3500 results and no keyword from 
To access over 4,000 articles you need to be an HBI Deals+Insights member. This gives you up-to date news, case studies of new business models, interviews with business leaders and investors and a record of recent private equity investments. To get access, contact us on 00 44 207 183 3779 or memberships@healthcarebusinessinternational.comOrpea's Refoundation Plan - one year on
One year ago Laurent Guillot, the new CEO of French nursing home operator Orpea, presented ‘ORPEA CHANGE! WITH YOU AND FOR YOU’ to shareholders. After a turbulent time, HBI speaks to two market experts asking - is the recovery plan on track? [+]
For-profit care home stock in Europe's four biggest care home markets - Infographic
Care homes comprise the majority of investment volumes within health care real estate in Europe. There are tens of thousands of care homes across Europe, but it is typically only those in the for-profit sector that are available to be acquired by real estate investors. In this infographic we look at the care home stock in Europe's four major markets for health care real estate investment - Germany, France, Spain and the UK - and provide estimates of how much are operated by for-profits. [+]
Two French imaging groups invested in by PE
Two medium-sized French imaging operators, X-Ray Phocea and Cardinet, have been invested in by private equity firms, in what could be a signal that the long-awaited consolidation of France's imaging sector is about to take off. [+]
The risks and challenges of regulating AI
A crescendo - in equal measure hype, hope and concern - about the use of artificial intelligence in a range of situations including healthcare is reaching unprecedented levels. [+]
UK tightens foreign recruitment visas
This week, the UK’s Home Secretary James Cleverly announced government plans to tighten health and care worker visas. HBI speaks to a global workforce expert to understand what this attempt to prioritise ‘British talent first’ will mean for operators already facing a workforce crisis. [+]
What's next for Aster DM?
A GCC expert tells HBI the next step for Aster DM’s GCC division is to expand in Saudi Arabia – but not how you might expect! [+]
Fresenius bans bonuses and ditches dividend for energy payout
Healthcare conglomerate Fresenius has suspended dividends and bonuses for the management board as a result of legislation which gives it €300m in energy price relief. The conglomerate has stated it will “examine” legal options as it believes the law is “unconstitutional”. HBI speaks to two expert sources to find out more. [+]
Affidea solidifies presence in Spain and Romania
Pan-European imaging and diagnostic firm Affidea is expanding in Spain and Romania. Its acquisitions of Clinica Atenea in Valencia and Odelga Imagistics clinic in Bucharest bring the number of Affidea’s centers in Europe to 340, cementing its influence in the region. [+]
IHH considers entry into Vietnamese and Indonesian hospital markets
The new CEO of listed pan-Asian hospital giant IHH says it is looking to move into new markets like Indonesia and Vietnam. Meanwhile, it is also planning to expand its offering in India and Turkey, and turnaround its underperforming China assets. [+]
NHS queues creating cancer care opportunities in UK - but not yet in Italy
The UK is seeing a boost in private cancer care provision driven by the state of the UK NHS, expanding offerings and a wider availability of convenient drugs – but a radiotherapy source tells HBI not all NHS markets are so lucky. [+]
Aster DM sells majority stake in Gulf business for $1bn
Dubai-based listed hospital and pharmacy chain Aster DM is selling a majority 65% stake in its Gulf business for a shade over $1bn to a consortium led by PE investor Fajr Capital. HBI investigates the thinking behind the deal, what this means for the group's expansion plans, and looks at the future of the GCC market generally with the help of expert commentary. [+]
Propco deal activity has been as muted as opco in 2023
We’ve written a lot about the slowdown in M&A activity over the past year or two. But rising interest rates haven’t only adversely impacted opco acquisitions. They’ve had a similarly negative impact on propco investment. [+]
Fertility: Cost of living crisis makes finding patients harder and TFP sale struggles
With a recent survey announcing 49% of fertility patients questioned are suspending their treatments, three fertility experts tell HBI it’s becoming increasingly difficult to attract patients. Meanwhile, fertility group TFP looks no closer to sale. [+]
VIDEO INTERVIEW: Walter Shekman, CEO, Dobrobut
HBI’s Lee Murray recently caught up with Walter Shekman, CEO of Ukrainian private hospital and clinic group Dobrobut. In this video, they explore Ukraine’s ~$16.4bn healthcare recovery need - and what this means for private providers in the country. [+]
Cigna and Humana "in talks to merge"
Two of the US’s largest health insurers - Cigna and Humana - are reportedly in talks to merge. A stock-and-cash megadeal could be announced by the end of the year, but any deal will likely attract the interest of the regulator. [+]
Venture fund buys Spanish imaging group HT Medica
HT Medica, Spain's third largest private imaging provider by revenue, is being bought by pan-European PE firm Fremman Capital, reportedly for around €100m. [+]
Fresenius Medical Care deconsolidation completed
The deconsolidation of multinational dialysis giant Fresenius Medical Care (FMC) from German health care conglomerate Fresenius Group has been completed. This means FMC is now a regular limited liability stock corporation; Fresenius Group still holds the largest minority stake (of 32.2%) in it but no longer has control over, nor unlimited liability in it. [+]
Medicharme tells HBI it is not on the brink of bankruptcy
French nursing home operators have been under scrutiny since Orpea ran into well publicised difficulties two years ago, and the current economic climate has added to their woes. Facing persistent rumours it may be facing financial difficulties, elderly care group Medicharme tells HBI it is not on the brink of bankruptcy. [+]
The sorry state of EMRs
Many operators have bemoaned the state of electronic medical records (EMRs). If only the data was more readable and transferable, then we would have a data revolution, they say. But there’s more to this complex landscape than first meets the eye. [+]
The tricky Belgian nursing home market: Why Orpea is staying, and Clariane likely to leave
Last week French nursing home group Clariane (formerly Korian) announced the sale of assets totaling €1bn, with its Belgian assets tipped to be top of that list. Within days, the Belgian CEO of rival operator Orpea revealed that - contrary to some expert predictions - Orpea will remain in the region. What does this mean for the market? [+]
NHS struggling to fund outsourcing needs
HBI hears financial pressure on the UK NHS is making it increasingly difficult to outsource to the private sector – but with waiting lists worse than expected, there are still opportunities for for-profit operators. Who is most likely to take advantage? [+]
Interview: Ty Greenhalgh, Healthcare Industry Principal at Medigate by Claroty
Hospitals have thousands of electronic devices - devices which increasingly are all connected to one another on one big network. The number of devices is so vast that most hospitals have very limited knowledge about what all of them are and what they are all doing at any given time. Ty Greenhalgh, healthcare industry principal for Cybersecurity firm Claroty’s Medigate platform for health care operators, explains to HBI why this is such a big problem, from both a cost management and a cybersecurity perspective, and how technology can help. [+]
The state of Spain's NHS driving patients to go private - Infographic
Spain's Ministry of Health has released its annual NHS report. HBI looks at three key indicators which show where demand for for-profit healthcare is coming from. [+]
PureHealth set to IPO
UAE-based healthcare provider PureHealth looks set to IPO in the coming months, with multiple sources suggesting it will list on the Abu Dhabi Securities Exchange. [+]
Billionaire activist investor takes stake in Synlab as Cinven's offer period ends
Billionaire activist investor Paul Singer has acquired a minority stake in pan-European diagnostic labs group Synlab, just before the deadline for shareholders to decide whether they want to sell to PE firm Cinven, which is trying to take the group private. Singer appears to agree with Synlab's board that Cinven's €10-per-share offer doesn't reflect the true long-term value of the company. [+]
Dutch regulators clamping down on M&A
The Dutch competition authority is looking to expand its influence over the healthcare sector, having already attempted to block some smaller M&A deals. HBI speaks to Rune Aresvik, founder of Dutch consultancy firm Vardetun, to understand what tighter regulations could mean for operators in the region. [+]
Interview: Jim Easton, CEO Practice Plus Group
Jim Easton is the CEO of Practice Plus Group, one of the UK’s major hospital operators. In June, HBI reported the group planned to offer a middle-market self-pay option – delivering elective surgeries like knee and hip replacements at around 75% of the usual price. Has the market's changing attitude to PMI shifted its focus? [+]
VIDEO INTERVIEW: Richard Banks, chief strategy officer and European managing director, Virtus Health
Watch this exclusive interview with Richard Banks, chief strategy officer and European managing director of global fertility company Virtus Health, as he shares valuable insights into the evolving market landscape. [+]
German hospital market facing an uncertain future
The future of the German hospital market still hangs in the balance. As winter approaches and energy prices remain high, politicians still cannot agree on what to about Federal Health Minister Karl Lauterbach’s proposed reforms - but whatever the outcome there are opportunities as well as challenges ahead. [+]
The declining profitability of UK care homes - Infographic
Profitability in the UK's care home sector has been declining pretty consistently over the past 15 years. This trend has continued over the past four years - although not as dramatically as you might expect given cost increases - according to data collected by real estate consultancy Knight Frank. [+]
Reasons to be cheerful
Given the turmoil of recent years – the pandemic, soaring inflation, soaring energy costs, supply chain issues, a work force crisis, and war – it is good to bring you some good news for a change. There is a real feeling among industry leaders that the tide is set to turn. [+]
EDG sale predicted for Q1 2024
Multiple sources tell HBI that Nordic Capital-owned multinational European Dental Group (EDG) will be back on the market in Q1 ’24. HBI also hears Mehilainen could be back in the shop window soon too. [+]
Jefferies: M&A climate to improve, but lack of funding the biggest threat
Multinational investment bank and financial services company Jefferies published its 2023 Healthcare Temperature Check report this week, to coincide with its healthcare conference which ran between Tuesday and Thursday this week. [+]
Clariane to sell €1bn of assets and possibly exit Belgium and The Netherlands
Pan-European French elderly care giant Clariane (formerly Korian) plans to sell over €1bn worth of assets to help shore up its finances and get its debt-to-equity leverage ratio under 3x by 2025. Its Belgian and Dutch nursing homes are top of the list of potential assets to sell. A real estate investor with close connections to the company tells us this will involve the sale of the opco as well as the propco, but a Clariane spokesperson declined to confirm this for us. [+]
Saudi focus on "value health" will change the way for-profits are paid
Value health is a key proposition in the Saudi 2030 transformation plan. But previous attempts in other markets have met with questionable results. What exactly does value health mean in this burgeoning market - and how is this set to change payor-operator contracts? [+]
Dutch dental deals have gone dry
It seems Dutch dentistry consolidation could be over before it had really begun, with a consultant source telling HBI the pool of top targets is drying up. [+]
Ramsay Sime Darby sold to Columbia Asia for US$1.3bn
Multinational Asian hospital chain Columbia Asia is buying Ramsay Sime Darby, a rival SE Asian hospital chain, for US$1.3bn. This marks Australian hospital group Ramsay's exit from SE Asia, as well as Malaysian trading and logistics company Sime Darby Berhad's exit from health care. [+]
No Cleveland Clinic hospital in Saudi for "near future"
HBI understands that US hospital group Cleveland Clinic is currently unable to open a hospital in Saudi Arabia, due to a deal struck in Abu Dhabi. [+]
Why is an essential sector not a more appealing investment?
Which is the least investable sector in health care services at the moment? A few years ago, answers would have differed, but increasingly – and contrary to rising demand – HBI hears it is nursing homes. [+]
Eugin sells for €500m
Healthcare conglomerate Fresenius has sold Eugin, its Spain-based fertility business, to KKR-owned fertility group IVI RMA and Spain-based asset management firm GED for €500m including earn-outs. [+]
Saudi's biggest recent transactions - Infographic
Vivek Shukla, interim chief commercial officer at SEHA (Abu Dhabi Health Services company), gave a presentation at a webinar HBI recently hosted in which he listed some of the biggest mergers and acquisitions that have taken place in the Saudi Arabian health care market in recent years. [+]
Clock ticking on Cinven's offer as Synlab management sits on the fence
Multinational labs group Synlab has left it up to shareholders to make up their own mind about whether to sell their shares to UK PE firm Cinven. Cinven has already secured 79% of the shares, but remaining shareholders have until November 20 to decide whether to accept Cinven's €10-per-share public acquisition offer. [+]
Affidea tightens its hold on Romanian imaging
Pan-European diagnostic giant Affidea has increased its dominance in the Romanian imaging market with the acquisition of Biomed Scan, a two-clinic imaging provider in Bucharest. This is the second acquisition it has made in the market in 2023, after its acquisition of a seven-clinic group in Teleorman at the beginning of the year. It now has 48 Romanian clinics, by far the most of any private provider. [+]
Ireland’s economic miracle hasn’t spared it from workforce woes
Ireland has seen significant wage inflation as its economy has grown over the past decade, which is attracting talent from overseas. But local imaging operators tell us this isn’t happening quickly enough to fill workforce gaps. There are significant shortages of radiologists and radiographers, as well as most other categories of health care workers. [+]
Interview: Nabil Fawaz, Multilateral Investment Guarantee Agency - a subsidiary of The World Bank
HBI speaks to Nabil Fawaz, sector manager for World Bank member MIGA. MIGA promotes cross border investment in developing countries by providing guarantees (political risk insurance and credit enhancement) to investors and lenders in sectors including healthcare. [+]
Orpea’s PR push in the Netherlands
As French nursing home operator Orpea polishes its public image in the Netherlands, HBI catches up with Rune Aresvik, founder of Vardetun consultancy, to hear how the operator is proactively stepping out of the shadows to promote itself, and why its subsidiary Dagelijks Leven is emerging as something of a success story. [+]
Interview: Kalle Conneryd-Lungren, chief operating officer, Kry
Sweden-based telehealth firm Kry is growing fast in France. After a series of layoffs and a German exit, HBI catches up with COO Kalle Conneryd-Lungren to talk about the appeal of the French market, profitability in the Nordics, and Kry's plans in general. [+]
Four Seasons slow sale continues
The prolonged breakup, sale and demise of what remains of former UK nursing home giant Four Seasons Healthcare continues, with a further nine care homes sold for over £16m in cash. Will anyone claim the rest? [+]
Opportunity in Saudi dialysis
In a rapidly opening up Saudi market full of opportunities, how attractive is the dialysis sector? HBI hears the answer is less straightforward than you might expect. [+]
Blackstone buys CARE Hospitals and KIMS Health
Global private equity firm Blackstone has entered the Indian hospital market with two big acquisitions. It is acquiring a 75% stake in Hyderbad-based CARE Hospitals. In a separate deal, CARE is buying a majority stake in rival group KIMS Health. The plan is to merge the two groups and create one of India's largest hospital chains. [+]
Workforce woes beckon in a winter of discontent
Winter is coming, and for the health care sector the end of the year could see a weary workforce and soaring costs push some groups to breaking point. HBI speaks to a selection of operators, analysts and advisers to understand how groups are planning for the potentially difficult months ahead. [+]
Is Ireland’s diagnostics scheme a good model for queue-busting?
