Aug25

Update 25 August 2026

Update 25 August 2026

Back from a wonderful vacation in France with one week in Normandy and one week in Burgundy (including a very expensive day in Chablis). I assume that most of you are now starting “normal” life again, and hope that you have all had a wonderful summer.  The summer has also been fairly quiet in the Dutch healthcare sector, but there is still news to be reported. In this update we cover:

  • Large, specialized clinics chains continue to grow. What are further targets?
  • Lawyers raise fundamental issues regarding Healthcare Minister’s plan to limit dividend payments. What is the story?
  • Acibadem opens new location in Rotterdam. Are they a hospital or a specialized clinic?

Large, specialized clinics continue to grow

Equipe, together with Bergman Clinics, is among the largest commercial providers of specialized medical care in the Dutch market. Most of the specialized medical care is provided under the brand Xpert Clinics. Care provided includes orthopedic care, ophthalmology, proctology, dermatology, gynecology and urology. Equipe / Xpert Clinics has recently acquired Woman’s Healthcare Center (WHC), which is focused on gynecology.  WHC has one clinic in Amsterdam with eleven specialists

This acquisition follows a number of earlier acquisitions by Equipe (Andros Clinics, Parkwegkliniek Sommer, etc.) and highlights the ongoing consolidation of the Dutch specialized clinic sector. A few years back the Dutch Authority for Consumers and Markets (ACM) tried blocking acquisitions made by Bergman with the reason that they were getting too big. However, these decisions were overturned on appeal, and Bergam has also made more acquisitions. It will be interesting to see which companies are acquired in the near future.

Issues raised concerning Minister’s plan to limit dividend payments

In the update in July we described the background and reasoning behind the Government’s plan to limit dividend payments to a given percentage of invested capital. We described the weak reasoning behind the suggested plan and highlighted expected legal issues. Legal experts have recently highlighted key concerns with the suggested approach:

  • Current rules limiting dividend payments by commercial healthcare companies are already under attack for not being “coherent and consistent” . The new rules would make this situation even worse.
  • The suggested change is an 180-degree turn from earlier decisions by the healthcare ministry where a choice was made not to implement generic rules regarding maximum dividend payments as this would be difficult to implement across individual sub-sectors with differing cost structures
  • The lawyers’ major issues related to defining a fair percentage to be used and the relevant investments that will form the starting point for calculating the maximum allowable dividends
  • The lawyers also foresee issues related to operators “gold-plating” investments in order to increase the maximum dividend payments

It will be interesting to see what further information the Minister will provide after the summer recess, but it is clear that actual implementation of this change is highly unlikely.

Acibadem opens new location in Rotterdam

Acibadem is a large Turkish provider of hospital-based care with operations in five countries. The  2017 opening of its first location in the Netherlands was the lead story in the first update we wrote on the Dutch healthcare sector. In Amsterdam Acibadem now treat 60.000 patients every year in a multidisciplinary centrum covering 10.000 m2. Internationally Acibadem operates hospitals. In the Netherlands they describe their concept as being a specialized clinic plus. This is reflected in the organization not being a member of the trade association for the specialized clinics (ZKN) nor being a member of the trade association for hospitals (NVZ).  Most of the care currently provided by the company (75%) is non-contracted. Acibadem has contracts with some of the smaller healthcare insurance companies but not with the four largest ones (Zilveren Kruis, VGZ, CZ and Menzis). These companies refuse contracts with Acibadem because they claim to have contracted sufficient volumes in the Amsterdam area with the traditional, non-profit hospitals.

In spite of these challenges, Acibadem has recently opened a new location in Rotterdam where they will provide care in eighteen  specialties (ranging from orthopedics to neurosurgery). They are currently in a soft-start mode with 200 patients per week but expect to grow to 1.000 patients per week. The company still hopes for contracts with the four large healthcare insurance companies and claims that they can provide 80% of all specialist care at a tariff that is 30-40% lower than that of the regional hospitals and 20% cheaper than specialized clinics that have contracts.

The future will tell whether the insurance companies will accept Acibadem’s arguments. The challenge the insurance companies are facing is to balance the need for buying high-quality care as cheaply as possible with their (implicit) responsibility for keeping the traditional hospitals up and running.