Jan13

Update 13 January 2026

I hope that you have had a wonderful break and a great start to the new year. Welcome back to first update of 2026. Before Christmas it was quiet on the news front, but it seems that the new year has brought many activities up to speed again. In this update we cover:

Consolidation of laboratories continues. What will be the end game?
Large acquisition in the physiotherapy sector. Who will be next?
Ministry provides overview of alternatives for prohibition on dividend payments. What does this mean for commercial healthcare providers?
In a new snapshot we give an updated overview of Arts en Zorg, a successful provider of commercial primary care services

Consolidation of laboratories continues

In the last few years, the medical laboratory sector has been a prime example of the ongoing consolidation in the overall healthcare sector. The process consists of two pathways. The first pathway is the acquisition of independent laboratories by foreign companies. Recent examples include the acquisition of Atalmedial by Unilabs. Another path is local companies joining together. The most recent example of this is the new agreement between Anna Ziekenhuis ( a hospital located near Eindhoven) and Stichting Kempenhaeghe (organization specializing in severe forms of epilepsy and other brain disorders). The two organizations have agreed to centralize their laboratory activities in a common location at the Anna Ziekenhuis.

The Dutch medical laboratory sector still clearly has a long way to go in its consolidation process and, in spite of examples such as the acquisition / cooperation between Anna Ziekenhuis and Kempemhaeghe, the process does not seem to be gathering any momentum, and it is unclear when the sector will reach a new equilibrium.

Large acquisition in the physiotherapy sector

Physiotherapy is in the Netherlands not covered by the compulsory healthcare insurance and the sector is facing issues related to tariffs and staffing. This has not stopped private equity investments in the sector and an ongoing consolidation process. One of the most active parties in consolidating the sector is TopZorgGroep One year ago TopzorgGroep acquired Fysiomed, and it has recently announced the acquisition of FysioHolland. FysioHolland is a chain with approximately 100 locations and 400 employed physiotherapists.

The acquisition of FysioHolland is TopzorgGroep ‘s 50^th acquisition and makes it the largest provider of physiotherapy related services in the Netherlands with approximately 600 locations. The acquisition almost gives the company nationwide coverage with only some white spots in the northern part of the country (Groningen and Friesland). The stated goal of TopzorgGroep is to have a location within a 30 km radius of all potential patients. In addition to physiotherapy the company also provides more general rehab, ergotherapy, lifestyle coaching and occupational healthcare related services. There is no reason to believe that the TopzorgGroep acquisition machine has stopped. Who will be next?

Alternatives presented for current regulations regarding dividend payments in the Dutch healthcare sector

As explained in the update on 4 November last year, there is an ongoing discussion regarding payments of dividends by companies providing healthcare services in the Netherlands. The Ministry of Health has been analyzing how the current situation can be improved. In a letter to Parliament the Minister of Health in the current caretaker government has suggested that there are three alternatives to the current (rather complex) system:

A general prohibition covering all healthcare sectors. However, this will require a general restructuring of the whole healthcare sector
A differentiated rule where dividend payments are prohibited in situations where this would lead to risks regarding quality, affordability, or accessibility. This is essentially the current system, but then updated to include a more “consistent and sound” justification for the choice of sectors that are covered by the prohibition. The Minister fears that this will lead to “calculating behavior” and multitudes of organizations to enable dividend payments (as is the current situation)
Allowing dividend payments in all healthcare sub-sectors but introducing rules and regulations to “limit excesses” and risky financing forms

Due to the caretaker status of the current government, further decisions will be delayed until a new government is in place. A general prohibition seems very unlikely (given EU rules, etc.), allowing dividend payments across all sub-sectors might be a possibility but will depend on the general horse-trading implicit to a minority government (that currently seems to be the most likely outcome of the ongoing discussions). Consequently, the most likely outcome will be a continuation of the current situation (with some changes).

Snapshot of a Dutch commercial healthcare company: Arts en Zorg

Arts en Zorg is an interesting company that has already been covered in a snapshot. We have also mentioned the company in updates related to the development of the Dutch primary sector where it is a success story as opposed to other providers such as Co-Med, etc. Arts en Zorg was recently the focus of a large article in one of the leading Dutch newspapers, and this has provided some interesting insights into the company.

Arts en Zorg currently has 28 primary acre locations, is responsible for the provision of primary care to all asylum seekers in the Netherlands (in 175 asylum centers), primary care in eight prisons and provides the care for 200.000 detainees in police stations. Arts en Zorg seems to have “cracked the code” regarding how to make primary care more efficient through digitalization. The initial contact of all patients to a GP is via an app (Gezond.nl). Depending on the patient’s question, the next step can be a webpage with specific information, a digital chat with a nurse or a GP, or a physical meeting. Arts en Zorg claims that 75% of patient interactions are managed digitally and that the GP has 40% less consultations. In addition to increasing the availability of care and reducing costs, this work process also improves staff morale and work pleasure as it enables more time for patients with complex issues.

Arts en Zorg has had a robust growth in revenues (from €103 million in 2022 to €156 million in 2024. The company is debt-free and has been making impressive dividend payments to its owners (€10.6 million in 2023, €11.5 million in 2024, and €4.2 million in 2025).