Queues for accessing publicly-funded health care are a feature of almost every country that has an NHS system. In most of these countries they have worsened since Covid. There is one very notable exception to this. [+]
How advanced is Saudi's Health Sector Transformation Plan? - Infographic
Vivek Shukla, interim chief commercial officer at SEHA (Abu Dhabi Health Services company), laid out the three key phases in the transformation of Saudi Arabia's health care sector at a webinar HBI hosted entitled ‘Saudi Health Transformation – The Real Opportunity’ last week. [+]
UK Health Minister looks for further collaboration with independent sector
The UK's Secretary of State for Health and Social Care has told for-profit operators collaborations between the NHS and private players have paved the way for them to have an increased role going forward - and that patients will be given greater opportunity to be referred to independent sector providers. [+]
AXA completes the acquisition of Irish insurer Layla
Global insurance company AXA has completed the acquisition of Irish health insurer Laya Healthcare Limited. [+]
Staff "threaten to quit" UK care home giant over pay
UK nursing home operator HC-One faces a potential staffing disaster with reports that nearly 40% of its workforce is threatening an exodus over “poverty pay”. The GMB union demands a real living wage for all staff at the ‘kind care company’, however, HC-One disputes this survey figure. HBI investigates. [+]
Fresenius transformation "on track", as it sells Peruvian asset
German health care conglomerate Fresenius is pushing ahead with its restructuring plans, selling its 70% stake in Peruvian hospital Clínica Ricardo Palma. The company says that focusing on hospital group Helios and drug/nutrition/devices subsidiary Kabi “is paying off” - but is this reflected in its most recent results? [+]
Three things we learned at Global Health, Riyadh
HBI attended the Global Health Exhibition in Riyadh, Saudi Arabia, and saw first-hand how the country is changing ahead of its 2030 transformation plan. Here are our three key takeaways from the event. [+]
Two bidders left for Ramsay Sime Darby, as CVC buys Filipino hospital chain
South East Asia is continuing to see much more large-scale M&A activity than Europe. The sale of Malaysian and Indonesian hospital group Ramsay Sime Darby is reaching its final stages, with only two bidders reportedly left in the running. Meanwhile, Luxembourg-based PE firm CVC Capital Partners has bought a controlling stake in The Medical City (TMC), the Philippines' most expansive hospital group in terms of outpatient clinic footprint. [+]
Bankruptcies, closures, and scandals: the bleak state of European nursing homes
Across Europe, nursing homes are in crisis. Between scandals in France, insolvencies in Germany, the threat of regulation in Spain, and fair fee woes in the UK, HBI hears that the nursing home sector is the least attractive healthcare services sector for investors. Are things really that bad - and is the threat of mass bankruptcies real? [+]
What do Europe's looming elections mean for for-profit healthcare?
Voters in the Netherlands, Belgium, and the UK will take to the ballot box in the next 12 months or so, and make their voices heard. HBI asks what this might mean for the future of the for-profit healthcare sector in those countries. [+]
Cerba to enter Saudi Arabia
Multinational French labs group Cerba is to enter the Saudi market, via a joint venture with Nexus Gulf Healthcare (an investment firm in the region) that will be headquartered in Riyadh. [+]
Lapland council votes to keep Mehilainen outsourcing contract - just
Councillors in Finland’s Lapland region decided by a majority of just one vote on Monday to keep an outsourcing contract with the country's largest for-profit health group, Mehilainen. This comes after a board of regional civil servants decided the contract should be ended, while almost 7,000 locals signed a petition in favour of keeping it. HBI speaks to Jussi Rantanen, a senior advisor to Mehilainen, to find out more. [+]
UK doctors demand higher fees from insurers for private work
UK doctors have been warned this week they could breach competition law if they take collective action over fees, following concerns about the actions of some private medical insurers (PMIs). [+]
Voyage Care seeks new CEO and CFO
Voyage Care, the UK’s largest provider of support for people with learning disabilities by revenue, is on the hunt for a new CEO and CFO. Andrew Cannon - who has served as CEO for the last eight years - will remain in position until a successor has been found. [+]
Key takeaways from 'Saudi Health Transformation - The Real Opportunity'
On Wednesday HBI hosted a webinar on the huge opportunities for health care services providers and investors in Saudi Arabia, as the country privatises large swathes of its health care system as part of its Vision 2030 plan to reform and diversify its economy. What were the key takeaways? [+]
Spain's access problems bleed into private sector
Spain has a record low number of primary care centres, and is splashing €1bn+ over the next two years to try and stop the rot. HBI hears that more value health initiatives, video triage and AI chatbot usage could be part of the solution. [+]
Saudi dentists fired for cheaper replacements
Saudi dentistry is seeing significant revenue growth, but HBI hears there are teething problems with significant numbers of experienced clinicians being kicked out in favour of less qualified - and cheaper - new graduates. [+]
Should new Slovakian government worry investors?
Robert Fico has formed a government in Slovakia. The former prime minister, who leads the centre-left populist party SMER, has formed a coalition with Hlas and the nationalist SNS Party. Given his track record, this could worry investors. Should it? [+]
Why the EU won’t become the global standard-setter for AI regulation
Last week HBI attended a breakfast event hosted by international law firm BonelliErede on the impact of AI in health care. Vincenzo Salvatore, an expert on EU law and the former head of legal at the European Medical Association (EMA), gave a presentation in which he discussed the EU’s plans for regulating the use of AI. [+]
Is a mountain of excessive NHS paperwork costing lives? - Infographic
A survey of over 200 NHS and social care managers in the UK to understand how much time is spent on admin tasks instead of patient care, and the impact this is having, has uncovered surprising results. [+]
Record breaking backlog offers further opportunities for UK providers
Four months on from the results of the Elective Recovery Taskforce which promised to bust the UK’s record-breaking backlog with the help of the independent sector, the number of patients waiting 65 weeks or more for treatment has risen to nearly 110,000 people. With the situation even worse than predicted, where are the opportunities for private providers - and who is most likely to benefit? [+]
Election raises hopes for for-profit prospects in Poland
Poland’s elections have ousted the populist Law and Justice (PiS) with only a coalition of opposition parties able to form a majority. With the defeat of such a controversial platform and a leftward lurch what can healthcare operators and investors expect next? HBI speaks to four expert sources to find out more. [+]
Advent to bankroll Donte Group expansion
Advent International, the PE firm which owns a majority of Spain’s largest dentistry group by revenue Donte Group, is reportedly injecting €70m of financing to boost the group’s growth. [+]
Interview: Mostafa ElSayed, Automata Technologies
HBI speaks to Mostafa ElSayed, CEO of Automata Technologies, a London-based start-up offering robotic systems to lab operators. Automata’s machines are designed to automate lab processes that were previously difficult to automate, especially in genomics and microbiology. ElSayed tells us that Automata’s machines can increase throughput by up to 5x for certain types of tests and are already being used in the UK, the Netherlands, Belgium, and the US. [+]
Spire Healthcare acquires Vita Health
The UK’s largest for-profit hospital group by revenue, Spire Healthcare, this week acquired London-based mental health specialist Vita Health Group in a £74m cash deal. HBI hears there are significant opportunities in outpatient areas like mental health for for-profits to fill the gaps left by a struggling UK NHS. [+]
HC-One acquires luxury care home group
Last week, large UK nursing home operator HC-One announced its acquisition of Ideal Carehomes. An additional 36 homes in England will be added to the provider's growing portfolio with another facility expected to open up in Cheltenham next September. [+]
A good or a bad year for the Top 100?
This week we publish this year's Top 100, a list of the top 100 health care groups by 2022 revenue in EMEA. Was it a good or a bad year for them? [+]
Stocks of €1bn+ groups almost all down since start of 2022 - Infographic
This week we are publishing our third edition of the Top 100, a list of the 100 largest health care services groups in EMEA by revenue. Out of the 100 companies, 33 are listed entities whose primary operations are in EMEA health care services, and 16 of those have over €1bn revenue. In this infographic we look at how the share prices of those 16 groups have fared since the start of 2022 (since the Top 100 is based on 2022 revenue figures). [+]
The Top 100 largest groups in EMEA by revenue
Who are the biggest health care services companies in EMEA? For the third year running we have compiled a list of the Top 100 companies by revenue from HBI Intelligence's database, which includes 5,000+ health care services operators across Europe, the Middle East and emerging markets across Asia and Latin America. The Top 100 shows these companies’ sales relating to health care service activities in EMEA only. [+]
Prospective sale of Indian division sees Aster DM's shares soar
The Indian division of UAE and Indian hospital group Aster DM Healthcare is reportedly proving popular with buyers - with multiple suitors purportedly valuing the business at around $1.5bn. [+]
Belgian crackdown after Orpea's French folly
Outside France, nursing home group Orpea has largely escaped scrutiny in the countries it operates in following its well publicised difficulties, except in its French-speaking neighbour - Belgium. HBI catches up with two operators in the region to hear what the knock-on reputational impact has been like for Belgian businesses. [+]
German threat to bonuses and dividends over energy price cap
Germany-based healthcare groups are assessing whether government aid on energy prices will prevent them from paying dividends or bonuses. [+]
PMI revenue up in Spain as inflation cripples insurance scheme
The MUFACE system which insures Spanish civil servants is at serious risk of collapse as it fails to keep pace with inflation, and concerned for-profit operators are starting to close their doors to its insured at a time where revenue is on the rise for PMI. [+]
Kenyan healthcare continues to attract overseas investor interest
Global private equity firm Alta Semper is injecting millions into MYDAWA, a primary and digital healthcare platform based in Kenya. It aims to solidify the group’s position as a key player in developing Africa’s healthcare industry at a time when Kenya is attracting a lot of interest from overseas investors. [+]
iCON buys Alliance Medical
The longstanding bidding war for pan-European diagnostic firm Alliance Medical Group is over, with iCON Infrastructure confirmed as the new buyer. The £910m deal ends months of speculation. HBI asks a UK-based consultant what this means for the market. [+]
Temperature-check on whistleblowing cultures
In the UK, the conviction of neonatal nurse Lucy Letby for the murder and attempted murder of numerous infants has shaken the healthcare industry. Many co-workers have since spoken publicly about how their suspicions, although raised, were dismissed by the very institutions meant to prevent harm. [+]
Why KKR is set to buy Eugin - and Fresenius wants to sell
Global investment company KKR is set to buy Eugin, the Spain-based fertility subsidiary owned by Germany-based conglomerate Fresenius, for €500m. We ask why KKR might want it, and whether it makes sense for Fresenius to sell. [+]
Record fines are putting care homes at risk
With UK for-profit group Cygnet Health Care being fined £1.5m last month following the death of an inpatient at Ealing Hospital in 2019 - the largest ever penalty imposed on a mental health provider - we speak to four European experts to consider how punitive fines from regulators are impacting providers’ bottom line. [+]
Hungary: high risk, high reward
The Hungarian hospital market is growing at 10% per year nominally, with some of the biggest players outstripping this. With such rapid growth and growing demand the potential reward for investors is great – but with this also comes big risks. [+]
Italy's nursing crisis causes wage spike as government looks abroad for help
Italy has historically been less affected by the health care workforce crisis gripping much of Europe, but HBI hears post-Covid pressure has created a nursing crisis which has seen wages shoot up, and led prime minister Giorgia Meloni to look abroad. Most recently she has signed an agreement with the Caribbean island of Cuba to fix her growing workforce challenge. This is the latest in a series of deals and rule relaxations designed to help funnel talent into Western Europe. [+]
Interview: Howard Podolsky, Group CEO, Cambridge Medical
Last week, Amanat Holdings announced the return of Howard Podolsky to Cambridge Medical Rehabilitation Center. HBI caught up with the ‘new’ group CEO to hear about current challenges and opportunities in the Middle East and what is different this time around. [+]
Key takeaways from the HETT 2023 London Conference
Last week, HBI joined thousands of delegates at the Health Excellence Through Technology (HETT) 2023 conference in London, where exhibiters congregated to explore how digital innovation can be leveraged to address record-level NHS waiting lists - something keynote speaker Vin Diwakar, medical director for transformation dubbed “the greatest crisis since the Second World War.” [+]
Fico returns in Slovakia - should investors be worried?
