left Chipsoft with a strong balance sheet and €119 million cash in the bank.

A further analysis by De Financiele Dagblad highlights the growing strength of Chipsoft in the Dutch market. In 2024 54 out of 75 Dutch hospital organizations used Chipsoft, while eleven used Epic, eight Nexus and two SAP/Cerner. Since then SAP/Cerner has left the market and Chipsoft serves 57 hospital organizations. Chipsoft is also increasing its dominance in solutions for patient data. As changing systems is a very large and complex task hospitals are unlikely to change providers and Chipsoft is likely to keep its dominant market position.

Bergman Clinics signs new multi-year contract

In the Netherlands there is a strong undercurrent of unhappiness about the increasing role of private equity and commercial providers of healthcare, and there has recently been two motions in Parliament to forbid private-equity investments in the healthcare sector. In sharp contrast to this is the general acceptance of commercial providers and private equity owned companies by key stakeholders in the sector. Dutch healthcare insurance companies essentially decide who can provide services to Dutch patients and clients as all contracting and invoicing takes place through them.

The acceptance of the key role played by commercial specialized clinics in ensuring that high-quality plannable care is widely available is highlighted by the recent announcement of a new multi-year contract between Bergman Clinics and Zilveren Kruis (one of the largest healthcare insurance companies). It is interesting to note that the new contract is positioned within the ASWA program for restructuring the Dutch healthcare sector as this clearly positions Bergman Clinics as a part of the long-term structure of the sector.

Mental healthcare provider enters receivership

Phitaal is a commercial mental healthcare provider focusing on helping patients with psychosomatic issues leading to physical pain. The company has ten locations and approximately 350 employees. The company is the result of a merger between two smaller companies providing similar solutions that were both owned by the same holding company (Integrative Interventions Group) that is again owned by Kartesia Management (specializing in private debt to lower mid-market companies). Kartesia acquired Integrative Interventions in 2023 (probably due to issues related to debts).

The company is now in the process of entering receivership. The key problem appears to have been that insufficient healthcare insurance companies have been willing to sign contracts with Phitaal. This has forced the company to rely on non-contracted care, which either results in less clients or lower average tariffs. The interim CEO claims that a party had been found that was interested in acquiring the company but that this would require a debt restructuring deal that did not receive enough support from key debtors.

Independent physiotherapists want to sell

We have recently written a number of times about the Dutch physiotherapy sector. In the last update we described how the NZA (Dutch Healthcare Authority) had decided against setting minimum tariffs for the sector. In an earlier update we described the ongoing consolidation in the sector and a recent major acquisition. A recent study by HU University of Applied Sciences Utrecht looks at the sector from the viewpoint of the small providers (often one-person companies).

While many of these independent providers of physiotherapy services seem to be doing OK financially, they have to work long hours and face increasing challenges related to restrictive contracts with insurance companies and higher costs. More than half of these providers are therefore thinking of selling. Often the first choice is to sell to employees or other physiotherapist in geographic proximity, but selling to the chains (TopZorgGroep, etc.) is certainly also an option.

According to a recent article in Het Financiele Dagblad the unwelcome news for the independent physiotherapists is that not all the independent physiotherapists are attractive to the chains. They will prefer buying physiotherapists that are profitable and where the owners are proactively developing new services (occupational healthcare, etc.) and reducing their dependence on healthcare insurance companies.

There is clearly more consolidation to come in the Dutch physiotherapy sector with a combination of willing sellers and willing buyers. We will continue following the sector and will keep you up to date.