Sep22

Update 22 September 2026

Update 22 September 2026

September is ending. The memories of the (very) hot summer are fading and we are now all hoping for a beautiful Indian Summer. Luckily, there is also a lot of activity in the Dutch healthcare sector, and in this update we cover:

  • Equipe continues expansion through acquisitions. Who has been acquired this time?
  • Healthcare budget for coming years presented by government. What are the big changes?
  • Guarantee fund reports growing pipeline of investments. Why the contrast with earlier reports?
  • The market for providing specialists to long-term providers is changing. What is happening?

Equipe continues expansion through acquisitions

Equipe is the second largest chain of specialized clinics in the Dutch market (after Bergman Clinics) with €130 million in revenues in 2025. We have recently written about other acquisitions that they have made, and now their acquisition of Andros Clinics has been closed. Andros is specialized in urology and has four clinics in the Netherlands. In 2025 Andros Clinics had €15 million in revenues.

The acquisition will strengthen and broaden  Equipe’s position in the specialized clinic market. It appears that the regulatory bodies are now less worried about market power than a few years back and it will be interesting to see whether further consolidation will follow, and whether the current situation of two dominant chains with a number of smaller, regional chains will stabilize.

Healthcare budget for coming years presented

The Netherlands is currently run by a minority government, and it faced various challenges in putting together a budget for 2027 but finally managed just in time for the official presentation by the King (Prince Day – always the third Tuesday in September). Key points for the healthcare sector include:

  • Total budget for 2027 is €118 billion (3% more than this year). 94% of the budget is financed by payments related to compulsory healthcare insurance and specific tax payments to cover long term care
  • The largest cost items are secondary care (hospitals, etc.) with €37 billion, and long-term acre (€44 billion) of which €22 billion is elderly care
  • Core focus of government is to increasingly move to “appropriate care”, where this not only related to effectiveness of care bit also to capacity issues and cost effectiveness
  • Healthcare insurance companies will be given more power. This will include
    • Ability to force providers to participate in regional changes to the healthcare sector and participate in functions such as night and weekend provisioning of care
    • The right not to pay for non-appropriate care
    • Reducing the rights of patients to use non-contracted providers
  • Care provided by municipalities (WMO) will be reformed. Home cleaning services will no longer automatically be a part of WMO services and payments for other services will depend on income and assets

There is little in these plans that should worry existing commercial providers. Higher participation in regional cooperative efforts can lead to higher costs, but these should be relatively minor. More power to the insurance companies to refuse coverage of services deemed “non-appropriate” could have effects on revenues, but is unlikely to have any effects of well-established services. Reducing the rights of patients to use non-contracted providers will not have any effect on existing commercial providers with contracts, but will make it much more difficult to establish greenfield companies.

Guarantee fund reports growing pipeline of investments

In the last update we wrote about a recent EY report highlighting structurally low investments by Dutch healthcare providers. However, there might be good news as well. The WfZ (Waarborgsfond voor de Zorgsector – Dutch Healthcare Guarantee Fund) is an independent not-for-profit organization set up by the healthcare sector’s umbrella organizations and the Ministry to provide guarantees for commercial loans made to healthcare organization. Currently the organization guarantees €5.7 billion in loans. The WfZ typically sees investment plans in an early stage, as healthcare providers will try to get a guarantee before making investment decisions and approaching banks for financing.

The WfZ reports that it currently has requests related to €2.2 billion in loans in its pipeline. This is the highest level since 2010. A key driver for the increase in requests for guarantees is the high average age of real estate owned by Dutch operators. Operators have delayed investments, many buildings are now at the limits of practical use, and are often not aligned with current rules regarding fire safety, etc. The WfZ also highlights that there are many other uncertainties regarding building permits, net congestion, etc., and that they therefore also see an uptick in share of projects not taking place.

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Market for provisioning medical specialist is moving

Dutch providers of long-term care, especially nursing home providers, have for many years struggled to find the elderly care physicians (a Dutch medical specialist in long-term care for frail older people). A key struggle has been to fill working schedules during evenings, nights and weekends. Various commercial organizations (GeriCall, ANW Nederland, MedTzorg) saw this as an opportunity and developed pools of doctors willing and able to fill these timeslots. Another company, Novicare, developed a proposition where essentially all medicalized care within a nursing home is outsourced. The commercial companies have been innovative in providing their services. GeriCall makes use of  residents trained to handle relevant issues and supported by a group of experienced elderly care physicians. GeriCall also makes use of Dutch specialist available per telephone, often based in other time zones.

As a consequence of the ongoing processes to make Dutch healthcare more efficient, providers are being forced to work together in regional structures. This also gives the providers more room to share staff, enabling more efficient use of physicians filling evening, night and weekend schedules covering more locations within a region. This typically means that physicians have to do less of the services, and also earn more money doing them as they are (partly) paid per call / activity being carried out.

These moves are a risk for the commercial providers, and these are moving into other services. This includes providing physicians to other long-term care sectors, but also providing software and consultancy services to regions developing cooperative structures.