Just in time for Halloween, Robert Fico is back. The former Slovakian prime minister who tried to renationalise insurer Dôvera has led his populist centre-left party to win the most seats in Slovakia’s 2023 elections. But a Slovak operator source tells HBI the private sector need not worry as even if Fico forms a government, it is unlikely to be the horror show some fear. [+]
For-profit oncology being held back by stingy tariffs and licensing in Portugal
HBI speaks to an oncology operator in Portugal who tells us that whilst there is no risk of public referrals running dry any time soon, the sector is being held back by stingy tariffs for publicly-funded care and a licensing system that favours the public sector. [+]
Where has for-profit hospital bed capacity grown most since 2010? - Infographic
Where has for-profit hospital bed capacity grown the most in recent years? To answer this we look at OECD data on hospital bed capacity in 26 countries between 2010 and 2021. [+]
KKR set to buy Eugin for €500m
US-based global investment company KKR looks set to buy Eugin, the Spain-based fertility group owned by Germany-based conglomerate Fresenius, with which it is reportedly in exclusive talks. The deal values Eugin at around €500m. [+]
Panic rush to do deals ahead of Lauterbach reforms
HBI hears that a glut of M&A deals are being rushed through, with panicking investors and operators competing for buyers before Federal Health Minister Karl Lauterbach's controversial reforms pass - though it remains unclear exactly what those reforms will be. HBI asks whether the panic is merited, just how low have multiples dropped, and who will benefit from this? [+]
Do you need a health care background to be a great health care CEO?
Anyone who’s been paying attention to new appointments in the for-profit healthcare sector will have picked up on an interesting emerging trend: executives being poached from outside industries. It raises an interesting question: do you need to have a background in healthcare to be a healthcare leader? [+]
Cinven goes ahead with Synlab take-private
UK PE group Cinven is pushing ahead with its €10-per-share acquisition of multinational labs group Synlab by launching a public acquisition offer to all shareholders. This comes after several months of slience after Cinven made an initial non-binding offer to take the group private back in March. [+]
Median expands into third major European market
Waterland-owned Germany and UK rehabilitation and mental health specialist Median has expanded into a third major market with the acquisition of Hestia Alliance in Spain. HBI asks "why Spain?" [+]
Controversial care cuts in the Netherlands on hold following fall of government
Elderly care in the Netherlands has been stuck in a state of limbo for a while now. Political upheaval over the summer and the collapse of a four-party coalition government after 18 months in power has only made the future of care - and the implementation of planned budget cuts - harder to predict. HBI chats to a consultant to find out more. [+]
Healthcare Activos rediscovers its appetite for M&A, targets Germany
Madrid-based REIT Healthcare Activos has rediscovered its appetite for M&A. HBI speaks to the group to find out why now was the right time for it to reenter the M&A arena - and why Germany is the market it plans to target next. [+]
Which sub sectors does PE invest most in? - Infographic
HBI has been analysing its investment database and asking "who is investing in what?" It may not be the most attractive sector financially or reputationally at the moment, but elderly care has the most active PE+* investments in EMEA, with 17% of all active investments. Hospitals is the second most invested-in sub sector, with 14% of all active investments. [+]
Why it pays to do the basics when building a patient pathway
A German outpatient operator tells HBI how providers are attracting and keeping patients within their businesses throughout the patient pathway, with as many as 50% of complex ophthalmology referrals coming from internal sources. HBI hears it pays to do basic (less profitable) work and even consider retail early in the patient journey so when they really do need help, they already have a provider of choice. [+]
Hungary's health care sector boosted by new state-of-the-art TritonLife lab
TritonLife, Hungary’s largest private hospital group, has significantly boosted the country’s diagnostic testing capacity by opening a new state-of-the-art laboratory in Budapest. The group tells HBI it will eventually have the capacity to process 10 million tests per year, including many which previously had to be sent abroad to be processed. As well as providing an in-house diagnostics service to the group’s own patients, TritonLife has agreed to provide testing services to more than 20 other private health care providers in the country. [+]
How to run a hospital in a warzone
For-profit hospital groups do not always enjoy the best reputation, especially in countries where an NHS system is revered and protected. Profit, not patient focused, is the accusation. But as recent events have shown, they readily put profit aside for the greater good. Just look at Ukrainian hospital group Dobrobut, and what it has been doing on the frontlines. [+]
Alliance Medical sale "imminent"
HBI hears that the longstanding sale of UK diagnostic firm Alliance Medical Group is imminent, with two bidders left in the process and pan-European operator Affidea tipped to be the front-runner. We speak to three market experts to find out more about the deal which is being valued at around $800m-$1bn. [+]
German for profits' growing influence in the healthcare sector - Infographic
Germany's for-profit hospital sector has a growing role in the market's provision. Between 2014 and 2021, the percentage of German hospitals which were owned by the for-profit sector rose 2.3 percentage points to 44.5% and the number of beds controlled by the for-profit sector rose 0.9 percentage points to 24%. [+]
Interview: Jim Kean, CEO, Molecular You
HBI speaks to Jim Kean, CEO of Molecular You, a North American start-up that does tests which analyse patients' proteins and metabolites (small molecules produced during metabolism) to predict what diseases they are at risk of having. Kean tells us that through the use of hundreds of biomarkers and with the help of AI, they are able to achieve a 98% predictive accuracy for certain conditions. [+]
Interview: Michal Tzuchman Katz, CEO and founder of Kahun
The possibilities of AI in medicine are seemingly boundless, with many talking about its labour saving potential. Yet concerns persist, particularly with Chat GPT, and its black box LLM (large language model) system which is designed to mimic conversation but is not always factually accurate nor able to spot signs of acuity. By their nature, black box systems also cannot explain the conclusions they reach. [+]
Optimo acquires Abbeycare
UK Homecare group Optimo Care is acquiring specialist supported-living provider Abbeycare, the deal marking the group’s eighth acquisition in the last year. HBI speaks to Ben Hales, Optimo’s group project director to find out more about its run of M&A in what, for most, has been a quiet year. [+]
Fresenius to sell Curalie after De Meo's discreet departure
Fresenius’ digital health subsidiary Curalie is reportedly up for sale, as the conglomerate’s CEO continues to win over investors, streamline the group, and replace management. Meanwhile HBI hears former Helios CEO Francesco De Meo may be unhappy with the circumstances of his departure - and could seek legal advice. [+]
Four Seasons revives portfolio sale, selling 11 homes
After a dragged-out sales process lasting over a year, UK care home operator Four Seasons Health Care (FSHC) has finally confirmed the conditional sale of some of its remaining homes. Eleven are due to sell for a total of £41.3m in cash. The deal is expected to be completed later this year. [+]
Hospital groups' battle for northern Portugal heats up
The battle for the for-profit hospital market in the north of Portugal is heating up, with CUF buying small group Arrifana de Sousa. [+]
International hospital market holding firm against inflation and workforce crisis
Hospital groups across Europe are looking at the best ways to deal with inflation and the workforce crisis – and new payment models are helping. HBI looks at the half-year results of three listed groups this week to find out what this looks like in the UK, Italy and Switzerland. [+]
Private pay: Rising - but not as fast as you think - Infographic
Data from the Private Healthcare Information Network (PHIN) shows the self-pay bubble in the UK seems to have reached its peak. While private pay admissions are still rising across the country, self-pay is out while private medical insurance (PMI) is in. [+]
The massive potential generative AI offers for health care
The AI Revolution in Medicine GPT-4 and Beyond is an unusual book because it is made up of conversations with Open AI, the research lab part-owned by Microsoft. So the loudest voice in the book is GPT-4. It is a voice which leaves you slack-jawed with amazement. [+]
Post Covid regulations in Spain could lead to care home closures
New regulations designed to protect an aging Spanish population post-Covid could see older, outdated care homes forced to close. HBI speaks to Alberto Fernandez, CEO of Madrid-based REIT Healthcare Activos to find out more about the risks and opportunities this presents. [+]
Helios CEO Francesco De Meo leaves with little fanfare
Fresenius Helios has a new CEO. Germany’s largest hospital group by revenue and subsidiary of Germany-based conglomerate Fresenius announced the news in a press release which ignores outgoing Francesco De Meo’s significant and longstanding contribution to the group. [+]
Interview: Walter Shekman, CEO, Dobrobut
Against the backdrop of the Russia-Ukraine war, HBI speaks to the CEO of the Ukrainian hospital group Dobrobut, Walter Shekman, to understand the day-to-day challenges it is facing, and how the private sector can assist the sector. [+]
Major outside hires at Orpea and AXA Health
This week, two major personnel changes were announced, one at the top of the French nursing home group Orpea and the other at UK health insurer AXA Health. Both names are outside hires, Fabienne Dulac from French telecoms company Orange France, and Heather Smith from financial service provider Allianz respectively. [+]
Interview: Simon Bain, CEO of Omnilndex
How can patients, providers and researchers create records which are usable by patients, aid research, but also protect patient anonymity and protect from cyberattacks? HBI speaks to Simon Bain, CEO at data platform Omnilndex, to find out more. [+]
Donte Group expansion could be prelude to sale
Spain’s largest dentistry provider Donte Group plans to have 420 clinics by the end of the year, possibly indicating its owners are looking to offload the group soon. [+]
Ramsay Sime Darby sale shortlist - Santé might be next
The sale of Malaysia and Indonesia-based hospital group Ramsay Sime Darby marches on, with a shortlist of candidates reportedly jostling for the $1.5bn purchase. Reports suggest French hospital group Ramsay Santé is next. [+]
The near-universal dominance of public and not-for-profit hospitals - Infographic
Inpatient health care is dominated by the public sector in most countries. In the few where this isn't the case, not-for-profits tend to dominate. Out of 32 OECD+ countries, the only exception to this rule is Colombia. Even the US has far more beds in hospitals classed as not-for-profit entities than it does in its for-profit sector. [+]
Aster DM set to sell GCC business
Listed hospital group Aster DM’s share price has rocketed in anticipation as the group’s long-awaited sale in the Gulf looms closer. [+]
People-friendly models will be the winners
Anyone can put up a building. The key is staffing it with the right people, particularly in health care. This means the next decade will see the rise of new people-centric models and the demise of businesses that rely on more traditional employee/employer relationships. [+]
Portugal's hospital market: IPO, reform and intrigue
The growth of PMI makes Portugal an exciting market for hospitals. With the IPO of a major hospital group on the cards, reform looking to change the way public-private partnerships are paid, and political intrigue which rivals Game of Thrones, HBI digs into what’s making the market tick. [+]
San Donato remains in family hands, plans international expansion
In July, prior to its proposed acquisition of American Heart of Poland, there was a big reorganisation at Gruppo San Donato, Italy's largest hospital group. This pours some light on the relationship between Tunisian entrepreneur Kamel Ghribi, whose GKSD vehicle is now intertwined with San Donato, and the Rotelli family. [+]
Interview: Andrew Chadwick-Jones, CEO, Welbeck Health Partners
Few £50m revenue healthcare companies can report growth of 30% a year - at least not in Western Europe. Yet this is exactly what UK-based Welbeck Health Partners (WHP) claims to be achieving. Since 2019, the outpatient day surgery group has built practices with nine teams of specialist doctors covering 14 practice areas, all operating from its plush six storey OneWelbeck facility in London’s West End. HBI speaks to Welbeck's CEO Andrew Chadwick-Jones about the group's plans for regional development in Oxford, followed by a national chain, with international expansion also on the cards. [+]
Commissioners hurt UK care homes
UK nursing homes are facing record fines and the prospect of financial failure, but one market expert argues that providers shouldn’t be shouldering the burden alone. HBI investigates who or what exactly is to blame and what more can be done to alleviate pressures and improve the quality of care. [+]
HC-One closes all Cambridgeshire homes
Large UK nursing home operator HC-One has confirmed the closure of its three remaining Cambridgeshire homes following extended embargoes placed on the operator by the council in the spring. The homes have been deemed “no longer operationally and financially viable”. HBI investigates. [+]
End of Covid windfall sends Sonic's share price to six-month low
Sonic's share price has been hovering around the A$32 mark for the past three weeks, after falling 5% in response to FY23 results released on August 16, which showed declining profits due to Covid testing winding down. This is the lowest the share price has been in the past six months. [+]
Top two Portuguese hospitals grow around 20% in first half
Portuguese hospital operator CUF released its H1 2023 results on Friday, with the group reporting increased activity and improved financials despite its large acquisitions and building projects. [+]
German dentistry buyers nervous of Lauterbach reforms
Despite dentists being eager to sell, new entrants in German dentistry are hesitant, as the spectre of the Lauterbach reforms hangs over the market. [+]
Why won’t British PMs admit to using private healthcare?
