Update 2 September 2025

It is September, vacations are over, the schools are open, and people are back at work. At the moment of writing, the weather is still nice, but there is a feeling that autumn is right around the corner. It is still relatively slow on the healthcare news front, but, as always, there is still news to report. In this update we cover:

• Three new private equity driven deals announced. Is private equity back?
• Strong financial results for the mental healthcare sector in 2024 – what is behind the improvement?
• In a snapshot we give an overview of Dovida, a provider of homecare services

Three new private equity driven acquisitions announced

In the previous update we wrote about the historic development of M&A, and a trend suggesting less private equity driven activity in the Dutch healthcare sector due to political developments. As before, our opinion was that the political threats are extremely unlikely to turn into action with negative consequences for commercial healthcare providers in general and private equity investors specifically.

It appears that private equity investors share this opinion as three deals have recently been announced with PE-investors:

• Novicare was one of the first companies we covered when we started with these updates in 2017. Since then the company has focused and developed its service providing long-term care providers with (para)medical staff. Novicare currently has 250 professional employees and provides services to seventy healthcare providers. Gilde Healthcare has been the majority owner of Novicare since 2017. Last week Gilde’s share were acquired by GIMV.
• Equipe is one of the largest Dutch chains of specialist clinics and is owned by Nordic Capital. Equipe recently announced the acquisition of Parkwegkliniek Sommer. Sommer is located in Maastricht, a large city in the utmost southern part of the country, and gives Equipe a new geographical market. Sommers provides low-complex services within dermatology, plastic surgery, gynecology, and urology. This also provides Equipe with new expertise.
• In 2021 we wrote a snapshot describing Nederlandse Obesitas Kliniek (NOK) a chain of specialist clinics focusing on helping patients with morbid obesity (BMI higher than 40). Until recently Medtronics owned 75% of NOK, with 25% being owned by the founder. Medtronics has now sold its 75% share to Vendis. The founder has sold 10%, keeping a 15% shareholding. Vendis is a Belgian PE-company that has already invested in Dutch cosmetic clinics. Vendis will support NOK in growing geographically in the Dutch market and expanding into Germany and Belgium (focusing on GLP-1 related activities)

Strong financial results for the mental healthcare sector in 2024

In the update of 8 July we presented the results of a study showing how the financial results of the Dutch elderly care sector had almost doubled from 2023 to 2024. A recent study from BS Health Consultancy highlights that the mental healthcare sector has also had a very good 2024. The study looks at the financial results of thirty-seven organizations with revenues higher than €25 million and mainly providing mental healthcare services financed by the healthcare insurance companies (cure). The analysis mainly includes non-profit providers, but also includes commercial providers such as HSK Groep and  Mentaal Beter (both part of  The Mental Care Group) , and Molemann Mental Health.

The average results (profit margin) for the companies included in the study improved from 1.4% in 2023 to 2.4% in 2024. The main reason for the doubling in results is an 8.6% increase in revenues. While direct staff-related costs representing almost 70% of total costs) had stronger growth than revenues, this was balanced by lower increases in costs in areas such as outsourced work, food and property-related costs, energy, and maintenance, etc.

The study does not structurally differentiate between the results of the non-profit and commercial operators. However, it appears that the commercial operators have lower profit margins than the non-profit operators. There can be many reasons for this including differences in activities (the commercial operators focus more on ambulant services) and financing (especially of private equity owned companies such as HSK and Mentaal Beter).

Snapshot of a Dutch commercial healthcare company: Dovida

Home Instead was one of the first companies to provide franchised non-medical home care in the Dutch market. It is a company that we have been following for many years. A few years back the country franchise for the Netherlands was acquired by a Swiss company that also owned the national franchises for Switzerland and Ireland and transformed the national operations by purchasing local franchises This company was in 2021 acquired by a Swiss PE-investor (Unigestion). Since then the company has expanded to other geographical markets by acquiring national franchises in France, Australia, and New Zealand. In addition, the company has left the Home Instead network and rebranded as Dovida. Dovida has recently been acquired by Ardian, a French private equity company.

In the Dutch market Dovida currently has 43 locations, some owned directly, and some owned by franchise holders. Dovida focuses on non-medical home care for the elderly, and 95% of the care provided is paid by municipalities or central government. The Dutch subsidiary of Dovida is one of the largest commercial home care providers with a (almost) national footprint and more than 4.000 employees.