Update 19 May 2026
After a period of beautiful early spring weather, the last few weeks have been cold and wet. The last few weeks have also all had a lot of public holidays, and it appears that not much has been going on in the Dutch healthcare sector. However, there is still news to report and in this update we cover:
- Update on Chipsoft hack? What happened and what are possible consequences
- Hospitals plan to increase competition with specialized clinics. What is the situation?
- Which elderly care clients are using alternative financing (VPT)? What are possible consequences
- Key trends in complex elderly care. Where are the clients receiving care?
Update on Chipsoft hack
In the 9 April update we described now Chipsoft (the largest and very profitable supplier of EPD-software for Dutch hospitals) had been hacked a few days earlier. The first response from Chipsoft was that no patient data had been lost. However, the situation quickly escalated with most hospitals using Chipsoft losing contact with referrers, closing patient portals, and having to print out patient reports. As the days passed, several hospitals reported data leaks, and questions were raised in Parliament regarding the high dependence on one IT-supplier, and the type of security-related demands that can be placed on critical IT suppliers. 16 April (nine days after the attack) Chipsoft reports that medical dossiers have been stolen . A week later a hackers group threatens to publish the stolen data on the dark web, and five days later Chipsoft reports that the stolen data has been destroyed. It is not known whether Chipsoft has paid ransom to the hackers.
Clearly the hack was part of an overall plan to steal data and (hopefully) earn money through a ransom payment. The hack has exposed major weaknesses in the Chipsoft systems and the vulnerability of the Dutch healthcare to such hacks and ransom demands. It has gone quiet about this issue in the last few weeks, but it will be interesting to see what the government comes up with.
Hospitals plan to increase competition with specialized clinics
Hospitals have in the last few years been facing increasing competition from commercial specialized clinics such as Bergman Clinics and Equipe. The specialized clinics have increasingly been gaining market share in plannable care segments where activities are structured and medical risks are relatively low. Traditional hospitals have had problems competing with the specialized clinics as they were not able to provide similar response times and customer-oriented service as the specialized clinics. A few years back one hospital (Rijnstate) decided that the only way to compete was to set up a clinic with a separate organization and brand similar to the commercial brands. The focus clinic was a big success and currently thirteen hospitals have developed similar focus clinics.
A recent survey by Zorgvisie, a magazine focusing on key issues in the Dutch healthcare sector, shows that the commercial clinics can expect increased competition from hospital owned focus clinics. Existing focus clinics have an average of six specialties, and many are planning to develop new service areas. While it will not be possible for all the sixty-two hospitals to develop focus clinics (due to size constraints, etc.), experts believe that 70% do have the ability to develop such clinics. Key reasons for hospitals to set up a focus clinic include increasing revenues but also improving patient satisfaction by reducing waiting time. The healthcare insurance companies appear to be quite happy with the development of focus clinics as they help keep hospitals financially healthy, improve their ability to provide the complex care that the commercial clinics cannot provide, and also reduce the negotiation power of the larger commercial clinics.
The survey also highlights some of the difficulties associated with setting up a successful focus clinic. This includes setting up and managing a very different service proposition (radically shortening time between diagnostics and an operation, etc.), separate branding and positioning, and , most importantly, communication with key staff, getting acceptance for different processes, and managing staff to ensure that the “Chinese walls” between the clinic and the rest of hospital stay in place.
It will be interesting to see how large hospital focus clinics can get before they are seen as interfering with the (other) core businesses of the hospitals and whether top management can successfully balance the needs of two different business models within the same organization.
Which elderly care clients are using alternative financing forms (VPT)
Back in 2021 we gave an overview of the key differences between ZIN and VPT financing for nursing home care in the Netherlands. The key difference for the operators is that with ZIN-financing the government pays for costs related to the provision of healthcare activities and for real estate costs, while VPT financing does not cover real estate costs. All clients receiving nursing home care have co-payments that are paid via the tax system. The co-payments depend on the assets and income of the client. Co-payments for clients receiving ZIN-financed care are higher than for clients receiving VPT-financed care, and also have a stronger increase with higher assets and income.
Commercial nursing homes are typically financed with VPT. The commercial nursing home receives government payment covering healthcare activities and a payment from the client covering rental and service costs. Depending on the strategy and market positioning of the commercial provider and rental and services costs can vary between €1.000 - €6.000. For “rich” clients with large assets (resulting from home ownership) and a high pension, the difference between the co-payments charged for staying in a ZIN-financed nursing home (typically traditional non-profit providers) and staying at a VPT-financed commercial operators will cover most of the difference in costs between a non-profit and commercial nursing home provider.
This difference is highlighted in a recent study by the Dutch Central Bureau for Statistics (CBS) that shows that clients using VPT financing are, on average, richer than patients using ZIN-financing. VPT (and related financing forms) have had a robust growth in the last few years (see next note). Partly, this is due to government policy as the overall number of ZIN-financed patients has been frozen at the current level of approximately 130.000, but also due to the overall increase in co-payments for ZIN-financed care.
Complex elderly care moving to home and hospices
Two recent reports highlight interesting trends related to where complex elderly care is being provided. The first is linked to the previous note as it deals with where care is being provided (closely linked to the type of financing used). The report from ZN (the umbrella organization of Dutch healthcare insurers) shows that clients using VPT financing increased from 22.587 in 2024 to 26.168 in 2025. While the majority of these clients use VPT to finance care in clustered homes (often commercial nursing homes) the share of clients using VPT to finance care in their homes grew from 26.5% in 2024 to 30.6% in 2025. The growth in elderly being provided by VPT-financing has resulted in a small reduction of places financed by ZIN from 131.520 in 2024 to 130.239 in 2025.
We referred to an overall analysis of hospice care in the Netherlands in November last year. One of the key messages was that the demand for hospice care will grow strongly in the coming years. A recent report from two branch organizations shows that the number of clients using hospices as end-of-life care grew by 8.5% from 2024 to 2025 (13.100 clients in 2025), and the number of hospice beds grew from 840 in 2024 to 945 in 2025. Four out of ten hospice providers expect to grow in the coming years.
These two data points can be seen as success in the government’s campaign to move elderly care away from expensive nursing homes (especially where the government also finances real estate costs) to cheaper care in a home situation. The government has planned to develop new guidelines for financing where MPT (similar to VPT but enabling care to be provided by various organizations) will be given a leading role from 2027. However no details have yet been released concerning how this will work.