When asked whether he used private healthcare, British Prime Minister Rishi Sunak was widely criticised for his evasiveness. His response “I grew up in an NHS family” was deemed defective and unsatisfactory, and after repeated calls this year from politicians and journalists to answer the “not relevant” question, he finally caved in. [+]
Where PE invests in health care across EMEA - Infographic
The UK remains by far the largest recipient of health care PE investments across EMEA, with 25% of all active investments across the 23 most invested-in countries. [+]
Circle Health set to be sold for $1.2bn
PureHealth, an Abu Dhabi group which is effectively state-owned, is set to buy Circle Health, the UK's second largest hospital group by revenue, for $1.2bn. The deal follows PureHealth's acquisition of a minority stake in a major US hospital chain. It comes as revenue from both private pay and NHS outsourcing surges in the UK. [+]
Germany cuts red tape to recruit outside EU
This summer, a new immigration reform was passed to make it easier for workers from non-EU countries to relocate to Germany. An Indian organisation plans to train 2,000 nurses for the German market. HBI speaks to experts to find out who will make the most of the changes and if it’s the best course of action to combat labour shortages. [+]
HC-One pilots flexible working for carers
UK nursing home operator HC-One has launched FlexForce, a flexible working initiative that hopes to ease staffing shortages by improving the sector’s notoriously low retention rates. The scheme is being rolled out to 269 homes, following a successful six month trial this June across the north of England and Scotland. [+]
Third bolt-on for Phoenix
M&A in the UK's for-profit hospital market is back in full swing. As well as the sale of the UK's largest hospital group, Circle, August saw the acquisition of One Healthcare, a small group which operates two multi-speciality hospitals in Kent and Hertfordshire, by Phoenix Hospital Group, a slightly larger UK operator. [+]
Counting the Cost: The impact of inflation on Italy, Spain and Switzerland
Two weeks ago we published an article looking at how inflation has impacted the health and elderly care markets of the UK, France and Germany. In our second instalment of this series we look at inflation's impact on Italy, Spain and Switzerland. [+]
Babylon saga reaches end
Digital unicorn-turned-mouse Babylon Health has placed two of its UK divisions into administration and reportedly sold its clinical services business to US digital health firm eMed Healthcare. [+]
Orpea sells 22 Dutch homes
This week, French nursing home operator Orpea announced the sale of 22 nursing home facilities in the Netherlands to Amvest Living & Care for €85m. [+]
Hot summer may thaw M&A ice age fast
The M&A ice age may thaw after the summer, with sources saying a flood of deals could be on the horizon. [+]
Interview: Jonathan Broomberg, CEO of Vitality Health International, Global Head of Health Insurance for Discovery
For nearly 20 years Broomberg has been intimately involved in the development of one of the world’s most sticky health care apps. If you have life or health care cover from Vitality or one of its partners you have access to an app which can reward you for exercise, diet, online or physical check ups with a range of rewards, ranging from a weekly free coffee to 50% off gym membership and discounts on flights. And in South Africa, even cheaper healthy food! Just like airlines, Vitality has different levels of status. The difference is you can move from Blue to Platinum with Vitality without spending a penny - just by better diet and exercise. [+]
IHH makes two acquisitions but reports 51% drop in Q2 profit
Listed pan-Asian hospital giant IHH is continuing to grow through bolt-ons, having made two major acquisitions this month. For Q2 2023 the company reported a drop of 51% in net profit compared to Q2 2022, to RM302m ($65m). However, the company said this was mainly because the Q2 2022 figure was unusually high, and is continuing to grow organically as well as through M&A. [+]
Circle Health sells for $1.2bn
Circle Health, the UK's second largest hospital group by revenue, has sold for $1.2bn (€1.1bn) inclusive of debt assumed. The buyer was Pure Health, a healthcare conglomerate based in the UAE, effectively owned by the Abu Dhabi government. [+]
EMEA PE investment volume almost halved in 2022 - Infographic
Using data from HBI's Investment Database, we look at the volume of private equity investments in health care services between 2017 and 2022 across EMEA. [+]
When needs must: politics and healthcare
Back in May, UK politician Wes Streeting made national headlines when he said patient choice was underused. Waiting lists were at a record high so this comment seems so obvious it's barely worth reporting. Of course the private sector should get involved! And yet because this was the UK, it was worth reporting, not least because Mr Streeting is the health spokesman for the centre-left opposition Labour Party. [+]
Ramsay share price plummets as results released
Australia-based multinational hospital group Ramsay Health Care’s disappointing results have seen its share price drop by double digits since close Wednesday. It seems its European segment’s performance did not match that of its other divisions. [+]
San Donato set to buy American Heart of Poland
The largest Italian hospital group is set to buy a majority of American Heart of Poland, a fast-growing Polish hospital group, in its first serious move outside Italy, although it has also outlined expansion plans in the Middle East. This deal is also backed by GKSD Investment Holding, the vehicle of Tunisian entrepreneur, Kamel Ghribi. But what exactly is San Donato buying? [+]
Icon’s UK debut deal with Nuffield
The UK's largest healthcare charity Nuffield Health is partnering with Australian oncology care provider Icon Group to debut its cancer care radiotherapy services in the UK market. [+]
German doctors demand more money as outpatient sector "faces collapse"
Germany’s National Association of Statutory Health Insurance Physicians (KBV) has put a series of demands to the Ministry of Health. These include sustainable, inflation-linked financing, more training and digitisation and less bureaucracy. The group says that if its demands are not implemented the outpatient sector is at risk of collapsing. [+]
Orpea likely looking to sell in Belgium
Orpea Belgium’s 2022 results are public, and it doesn’t look good. Having suffered a historic loss approaching €400 million last year and with Orpea looking to sell its non core business, we ask a market expert whether and when divestment there looks likely. [+]
Garofalo's Roman return signals boost to Italian hospital sector
Listed Italian hospital group Garofalo Healthcare has re-entered Rome by acquiring rival Aurelia 80. Despite a difficult regulatory environment, HBI hears conditions are set up for the group to thrive. [+]
Scottish care homes "closing at the rate of one a week"
HBI hears care homes in Scotland are closing at a rate of one a week due to underfunding and an inability to find staff, sending alarm bells across the sector. HBI speaks to two market experts to find out more. [+]
UK private sector set to expand nursing degree apprenticeship programmes
The UK private sector is set to take a more active role in training nurses. As the market’s biggest group by revenue expands its nursing apprenticeship programme, HBI speaks to a workforce expert to find out more. [+]
Sell-side valuations jump in Italian dentistry
M&A in Italian dentistry is becoming less profitable for buyers, and sell-side valuations have jumped. [+]
Interview: Andrew Cowley, Impact Healthcare REIT
HBI speaks to Andrew Cowley, investment manager at Impact Healthcare REIT, a listed real estate investor that invests in UK nursing homes. [+]
Vox tries to force Alzira restoration
The far-right Vox party in Spain is trying to force Valencia’s regional government to restore the Alzira model. [+]
Counting the Cost: The impact of inflation on Europe's health care market
What impact has the high inflation of the past 18 months had on growth in Europe’s health care market? Have for-profit operators been able to pass on cost increases to payors? And have patients paying out of pocket, in the face of rising prices and squeezed budgets, cut back at all? In this first instalment to answer these questions, we focus on the for-profit hospital, imaging and nursing home sectors in the UK, France and Germany. [+]
Is domiciliary care really the answer to the nursing home crisis?
The sorry state of affairs in nursing homes across Europe has been making for troubling headlines for many months. Homecare and technology platforms claim to have the answer. But just how far can they really replace proper care in a purpose built environment? [+]
Four Seasons filing for dissolution, takes some homes off the market
Troubled UK care home operator Four Seasons Health Care Limited has filed notice at Companies House to move from administration to dissolution, but neither its administrators nor its PR representatives are willing to comment on this. HBI hears the lengthy sale of most - but not all - of its remaining business is still ongoing. [+]
Finnish outsourcing will drive double digit revenue boost
Finland’s for-profit health and care sector is ecstatic as an invigorated push for public-to-private outsourcing could see a double-digit boost to revenues. [+]
Blackstone likely buyer of KIMS Health
US private equity firm Blackstone has emerged as the likely buyer in the sale process of KIMS Health, an Indian hospital group which also has multiple hospitals and clinics in the Middle East. [+]
Buy or bust for Babylon UK?
Digital health unicorn-turned-mouse Babylon could still have buyers for its UK business, despite its recent difficulties. [+]
Germany can't save small hospitals from insolvency
German health minister Karl Lauterbach’s reforms may not save all small, struggling hospitals from a natural demise after all, despite previous claims to the contrary. [+]
Fresenius shares rocket to one year high
Germany-based healthcare conglomerate Fresenius SE is trading at its highest share price in over a year – and three high-profile investment banks predict things will get even better. [+]
Interview - Ingeborg Oie, CFO and Chief Strategy Officer, Huma
In this wide ranging interview we discuss the future of remote patient monitoring (RPM) software and government progress in ehealth. Through its RPM platform, Huma claims to massively cut costs and improve outcomes for patients with chronic conditions. [+]
Italian scoops up UK medico-cosmetic chain
Milan-based Quadrivio Group has bought 100% of UK-based cosmetic-focused The Private Clinic (TPC) from PE group Bluegem, and has added a further four smaller clinics. This is the second transaction from its Silver Economy Fund which targets "healthy longevity". We look at deal, fund and market size. [+]
Diagnostic imaging capacity by country - and its impact on mortality - Infographic
Diagnostic imaging capacity varies significantly by country, even amongst rich nations. Using OECD data, we look at how the number of CT scanners and MRI scanners per million inhabitants varies between 39 OECD+ countries, and whether this has an impact on avoidable mortality for 27 of those countries. We used 2019 data, to avoid any distortion from Covid. [+]
Emerging market providers make up half the Top 50
Half the top 50 listed health care service groups globally by market cap are now headquartered in emerging markets. What does that tell us about the sector internationally? We publish the top 50 with detailed analysis in Deals and Insights. [+]
Stalemate for the only solution to doctor shortages
An innovative distance learning platform that trains doctor for just €100,000 has frozen its 2023 intake thanks to the intransigence and obfuscation of the medical profession. Malta-based EDU, accredited by Maastricht University Hospital, has faced four years of delay in accreditation from the Medical Association of Malta despite being able to demonstrate that its doctors outperform those trained in university hospitals. [+]
American Heart of Poland set to sell before election
M&A is quiet in much of Europe but roaring in Poland where a series of groups are set to sell before the general and presidential elections late in the autumn of 2023. [+]
See the Global Top 50 by Market Cap
Who are the Global Top 50 Health Care Service Companies by market cap and what does this tell us about the industry? What is striking is how very few of the top 50 are now EMEA companies - just 13, and of those only four are headquartered in Europe, rather than the Middle East or South Africa. [+]
CUF given greenlight to acquire occupational health provider
Portugal’s competition authority has given the greenlight to CUF, the country’s largest hospital group, to acquire occupational health provider AtlantiCare. [+]
UK nursing home sector "still viable"
Despite their travails, good nursing home groups in the UK are still making decent money, according to OakNorth, a bank which has some half dozen on its books, and Impact Healthcare REIT, a listed UK-based nursing home real estate investment firm with 14 operators as tenants. The government deserves some of the credit for this, having increased fees above inflation and made it easier for foreign care workers to get visas. [+]
Beleaguered Babylon searches for UK buyer, closes in the US
Under fire digital health company Babylon is shutting down its US operations and looking to sell its UK business. Plans to merge with Swiss digital neurotherapy company MindMaze and be taken private by creditors have collapsed and it is now on the brink of bankruptcy. [+]
Ramsay teams up with Google Cloud to build data hub
UK-based hospital group Ramsay Health Care has announced its partnership with cloud computing service Google Cloud to build a centralised data hub as part of its 2030 digital transformation strategy. Ramsay will use Google Cloud’s AI and machine learning to give nurses, hospitals, and clinicians better access to patient data. [+]
Two Southeast Asian groups up for sale and an Indian group to IPO
In contrast to Europe, South and Southeast Asia are continuing to see significant deal activity. HBI hears that SAFE Fertility Group, one of Thailand’s largest IVF providers, and Qualitas Medical Group, a primary care chain with practices across Malaysia, Singapore and Australia, are up for sale. On top of this, Agilus Diagnostics, one of India’s largest labs groups, is set to IPO. [+]
Interview: Ewan Davis, Quadria Capital
HBI speaks to Ewan Davis, partner at Quadria Capital, a private equity firm headquartered in Singapore. With offices in New Delhi and Ho Chi Minh, it invests in health care companies across South and Southeast Asia. [+]
UK Government turns to for-profits to bust backlog
The UK independent sector is gearing up for an explosion in backlog-busting public outsourcing. The for-profit hospital, ophthalmology and imaging markets in particular look set for a significant boost according to wide-reaching government plans announced today (January 4). [+]
Is the term 'brain drain' fair and accurate?
There is a widely held view that brain drain - especially in health care - hits the country of departure hard. And yet there were dissenting voices to this popular view at HBI 2023. [+]
Does Europe need a more harmonised health care system?
HBI speaks with three Germany-based contacts at strategy consultancy L.E.K. about the case for a more harmonised health care policy across the EU. [+]
Fresenius half-year results get lukewarm reception
Investors had a mixed reaction to Fresenius’ half-year results, which saw the firm perform poorly on a group-level, but the core businesses highlighted by the restructuring plan perform well. The company did not confirm rumours of divestments. [+]
HBI 2023: Opportunities in ophthalmology
Ophthalmology continues to be a big area of interest for investors, with considerable scope for consolidation. An expert panel including the CEO Europe's largest chain (Veonet) and the CEO of Latin America's largest player (Opty) discussed opportunities in the sector at HBI 2023. [+]
Elective care waiting times predict patient satisfaction - but not private pay growth - Infographic
Waiting times for hip replacements appear to have a significant impact on patient satisfaction, but don't reliably predict growth in private pay. [+]
Is Macron pushing for ‘stealth nationalisation’ of French nursing homes?
French president Emmanuel Macron is facing accusations of tacitly pushing a policy of ‘stealth nationalism’ in French nursing homes. HBI speaks to market experts to find out more. [+]
Aedifica finds buyers for Orpea's Brussels homes
Belgium-based real estate specialist Aedifica has confirmed the sale of five of its nine Orpea homes, all located in Brussels. The news confirms previous speculation that Belgium was next on the French nursing home’s divestment list from a €1.2bn chunk of its real estate portfolio. [+]
Dutch care staff awarded pay hikes to compete with temp agencies
In a bid to compete with temporary agencies, elderly care staff in the Netherlands as set to receive salary hikes of 5% this October - with another 5% increase again in 2024. HBI speaks to one Dutch sector expert to understand the reasoning behind the move and ask if will it have the desired effect. [+]
Max Healthcare appeals Care Hospital decision
Indian hospital group Max Healthcare is appealing a court decision to reject its claim concerning Care Hospital, another Indian hospital group which it tried to acquire, which it made after the latter accepted an alternative offer from US private equity firm Blackstone. [+]
French dentistry investors could be undermined if loopholes are closed
Investment in French dentistry could be undermined if the government closes legal loopholes, an orthodontics operator tells HBI. [+]
Orpea sells in Austria and the Netherlands
The ongoing sale of significant parts of French nursing home operator Orpea’s €1.2bn real estate portfolio has expanded to Austria and the Netherlands. As newly released H1 figures show low occupancy rates in France, HBI speaks to three market experts to gauge the current state of affairs for the French giant looking to bounce back from its recent troubled history. [+]
Does PE ownership improve care?
Do private equity-owned health and care providers perform better - on quality and cost efficiency - than their public, not-for-profit and doctor-owned counterparts? A new review of the scientific evidence suggests perhaps not. [+]
Are fertility add-ons a bad idea?
In a successful fertility market, add-ons remain a controversial subject. HBI speaks to two experts with differing opinions to find out why. [+]
Interview: Annabelle Neame, VP for new markets and innovation, HCA UK
HBI catches up with Annabelle Neame, vice president for new markets and innovation at top five UK hospital player HCA UK, and hears how HCA and others are using concierge services to help tourists navigate tricky foreign patient pathways as London is increasingly “more on the map” for health care tourism. [+]
Private pay grew in 2022 in NHS countries - despite cost of living crisis - Infographic
You might have expected the cost of living crisis to have halted the growth of discretionary private health care spending in 2022. But this wasn't the case in the UK, Portugal or Italy, all of which have NHS systems. By contrast, Germany, which has a Bismarckian system, did see a fall. [+]
Affidea expands in Portugal by buying two clinics
Pan-European diagnostics group Affidea has bought two outpatient clinics in Portugal, strengthening its market position in the country’s for-profit health care market. [+]
Spire boosts its imaging capabilities
Spire Healthcare, the UK’s largest for-profit hospital group, has extended its control over the patient journey with a new state-of-the-art MRI scanner worth £500,000. [+]
HBI 2023: Dentistry - what is the elixir of growth?
What is the best way to grow a dental business – is there an elixir of growth? Do you buy? Do you build? Or should you shuffle the pack and grow organically? HBI's dental partner Straumann, the world's largest implant and esthetic dentistry specialist, invited the leaders of three hugely successful businesses onto the stage at HBI 2023 to share their thoughts and expertise. [+]
Tracking health care expenditure growth - Infographic
In the following infographics we look at OECD data illustrating how health care expenditure has changed over the past few years across several European countries. These three examples show quite different patterns of expenditure growth. [+]
Cybersecurity: Four things operators must do
Cybersecurity is important for healthcare. Data and system breaches could take away patient privacy, destroy their trust in much-needed data collection, cost a bucketload of ransom money or even risk patients’ lives. So what can operators do to protect their data? Here are 4 things we’ve learned from talking to experts recently. [+]
$1.5bn Ramsay Sime Darby for sale (again)
Ramsay Sime Darby, the South East Asian branch of multinational Australian hospital giant Ramsay, is up for sale again. The owners are reportedly seeking a valuation of around $1.5bn, which would make it the largest health care deal in the South East Asian region since 2019. [+]
Saudi crackdown will shut businesses as new path paved for investors
The Saudi Arabian government is overhauling the regulatory regime governing its health care sector to make way for the huge amounts of private investment needed to deliver ambitious growth targets. As well as simplifying laws governing private ownership and foreign investment, it is increasing auditing checks on providers - and closing hundreds of sites that don’t meet health standards. [+]
Spanish hospitals embrace organic growth opportunities
The M&A market remain mostly shut and operators are looking to organic growth instead. HBI speaks to a Spanish analyst who explains how this looks in the hospital sector. [+]
Interview: Dr. Nadine Hachach-Haram, CEO and Founder, Proximie
HBI catches up with Dr. Nadine Hachach-Haram, the CEO and founder of global health technology platform Proximie to hear about how MedTech can improve surgical education and performance, address variations in quality of care, and bring the operating theatre into the 21st century. [+]
HBI 2023: Healthcare Data and the Emergence of Artificial Intelligence: What’s Next?
The hype around artificial intelligence may have reached a new high, but the tools certainly aren’t recent. At HBI 2023, L.E.K. Consulting’s digital health lead Klaus Boehncke and L.E.K. partner Guillaume Duparc shared their perspectives on concerns around privacy and the adoption of AI, as well as advice on how to leverage data effectively. [+]
What operators must do to protect against cyberattacks in the wake of HCA
In the aftermath of the cyberattack against US hospital group HCA, HBI talks to two cybersecurity providers to find out how worried operators, investors and patients should be. [+]
IK Partners completes take-private of Medica
PE firm IK Partners has completed its €271m acquisition of Medica, the UK’s largest teleradiology company, taking it off the stock market. [+]
HBI 2023 Panel: Building Population Health Management Solutions
University hospitals are helping to create a more holistic, 360° understanding of the patient experience. With increasing needs and static budgets, population health management could be the only way forward. A panel at HBI 2023 considered the options. [+]
HBI 2023 Panel: Opportunities in Nursing Homes
As ageing populations collide with a shrinking workforce, nursing homes face an uncertain future. Covid thrust this oft taken-for-granted sector into the spotlight and in the wake of recent scandals in France, three experts weighed in on opportunities and trends in nursing homes at HBI 2023. [+]
HBI 2023 Panel: This time it's personal: rethinking patient pathways
When we talk about personalised medicine, we often hear about the therapy component, but less so about the service element of care. In an HBI 2023 panel entitled ‘This time it's personal: rethinking patient pathways’ speakers argued that's exactly where personalisation should be occurring. [+]
HBI 2023: Predictive medicine and fear of the machine
“You wouldn’t manage your car by driving until it broke – so why would you manage yourself by waiting for pain and discomfort?” Ran Balicer asked at the HBI 2023 keynote ‘What is Possible Today?’. But while predictive medicine is common sense, there is still a fear of the machine. [+]
FMC shareholders vote to deconsolidate
Fresenius Medical Care (FMC) shareholders have voted in favour of the dialysis group’s deconsolidation by a 99.88% majority. [+]
HBI 2023: Managing your costs in challenging times
Rising costs from inflation, wages, and energy are indiscriminately hitting the health care sector and despite government support packages being pledged, the road ahead looks arduous. So how do providers control costs, and what are the strategies to keep costs at bay? [+]
HBI 2023: Models that cover more people
Insurers are making fundamental changes to health care delivery. A lively discussion at HBI 2023 explored the changing relationship between private medical insurance, the providers who are delivering new models, and the rise of employee paid insurance. [+]
75 years on: is the future of the NHS private?
The UK NHS was once globally revered, but cracks are showing as it marks seventy-five years and a question mark hangs over its future. HBI asks half a dozen experts what role for-profits have in its future - and whether it will it last another 75 years. [+]
Interview: Tom Whicher, DrDoctor
Tackling no-shows is a key part of better utilising NHS capacity. HBI speaks to Tom Whicher, founder of NHS-facing technology platform DrDoctor to find out how it can be done. [+]
Eugin sale "imminent"
Germany-based healthcare conglomerate Fresenius’ restructuring plans seem to be gathering steam, as HBI hears the sale of its Spain-based fertility clinic Eugin is imminent. [+]
Has the demand for self-funding recovered in UK care homes? - Infographic
Data from the UK office for national statistics (ONS) showed the percentage of residents self-funding nursing home care dropped in 2021/22 due to the pandemic. Recovery has been mixed. [+]
Fertility for sale - why profitable assets are coming to market
An ex-employee of hospital group Circle BMI described its former fertility asset as “a nice little profitable part of the business”. And yet all the UK hospital groups are selling them off. Why? [+]
HBI 2023 Panel: Opportunities in Mental Health
As the world faces a mental health crisis, a panel at HBI 2023 discussed the impact telehealth and digital therapeutics have on the sector. But with growing demand and a lack of capacity, to what extent can a crisis of global proportions be tackled? [+]
HBI 2023 Panel: The Homecare Technology Revolution
When election seasons roll around, reforming social care is often allegedly at the top of party agendas, yet care systems across Europe remain chronically underfunded and under stress. In an HBI 2023 panel entitled ‘The homecare technology revolution’, three business founders shared how technology and their business models are disrupting the home care sector. [+]
HBI 2023: AI and Big Data - cutting diagnosis to treatment times
AI and big data are primed to improve clinical outcomes and standards for radiologists as well as the health care as a whole, but how far along the journey to automated care delivery are we? In an HBI 2023 panel discussion ‘AI and Big Data: Outcomes and Automation,’ panellists explored how automation could speed up diagnosis to treatment from 2 weeks to 15 minutes. [+]
HM Hospitales reports strong FY22
Unlisted Spanish hospital group HM Hospitales’ announced its FY22 results which saw revenue up 7.5% to €617m, as groups battle for second place in the market. [+]
HBI 2023: The outpatient differential
For years there has been a trend towards using outpatient services wherever possible - to improve patient outcomes, to better use an increasingly scarce workforce, and to increase cost efficiency. On the “Outpatient differential” panel at HBI 2023, how this push looks across the world was a key topic for discussion. [+]
HBI 2023: Opportunities for integrated women's healthcare
“There are so many other areas in women’s health, beyond fertility, where funding isn’t developed”. Katya Zubareva, a partner at L.E.K. Consulting kicked off HBI 2023’s “Investment opportunity in fertility and women’s health” panel with a fascinating question: why is women’s health hyper focused on fertility? [+]
HBI 2023: Big opportunities in the UK and Ireland
Speakers at HBI 2023's 'Investing in the UK and Ireland' panel were hugely optimistic about the investment opportunities in the UK and Ireland. [+]
HBI 2023: Dental models that benefit both customers and clinicians
Outpatient models have the ability to lower barriers for customers through location, opening hours and convenience - but what do clinicians make of changes designed to keep patients happy - and how do operators keep key staff onboard? [+]
HBI 2023: Is self-testing the future?
During the Covid pandemic everyone had to get used to self-testing at home on a regular basis. Speakers on the ‘Laboratory diagnostics - where after Covid?’ panel at HBI 2023 said we will likely be doing a lot more at-home testing in the future, but that it won’t replace in-clinic testing. [+]
HBI 2023: The shape of things to come
In the future health care will be much more consumer-centric, personalised and outpatient-heavy. Speakers on a panel at HBI 2023 entitled ‘The shape of things to come’ explained how digitisation, data and new types of medtech are already beginning to move things in this direction. [+]
HBI 2023: The evolution in primary care
There is a unique opportunity in the primary care sector to build a more efficient, effective and prevention-oriented health care system. Panellists at HBI 2023’s ‘The evolution in primary care panel’, explained that many of the tools needed to do so already exist. [+]
HBI 2023 Panel: Opportunities in Oncology
Oncology has come a long way in just a few decades to the point where cancer care is increasingly understood as a chronic condition, but more capacity is still needed. At HBI 2023, oncology panelists debated where the best opportunities for growth in the sector lie. Here were some of the takeaways: [+]
HBI 2023 fireside chat: Women in Healthcare
A whopping 80% of the healthcare workforce is made up of women, but senior leadership level that figure drops down to 20%. As part of HBI’s Women in Healthcare initiative, partner at L.E.K. Consulting Katya Zubareva shared her experiences with an audience of attendees and addressed the unique challenges women in leadership often face. [+]
HBI 2023 Panel: Seeking Efficiency: How Tech is Impacting Operations
Between resource shortages and growing waiting lists, efficient operations are hard to maintain. In HBI 2023’s panel discussion, “Seeking efficiency: how tech is impacting operations”, a panel explored how tech is an invaluable investment in the future of care. [+]
HBI 2023 Panel: Investing in Healthcare Property
With energy prices soaring, material costs rising, and care increasingly turning digitised, panellists at HBI 2023 London explored what investment in brick and mortar looks like in the current climate as part of a session titled ‘investing in healthcare property’. Here we highlight the four key takeaways from the session. [+]
The fall of Babylon
Telehealth company Babylon will be merged with digital neurotherapy company MindMaze and taken private by its creditors. HBI catches up with two digital health experts to discuss what happened to Babylon and what the sorry saga means for the market. [+]
The families at the heart of Italian health care
Italian industrialists have a penchant for investing in health care services. And it is striking how many of the major groups in Italy are controlled by wealthy families. [+]
HBI 2023: Healthcare regulation - opportunities and risks
Regulatory changes are one of the major concerns among players in healthcare services. A busy panel of lawyers, operators and investors considered this thorny issue at HBI 2023, with a general feeling that even the strictest of regulations can provide some kind of opportunity, and that private funding is so essential a component in health care today, it cannot be legislated away. [+]
HBI 2023 Keynote: How to partner better
What does effective partnering look like? In a keynote session at HBI 2023 entitled ‘How to partner better’, Neil Wright, commercial director at Guy’s and St Thomas NHS Foundation Trust shared his experiences. [+]
How US university hospitals are buying or building primary care
In the US, firms like Amazon have been looking to dominate the patient journey, a move which seems unconscionable in Europe. To understand this culture shock, HBI spoke to a US-based university hospital operator. [+]
HBI 2023: Solving the workforce puzzle
The workforce shortage affects all types of service providers, but not all groups deal with it in the same way. HBI 2023 heard the views of operators from a radiotherapy group, a hospital group, and a social services organisation on "how to solve the workforce puzzle”. [+]
HBI 2023: Major opportunity in German dentistry despite reform uncertainty
Despite the uncertainty around regulatory reform, there are still significant opportunities in the German outpatient market, according to speakers on the ‘Investing in DACH’ panel at HBI 2023. Dentistry, which isn’t subject to the same regulatory restrictions as other outpatient specialities, presents a particularly big opportunity. [+]
HBI 2023: How the private sector can help Ukraine's health recovery
The private sector will be vital as Ukraine's health service is restored, but there are some caveats, as panellists as HBI 2023 discussed. [+]
Humana wins appeal against licence revocation
Pan-Nordic care company Humana Group has succeeded with an appeal against the decision by Sweden's health care inspectorate to revoke its licence. The company's share price shot up 48% after the announcement. [+]
HBI 2023: How to build a massive data platform
Building massive data platforms is a great way for university hospitals to take advantage of all their research – but how can they get the best value from them? The panellists on the “Building massive data platforms” session at HBI 2023 shared their thoughts. [+]
HBI 2023: Partnership challenges and value
Overburdened public health services are in dire need of help which the private sector could provide, but politicians can be hesitant. The ‘Building value through partnerships’ panel at HBI 2023 explored why. [+]
HBI 2023: How digital can add value
Digital tools can add value by improving operational efficiency and reducing costs, as well as by improving access and convenience for the patient. Panellists on the ‘Building the best model for digital’ panel at HBI 2023 stressed that it's important to get implementation right. Business leaders must have a clear vision of what they want to get out of the tools. [+]
HBI 2023: Saudi opportunity "best you could get"
The scepticism which used to exist about whether the Saudi government would follow through on its ambitious moonshot projects appears to be dissipating. Investors are now increasingly confident - and enthusiastic - about the opportunities presented by one of the most rapidly developing economies in the world. This was the overwhelming message from speakers on the ‘Investing in MENA’ panel at HBI 2023. [+]
HBI 2023 Panel: Investing in Emerging Markets
Emerging markets present opportunities you wouldn't find in more established geographies. In a panel entitled ‘investing in emerging markets’ at HBI 2023 in London, panellists explored where the most potential for investment in emerging markets lies. The main takeaways were: [+]
HBI 2023: Challenges and solutions in population health partnering
Partnering is all about finding the win-wins, and it seems obvious that population health management and genetic testing should be a win-win scenario. But the “Challenges and solutions” panel at HBI 2023 explored how difficult it can be to create a collaborative culture, get politicians to listen, and get systems to work effectively. [+]
Interview: Mark Ugbomah, Chief Technology Officer at AfyA Care and Co-Founder, CEO at Octosoft
Healthcare delivery in Nigeria is extremely fragmented. At HBI London 2023, we caught up with the chief technology officer of investor AfyA Care, and CEO of health-tech start-up Octosoft - Mark Ugbomah - to hear about plans to create more vertically integrated healthcare institutions in the region. [+]
Is Orpea set to sell up in Belgium?
Multiple sources tell HBI that French nursing home operator Orpea is looking to sell up in Belgium, as it looks to sell off a chunk of its 1.2bn real estate portfolio. HBI also hears more speculation on the ongoing country-by-country review. [+]
Is it good business to do good?
At a session on ESG at HBI 2023 ('Building a robust ESG framework') all panellists appeared to be on board with the idea that adopting serious ESG strategies is not only good for society and the planet, it's also ultimately good for the business itself and its shareholders. Companies need to shift from thinking of it as a burdensome cost to thinking of it as a necessary investment. Is this true? [+]
Sonic buying Synlab’s Swiss operations
Australian multinational labs group Sonic is acquiring the Swiss branch of competitor Synlab, for 150m CHF (€154m). [+]
PP in Valencia defends Alzira model
For-profit hospital group Ribera Salud says that having won the May 2023 elections, the new Partido Popular (PP) administration in Valencia is keen to protect and grow the Alzira model that was being dismantled by the previous leftist government. Meanwhile, Ribera is growing in the Middle East. [+]
Penta's fight with Slovak government continues
The Slovak government is refusing to allow the state-owned National Health Insurance Fund (NHIF) to pay for any treatments at Bory Hospital - the new €250m, 400-bed facility that Penta Hospitals International (owned by Penta Investments) has recently opened in Bratislava. The refusal marks another round in the battle between Penta and the Slovak state. [+]
HBI 2023: Market conditions making minority stakes and public-to-private more attractive
Investors in Europe’s health care sector are increasingly looking at minority stakes and public-to-private deals in the face of market uncertainty and unfavourable debt financing conditions, according to speakers on the Investing in Europe panel at HBI 2023. [+]
Interview: Dr Marta Jansa Perez, Bridge Clinic
Demand for fertility is rising, but access can still be difficult. HBI speaks to Dr Marta Jansa Perez, director of embryology at low-cost UK fertility provider Bridge Clinic, to find out what can be done. [+]
Flagler seeks European investments
US-based healthcare real estate investment company Flagler Healthcare Investments is eyeing up opportunities in the big five European markets. Undeterred by high levels of regulation and hyper fragmentation, the German market is of particular interest. [+]
Health care real estate investors focusing on small all-equity acquisitions
High borrowing costs are making large scale health care real estate acquisitions funded by debt unprofitable in Europe, according to a consultant we spoke to at HBI 2023. Instead, investors are concentrating on smaller acquisitions financed purely by cash. [+]
EDG "will want to keep buying small clinics"
Pan-European dental group EDG will likely want to keep buying to keep the asset interesting once M&A markets resume, according to a banking source. [+]
HBI 2023: ESG initiatives can align with other business goals
“Doing good is good for business,” said Thomas Rajzbaum, partner at Swedish private equity investment firm EQT Partners, in a succinct summary of the overwhelming sentiment of all the speakers on the ‘Building a robust ESG framework’ panel at HBI 2023. [+]
HBI 2023: The arid M&A landscape
“Normally I begin by presenting lots of M&A activity over the past 12 months and a rosy outlook,” Hedley Goldberg, managing director at multinational investment bank and financial services company Rothschild & Co., told delegates at the M&A Landscape plenary session at HBI 2023, “but today is not that day.” [+]
Preventive health "needs good data, not more advanced AI"
The rapid advances in AI over the past year are not improving the predictive capabilities of health care providers delivering a preventive model of health care, according to Ran Balicer, chief innovation officer at Israeli health care group Clalit Health. New generative AI models have a lot of potential, but also a lot of issues. And older AI models provide plenty of predictive power. The key to unlocking preventive health care is access to good quality data. [+]
Diagnostic groups to take on the Greek government
The big Greek for-profit health care groups are forming a national association to take on the Greek government which continues after a decade to claw back yearly a percentage of their profits. Meanwhile an investor tells us that the French government is worried there may be similar moves in France where labs are seeking to negotiate a new three-year price deal. [+]
San Donato expands in the Middle East
San Donato, the largest Italian hospital group, continues to expand in the Middle East under the influence of Kamel Ghribi, the Tunisian entrepreneur who has deep links with the Rotelli family who own the business. But sources say moves to find a minority investor in San Donato have ended. President Paolo Rotelli said the group was taking a sabbatical from investing in 2023 after spending nearly €500m on new hospitals. [+]
Organic growth more attractive than M&A - Infographic
This week we share some fascinating data from Hedley Goldberg, managing director at Rothschild & Co, which was presented in the 2023 healthcare M&A landscape panel at HBI 2023. [+]
17 things we learned at HBI 2023: Our key insights and takeaways
Our annual conference took place earlier this week in London. Over a jam-packed three days of HBI 2023, an impressive array of delegates from across Europe and beyond gathered in the heart of London and shared their insights into the myriad challenges and abundant opportunities the sector faces, and offered their views on how some of them might be addressed. Here are some of our key takeaways. [+]
Mozaic launches sustainable healthcare fund
European real estate asset manager MoZaïC Asset Management announced the launch of its sustainable healthcare fund this week at HBI 2023 - the target value sitting at €500 million. [+]
Opportunities in Italian dentistry
Italian dentistry patients are seeking cheaper treatment abroad – but HBI hears there is a big opportunity for Italian consolidators who can push prices down at home. [+]
Public funding of fertility in Ireland imminent after six year delay
It has been a long time coming, but HBI hears that the Irish fertility market is set to open up in September of this year as the Irish government funds fertility treatment for the first time. [+]
Is there any need to panic over South African NHI?
Last week HBI reported on the South African parliament approving a national / statutory health insurance scheme, which would bring universal healthcare to the rainbow nation at the expense of private providers. HBI speaks to a South African operator to find out how this may affect them. [+]
Small practices in Germany looking for quick sale ahead of legislation
A glut of small outpatient clinics in Germany are coming to market as uncertainty grows over the nature of the reforms which federal Minister for Health Karl Lauterbach may be able to pass - but there are questions about the limits of Lauterbach's power. [+]
Why assisted living growth has stalled
Growth in the assisted living sector has stalled in the last year, as the cost of new developments has become prohibitively expensive. A delegate at HBI 2023 told us that many projects across Europe have been left half built. [+]
Interview: Dr Sridevi Kalidindi, Klip Global
HBI speaks to Dr Sridevi Kalidindi, a national award winning consultant psychiatrist and founder of Klip Global, a digital health startup in the UK which helps employees improve their wellbeing and reduce burnout through a mobile app. [+]
Why are countries ignoring the WHO ‘red list’?
In March, the World Health Organisation published an updated list of 55 countries that have reached a critical point when it comes to shortages in their health care workforces. The implication - or ‘recommendation’ - is that wealthier western nations in particular need to cool it when it comes to actively recruiting nurses and doctors from selected countries. [+]
Where to look for green shoots in health care M&A
M&A in European health care has been almost at a standstill in H1 2023, as the chasm between the price expectations of buyers and sellers has grown. HBI asks if the prospects look better for H2 and beyond, with the help of market experts. [+]
Which countries are spending the most on preventive care? - Infographic
In this week's infographic we look at OECD data for expenditure on preventive care across 41 countries. [+]
South Africa votes for SHI at expense of private care
South Africa's parliament has voted for a new health insurance bill which will pave the way towards universal healthcare – at the expense of private care. [+]
Ukraine Minister of Health Recovery to speak at HBI 2023
Ukraine has big plans to leverage the for-profit sector to rebuild its shattered health care system after the war. Oleksii Iaremenko, Head of Health Recovery at the Ukraine Ministry of Health is speaking at HBI 2023, June 19-21. Meanwhile we talk to fellow panelist Mark Hellowell, an academic at the University of Edinburgh who with the EBRD is sitting alongside Iaremenko on the Ukraine panel. [+]
Stockholm’s plan to reduce patient choice may increase queues and private pay
The government of the region of Stockholm in Sweden wants to reduce the choice of health care providers patients currently enjoy in secondary care. The government says the move will save money, but private providers are concerned it will be damaging to patient access and efficiency, and could force more people to take out private insurance. [+]
Orpea-tunity in Italian nursing homes?
As French nursing home operator Orpea considers which countries it might exit, sources are speculating that Italy could be on its hitlist. If that happens, opportunities could open up for middle size players to make their mark. HBI speaks to two market experts to find out more. [+]
Robotic surgery on the rise
Robotic surgery is on the rise and increasingly being deployed for less invasive and more precise surgery. HBI speaks to a consultant (and robot enthusiast) to find out more. [+]
Interview: Biju Mohandas, Partner and Global co-leader for Health Investments, LeapFrog Investments
HBI talks to Biju Mohandas, partner and global co-leader for healthcare investments at global impact investor LeapFrog Investments, about investment strategy, increased localisation of supply chains, and the opportunities and the risks of artificial intelligence. [+]
AXA IM Alts enters nursing home market in Italy
Global asset manager AXA's investment arm, AXA IM Alts, has entered the Italian market with the forward-purchase of a six-asset portfolio from real estate management company Namira. [+]
Markets in Middle East and India on brink of maturity
The private healthcare markets in major Indian and middle eastern cities are on the brink of becoming mature according to a consulting source, and this will require operators and investors to take a different approach. [+]
Bupa partners with Ascenti
Multinational insurance giant Bupa has partnered with Ascenti, a UK post-acute rehabilitation provider, to offer physiotherapy services for members. [+]
A tough first half
Deal volume in health care was massively down in the six months to June 2023. Will it get better and where? [+]
Silverline evicted after missing rent
UK-based Impact Healthcare REIT has ended a deal with care home operator Silverline Group after the latter failed to pay its contractual rent for two quarters. It is transferring the operations of all homes formerly let to Silverline to an affiliate of an existing tenant, Melrose Holdings Ltd, with immediate effect. [+]
Luz Saude's owner aiming to raise €300m+ in IPO
The owner of Portuguese hospital chain Luz Saude is looking to raise at least €300m in an initial public offering (IPO) of the group. [+]
How worried should we be about AI?
As public health experts, governments, and the WHO ask questions about the risks posed by AI, HBI speaks to two market experts. Should we be concerned or optimistic about its increasing use, specifically in health care? [+]
Sanitas and Generali face court action over Spain partnership
Spanish insurer Sanitas and Italian insurer Generali are facing court action over a patient-sharing partnership affecting Spanish providers, which allegedly violates Spain’s competition rules. [+]
UK middle market set to boom
The growing self-pay middle market in the UK is set to boom off the back of continuing NHS struggles, and patients' increasing willingness to pay for affordable alternatives. HBI speaks to multiple sources and hears groups accustomed to NHF tariff work could benefit most. [+]
German investor ban would have "huge impact" on radiotherapy
Plans to ban indirect private equity ownership of MVZ outpatient facilities in Germany would have a huge impact on radiotherapy according to an operator source and panellist at HBI 2023. [+]
Orpea draws €200m from new financing
Headline grabbing French nursing home giant Orpea has made a drawdown of €200m from new financing, as it tries to restructure after a difficult 18 months. [+]
India continues to boom
India is continuing to buck the global trend of slow deal activity in 2023, with multiple major health care services deals in process. [+]
Ribera CEO positive about Alzira future
Last week we reported how the result of the recent elections in Valencia means the Alzira model may yet survive in Spain. We speak to the CEO of the hospital group which pioneered that model to see what he thinks might happen next. [+]
AI is in dire need of regulation
From silicon valley to national legislatures, debates around the impact artificial intelligence could have on the future of humanity seem to have reached a new fever pitch in recent weeks. [+]
Interview: Jennifer Gendron, Koa Health
HBI speaks to Jennifer Gendron, Global Chief Commercial Officer at digital mental health company Koa Health. Gendron tells us about the digital well-being service Koa Health offers, the new partnership the company has made with global medical and travel risk services provider International SOS, and how this will advance the company’s long-term vision of making personalised, user-friendly mental health tools available for all. [+]
GenesisCare in the US files for bankruptcy
GenesisCare, the radiotherapy group with operations in the US, UK, Australia and Spain, has filed for voluntary reorganisation under chapter 11 of the US bankruptcy code and will look to sell off its US assets. HBI speaks to an advisory source to find out more. [+]
Sweden wants to bring health care system under national government control
Sweden’s government wants to place the country’s health care system under greater central government control. We speak to two Swedish health care experts to find out what this could mean. [+]
Valencian elections hint at the resurrection of Alzira
The leftist government of Valencia has been routed in regional elections. Could this mean a restoration of the out-of-favour Alzira model of public-private partnership (PPP) hospitals? HBI speak to a consultant source to find out more. [+]
Low key Latvia sale kicks off Orpea refocusing
Last week, French nursing home operator Orpea initiated the start of the partial sale of its €1.2bn real estate portfolio, commencing with its Latvian presence - a singular retirement home in Riva. This low key sale marks the first small step in a major three-year plan to refocus its geographies. HBI speaks to a market expert to find out more. [+]
Changes at the top of Runwood Homes
Three members of the senior leadership team at UK nursing home operator Runwood Homes departed the firm last month. COO Lorraine McGarry-Wall, CFO Phillip Thomas, and CEO Jeremy Richardson had all been appointed as directors of the company within the last 12 months. [+]
Market welcomes Apollo hospitals strong FY23 results
Indian hospital group Apollo had a strong showing for its FY23 results, which saw shares in the listed group surge. [+]
Interview: Rahma Samow, global head dental services organization, Straumann Group
Ahead of HBI 2023 next month, we catch up with dentistry panelist Rahma Samow, EVP dental services organizations at Straumann Group, to find out more about her role and the trends surrounding oral health and their impact on enterprise DSOs globally. [+]
Interview: Jason Powell, Co-CEO, UK Vein Clinic Group
We look at how to build a dynamic, low-cost outpatient chain which delivers high quality care and at the UK venous market more generally with Jason Powell, whose UK Vein Clinic Group looks set to grow revenue 50% in 2024, after doubling sales in 2023. [+]
Dutch competition authority gets reined in again
The Netherlands’ activist competition authority has been reined in again. The acquisition of dermatology specialist Mauritskliniek by hospital group Bergman Clinics is no longer barred, after another reversal by a judge. However, the decision is moot, as Mauritskliniek has already been bought by German cosmetic surgery provider Corius Gruppe. [+]
UK private pay growing, but self-pay declines slightly - Infographic
The Private Health Information Network (PHIN) has released its quarterly private market update, showing private pay admissions in the UK through to Q4 2022. [+]
UK outsourcing gets bi-partisan support
Outsourcing to the for-profit sector will become an increasing fact of life in the UK. The two major parties agree it’s necessary to reduce the record-breaking elective care waiting list. A detailed report has already been prepared and is ready for publication, yet HBI understands the long awaited Outsourcing Taskforce plan is set to be released in dribs and drabs. HBI investigates. [+]
Fighting back against brain drain
Western Europe is becoming increasingly dependent on importing talent to address its workforce crisis, but there are signs of resistance to the brain drain. With Nigeria looking to introduce a mandatory domestic five-year service for all doctors, HBI speaks to a global workforce expert to see if this kind of pushback could have any lasting impact. [+]
€1bn+ Luz Saúde IPO could mark return of European health care listings
Luz Saúde, Portugal’s second largest private hospital group by revenue, is set to become a listed company once again after five years of being privately held, in an IPO which could mark the return of European health care listings. The group’s insurer owner Fidelidade plans to retain a strategic majority stake. [+]
The German hospital reforms have become a farce
When German health minister Karl Lauterbach proposed his hospital reforms, he probably imagined himself as the hero of the drama, striding across the political stage and heroically redefining an oversupplied market. Instead, increasingly he looks to have penned a farce. [+]
Lauterbach's "plan to close hospitals" will prevent hospitals closing
German health minister Karl Lauterbach’s broad hospital reform may be dissolving into farce, as he acknowledges a plan which looked designed to close unneeded hospitals could actually save them. [+]
China's new elderly care guidance will create opportunities
China has announced guidance for all provinces to establish a basic elderly care system by the year 2025, according to state-run news channel Xinhua. As the government works to address the impending demographic crisis born largely out of the country's 'one-child policy', HBI speaks to two experts from global strategy firm L.E.K. Consulting to learn more. [+]
The AI revolution in oncology
The AI revolution is coming for oncology, according to CEO Ralph Hefti who helms pan-European radiotherapy group Stingray Healthcare. We catch up with the HBI 2023 panelist to find out more. [+]
Germany looks to emerging markets for care workers
As an aging population compounds Germany’s workforce crisis, the search for staff continues to expand outside Europe. With the government launching an initiative to attract skilled care workers from Brazil and beyond, HBI speaks to two market experts to find out more. [+]
TVM Capital opens Riyadh office to expand Saudi footprint
Emerging markets-focused PE health care firm TVM Capital Healthcare is opening a new office in Riyadh, Saudi Arabia, to assist the expansion of its portfolio companies in the country. [+]
UK patients paying up to £550 for GP appointments
As the UK NHS continues to struggle, increasingly patients are turning to private primary care. HBI understands some are paying up to £550 per hour. [+]
Are some private clinicians effectively licensed drug dealers?
This week the BBC released a panorama episode entitled ‘Private ADHD Clinics Exposed’, in which it went undercover to find that three private clinics in the UK are giving out ADHD prescriptions based on a short and potentially unreliable online assessment delivered by a non-psychiatrist. Is there a wider issue that there is a perverse incentive in private health care to over diagnose and over prescribe? [+]
WHO warnings of AI in healthcare
In a report published this week by the UN agency, the WHO has raised concerns about the patient safety and potential risks associated with the use of AI language platforms simulating human interactions in healthcare. Public health experts are also calling for a pause on developments until regulations have caught up. [+]
Private ADHD clinics in the UK prescribing after online assessment
The BBC’s Panorama team has found that there are private ADHD clinics in the UK that are prescribing for ADHD based on just a short and, it says, unreliable online assessment. [+]
Another German nursing home restructuring due to financial issues
Last month Berlin-based Dorea - a subgroup of European care homes Groupe Maisons de Famille - became the latest German nursing home operator to file for restructuring due to financial difficulties. As the number of companies financially struggling ramps up at an alarming rate and in quick succession, HBI speaks to two market experts to find out what’s going on. [+]
Interview: Stephane Pichon, Your Care Consult
HBI catches up with Stephane Pichon ahead of the Investing in Health Care Property panel at HBI 2023, to discuss the dramatic changes of the past year and how this has impacted health care real estate investment, and the long term outlook for the health care sector. [+]
Top destinations for holiday dialysis - Infographic
In its recent ESG report, multinational dialysis firm Diaverum revealed the top 10 countries in Europe and internationally where patients use the group's holiday dialysis treatment. [+]
Korian says name change is “not a rebrand”
Last month leading French nursing home operator Korian announced that as of July 1, it will be adopting a new name. Going forward, parent company Korian will be known as ‘Clariane’ - a name HBI understands is designed to evoke clarity and transparency. Is this a reaction to the recent scandals engulfing the sector? Korian claims not. Our sources disagree. [+]
EDG "pulled from sale"
HBI hears the sale of Nordic-owned multinational dentist-led European Dental Group (EDG) is no longer going ahead. Multiple well-placed sources tell us more. [+]
Blackstone acquires Care Hospitals, whilst rival bidder sues
US-based PE firm Blackstone is acquiring Care Hospitals, one of India's largest hospital groups, for around $800m. Meanwhile Max Healthcare, another one of India’s largest private hospital groups and a former front-runner in the sale process, is suing Care Hospitals and its PE owner TPG, for breaching an exclusivity agreement for the sale signed in March. [+]
Is Kursana a Cinderella?
Dussmann, the big European facilities management company which also owns Kursana, the fifth largest German nursing home group, saw revenue grow 20% to €2.8 billion in 2022. The company claimed that this was “almost exclusively organic.” But the Care & Kids division which is mainly Kursana didn’t grow at all. Is it a Cinderella? [+]
UPMC continues Irish expansion
US-based multinational hospital group UPMC (University of Pittsburgh Medical Centre) has bought Irish sports medicine hospital Sports Surgery Clinic. It is the US group’s fourth hospital in Ireland. [+]
Strong growth for Synlab in final quarterly results before going private
Multinational listed labs group Synlab continues to grow its core operations as Covid testing winds down and it prepares to go private, with a healthy 10% organic revenue growth in Q1 2023. [+]
Babylon to be taken private by creditors
Shareholders in Babylon, which was worth $4.2bn at listing in October 2021, face being wiped out as it reverts to private ownership as creditor Albacore takes over. CEO and founder Ali Parsa, whose remuneration totalled $7.1m in 2022, is likely to stay on, says a legal expert who says the group could face legal action. [+]
A bientôt Korian, bonjour Clariane!
When an organisation is marred by a reputational scandal so harmful that it jeopardises the bottom line, often a corporate rebrand is the only solution. This course of action is nothing new and there are countless examples of successful makeovers across industries, and health care is no different. [+]
Dutch nursing home consolidation infographic - Infographic
The Dutch nursing care market is highly consolidated, primarily by the top for-profit French operators - namely Korian and Orpea - who have been acquiring multiple smaller Dutch operators since 2018. Five years on, the two leading French giants control over 60% of the beds in the market under various different brand names. The big two have acquired the lower tier competitors so there aren't that many targets left to acquire. This infographic is kindly supplied by Dutch healthcare consultancy Vardetun. [+]
€1bn+ German outpatient group sale to shake up market
German out-of-hospital intensive care provider Deutsche Fachpflege is reportedly up for sale, in a deal that could value the company in excess of €1bn. HBI understands other players in the sector may also be coming up for sale in the coming months. [+]
Sales rumours make Fresenius' future clearer
Germany-based health care conglomerate Fresenius’ plans for its future are becoming clearer as rumours of subsidiary sales come to the fore. [+]
Catalonia ripe for investment
Catalonia has witnessed a string of promising health-focused investments in the first quarter of 2023. [+]
Ireland's ‘Fair Deal Scheme’ for nursing homes under fire
As an Irish nursing home is pulls one of its homes out of the public funding scheme citing “extreme financial pressure”, and elements in the government appear increasingly hostile to for-profits in the sector, HBI speaks to a market expert and asks if this is a blip, or a trend. [+]
Finnish outsourcing opportunities slow to materialise
The SOTE reform to the Finnish health care system has been in place since January 1, 2023, but additional outsourcing opportunities have been slow to materialise. Operators are nonetheless convinced they are on the way. [+]
NHS England to give pharmacists right to prescribe for common ailments
NHS England is giving pharmacists the right to prescribe antibiotics for seven common ailments, in a plan that is expected to free up 15m GP appointments. [+]
Orpea restructuring: What will it look to sell?
It has been almost six months since under-fire French nursing home giant Orpea announced plans to get its core business back on track, restructure its debt, and sell around €1.2bn worth of real estate over the next three years. As discussions separating the wheat from the chaff go on behind closed doors, HBI asks three experts where, and what it might sell, and reviews what other French operators like Korian are doing to repair reputation. [+]
Why there is no quick fix for German healthcare
At times, it can feel like healthcare reform moves at the pace of an oil tanker, and currently, nowhere is this more true than in Germany. Among the issues holding the EU5 market back are an allergy to digitalisation, an inability to make unpopular decisions, and the rigidity of roles in the medical profession. [+]
Finnish healthcare looks strong despite big groups' mixed results
On first glance the Q1 reports for Finnish groups Pihlajalinna and Terveystalo present a mixed look at the state of the for-profit market in Finland – but this couldn’t be further from the truth. [+]
Challenges and opportunities in Italian imaging
HBI catches up with an operator in the Italian imaging market to discuss some of the major challenges and opportunities the sector faces. [+]
CQC in UK ramps up prosecutions - and penalties - post Covid
UK healthcare watchdog the Care Quality Commission (CQC) has ramped up its prosecutions post Covid, with the average penalty increasing by 242% - from £160,000 pre-pandemic (2017-2019) to £550,000 post-pandemic (2020-2022). [+]
Inflexibility and data protection holding Germany back
Role rigidity in German hospitals and data protection laws are holding Germany back, according to a professor at a university hospital. HBI speaks to a workforce expert to find out more. [+]
More strikes on the way in Finland and Croatia
As the global health care workforce crisis shows no signs of slowing, HBI looks at what is happening in Finland and Croatia, where industrial action is underway. [+]
Activist Dutch competition authority gets reigned in
Last year we reported that The Netherlands’ competition authority was becoming increasingly activist in blocking health care mergers. But two recent decisions, one from the government and one from a judge, call into question the extent to which it can do this. [+]
Sonic continues consolidation of German labs with another acquisition
Multinational Australian labs group Sonic is acquiring regional German labs group Medical Laboratories Duesseldorf (MLD), in its second acquisition in the sector in the space of one month. [+]
German hospital reforms "breach constitution" - but some hospitals will close
German health minister Karl Lauterbach’s controversial hospital reforms have hit another bump in the road, with a new 144 page legal report stating the proposals are outside of the federal government's jurisdiction - and against the constitution. [+]
UK healthcare property market healthy, despite headwinds
According to global property consultant Knight Frank, the UK healthcare property market saw significant transaction volumes closing at circa £2.4bn in 2022 despite political instability, with overseas capital accounting for 31% of transaction volume due to a mix of European and American capital being deployed into various care assets. [+]
Spanish PMI boost as government tries workforce fix
Continued inefficiencies in the Spanish NHS continue to drive an increased uptake in private medical insurance (PMI), as the government tries to patch up an under par public workforce. [+]
Bismarckian systems tend to pay nurses better than NHS systems - Infographic
In this week's infographic we look at data on average nursing salaries across several European countries, categorised by whether they have Bismarckian/statutory insurance systems or NHS systems. [+]
UK CQC strike escalates - inspections could be delayed
Hundreds of staff at UK government watchdog the Care Quality Commission (CQC) have voted for further industrial action amid an ongoing dispute over pay. A one-day strike took place last week on Monday, April 17 and another is expected to happen next week on Tuesday, May 2. [+]
Flemish government wants to ban profit on care-giving
The Flemish government wants to ban profit-making from care-giving in the nursing home sector in the Flemish region of Belgium. [+]
Is any German nursing home truly safe from bankruptcy?
The nursing home industry in Germany has been rocked by a spate of bankruptcies in recent months. As another operator bites the dust, it has left many wondering - are more to come? HBI speaks to two market experts to decipher whether the ‘once is a mistake, twice is a coincidence, three times is a pattern’ adage holds any water. [+]
IK Partners to take UK teleradiology provider Medica private
Listed UK-based teleradiology provider Medica is being taken private by PE firm IK Investment Partners, which has made an offer of £269m to buy all of the group’s shares. Medica has accepted the offer, which was 32.4% higher than the group’s average market cap over the past three months. [+]
Interview: Dr. Francois Sarkozy, Président FSNB Health & Care, Founder of Tous pour la Sante.tv
What is the trajectory of healthcare reform in France? And what opportunities and threats does that pose for the for-profit sector? Is outsourcing likely to increase? …Who better to answer this than Dr Francois Sarkozy, whose strategy consultancy covers everything from market access through to public affairs. [+]
What the Marie Celeste NHS feels like today
Mansfield Advisers recent research showed that whilst the number of doctors and nurses working for the NHS has risen by 15% since 2019 and the Covid pandemic, the actual volume of work has fallen to 90% of the levels in 2019. What does that really feel like? [+]
Unilabs consolidates Dutch labs by acquiring Atalmedial
Multinational Swiss labs giant Unilabs is consolidating its position in the Dutch labs market by acquiring Atalmedial, one of the largest national players. [+]
The confused politics of health care
Regular HBI readers understand the widely-held belief that in health care “for-profit = bad” is far from the whole story - and often not a part of it. But it is worth pondering where this view comes from, and disentangling the various assumptions which underlie it, in order to separate ideas which have some justification from those that are confused, or even outright inconsistent. [+]
Amanat loses a CEO, and gains a platform
UAE-based listed health care and education investment firm Amanat Holdings has had an interesting few weeks. First, its high-flying CEO departed the group, allegedly by mutual consent - but without an immediate successor. Now Amanat has announced it is consolidating its healthcare assets into a single platform. [+]
Swiss premium rise will not benefit operators
Despite 2023 seeing the highest premium increase in over a decade, the price of Switzerland’s compulsory insurance is likely to rise again in 2024. Swiss operators tell HBI they aren’t getting help to deal with inflation. [+]
Interview: David Talby, John Snow Labs
HBI speaks to David Talby, a computer scientist based in Seattle who has been working as chief technology officer at John Snow Labs, a US-based AI software company with a keen interest in natural language processing, for the past four years. [+]
Temasek buys $2bn additional stake in Manipal
Singaporean state-owned investment conglomerate Temasek is to become majority shareholder in Manipal Hospitals, one of India’s largest hospital chains, as it increases its stake from 18% to 59%. [+]
Two Korian cooks to face manslaughter charges
Two cooks working for multinational French elderly care giant Korian are being charged with manslaughter over the deaths of five elderly care residents in a food-poisoning incident which took place at one of the group’s French nursing homes in 2019. [+]
Consolidation is not the only answer: Why PE must focus on efficiency
European private equity (PE) health care investors have relied heavily on growing the scale and revenue of the companies they’ve acquired to create returns over the past decade, especially through consolidation, according to a new report by consultancy Bain & Company. But changing economic conditions may force them to pivot towards focusing on boosting margins through operational efficiency in the coming years. [+]
Mubadala-backed M42 buying Diaverum "for $2bn+"
Swedish multinational dialysis firm Diaverum is being bought by M42, a joint venture between Abu Dhabi sovereign wealth fund Mubadala Investment Co and AI firm G42, for a reported $2bn-$2.5bn. Diaverum’s CEO tells HBI the deal offers further opportunities to develop its digital strategies, and international expansion. [+]
How will AI change healthcare services?
Healthcare services companies and public health systems are looking at ways they can integrate AI into their workflows. What will the future of healthcare services look like? HBI speaks to digital health experts to find out more. [+]
More UK outsourcing on the way, and NHS crisis here to stay as doctors look abroad
The government taskforce setting out how the UK NHS will outsource more to tackle its record-breaking backlog is set to be published soon. However while the private sector is willing to help, other long-term issues like workforce and capacity mean public sector issues will persist. HBI speaks to UK healthcare sources to find out more. [+]
Why are so many European health care workers revolting?
One of the enduring themes of 2023 is the hundreds of thousands of healthcare workers across Europe taking to the streets to strike, protest, and voice their anger. [+]
Founder of DomusVi Spain to stand down
After 23 years, the former CEO and founder of elderly care specialist DomusVi Spain is leaving the group. [+]
Interview: Edward Booty, CEO, reach52
HBI catches up with Edward Booty, CEO at Singapore based health platform Reach52, to find out about growth during a pandemic, the importance of primary care, and digital health solutions. [+]
What is the solution to the German nursing crisis?
German nursing homes are struggling to attract staff in a competitive workplace, as paperwork and regulations are getting in the way. Two market experts tell HBI bureaucracy is stifling growth at a time when it is vital a pragmatic view is taken of the workforce. [+]
Practice Plus Group launches affordable self-pay offering
UK hospital operator Practice Plus Group has launched a middle-market option for self-pay at a time when the segment is growing. [+]
Medica results show familiar state of UK healthcare services
Medica, which provides teleradiology services to the UK NHS, operates in Ireland, and has a presence in the US, has released its latest financial results. The company is continuing to grow, but feeling the pinch from inflationary pressures. [+]
Digital health booming in CEE
Digital health is booming in Central and Eastern Europe (CEE), boosted by several countries in the region introducing major policy initiatives to integrate telehealth solutions and digitise their health systems. CEE-based multinational law firm Kinstellar spells this out in its latest ‘Current eHealth trends in CEE and Turkey’ report. [+]
Spanish insurer for doctors sees profit boost
A Spanish mutual insurance company which caters specifically to doctors saw its profits and uptake rise as the global health workforce crisis shows no signs of abating. [+]
Interview: Anuschka Coovadia, CEO, Usizo Advisory
HBI talks to Anuschka Coovadia, CEO at South-Africa based advisory group Usizo Advisory, about payor-provider relationships in Africa and ongoing efforts to improve healthcare coverage. [+]
German property group selling off €1.3bn portfolio
It has been almost two years since listed Germany-based healthcare property specialist Vonovia acquired its former rival Deutsche Wohnen. We speak to three Germany-based experts to find about more about the ongoing sale of its £1.3bn property portfolio. [+]
Do AI chatbots work in healthcare as well as humans? (Poll)
AI chatbots are becoming increasingly popular in the healthcare industry, and there is growing evidence to suggest that they can work just as well as humans in certain scenarios. [+]
The state of digital health policy in CEE - Infographic
CEE law firm Kinstellar has released its latest update on the state of digital health in Central and Eastern Europe. The April 2023 version of 'Current e-Health trends in CEE and Turkey' focuses primarily on the state of policy and regulation on digital health across nine countries in the region. [+]
Uptake of telemedicine is higher in women in emerging markets
Telemedicine is being hailed as healthcare’s answer to the problem of access, particularly in emerging markets. But it’s women - often unintentionally - who are proving to be the most avid users of decentralized models. HBI speaks to two Africa and Asia based access experts to understand why. [+]
Deal activity bouncing back in SE Asia
Last week we wrote about an expected return to normal of M&A deal activity in Europe in Q2, after a slow few months driven by macroeconomic uncertainty. In South East Asia deal activity already appears to be returning to a healthier level, with multiple $1bn+ deals reportedly underway. [+]
Diaverum deal: An analysis
Last week the news broke that Abu Dhabi sovereign wealth fund Mubadala Investment Co might be set to buy Swedish multinational dialysis firm Diaverum for a reported $2.5bn. HBI speaks to an operator source who thinks this would be a good price for the seller - and hears why some investors are switched off by dialysis. [+]
Interview: Steven Pink, CEO, Verve Healthcare
HBI speaks to Steven Pink, CEO of London-based primary care co-op SELDOC, about a new corporate wellness spin-out called Verve Healthcare. [+]
Interview: Jose Bailey, commercial director, CHEC
UK-based and NHS focused ophthalmology group CHEC is branching out - expanding its offering, going private in Wales, and diversifying into endoscopy with new dual purpose clinics. HBI chats with Jose Bailey, commercial director, to find out more. [+]
Sonic acquires Diagnosticum
Multinational Australian labs giant Sonic is buying Diagnosticum, a medium-sized German labs chain which operates 15 laboratories and employs 25 pathologists, for €190m. [+]
Mediclinic acquisition conditional on "hidden tax" pro-bono surgery and training spend
South Africa’s competition tribunal have officially approved the acquisition of South Africa-based multinational hospital group Mediclinic, but the buyers needed to accept conditions which were less to do with competition, and more to do with the public good. [+]
The secret to REIT success: Be picky
As inflation and energy costs spiral out of control, traditional brick and mortar investments in elderly care are increasingly being perceived as potentially risky business. An award-winning Madrid-based REIT tells HBI its formula success in a difficult climate. [+]
Orpea shareholders try to avoid mass dilution
French nursing home giant Orpea’s snubbed shareholders group Concert’O has teamed up with other unsecured lenders in a last-ditch attempt to avoid mass share dilution. Protesting at the operator’s restructuring deal, the group has presented an alternative plan. [+]
Bupa Dental Care to close 85 UK practices
Bupa Dental Care, the UK’s second largest dentistry group by revenue, is closing 85 of its 450 UK practices. The group says the move was driven by difficulty in recruiting enough dentists to provide NHS care, as well as rising costs and difficulties surrounding the NHS contract model. [+]
Infographic: Life Expectancy in top 5 European Markets - Infographic
This week, HBI looks at the life expectancy of total populations in the big five Western European markets - the United Kingdom, Germany, France, Italy, and Spain - using public data from OECD. This report doesn’t include Scandinavian countries which notoriously boast the longest life expectancies on the continent. [+]
M&A set to bounce-back in Q2?
Economic uncertainty and concerns about a looming recession led to a slowdown in M&A deal flow in H2 last year. 2023 has got off to a slow start too - with a dearth of larger deals in particular. But HBI hears Q2 could see the start of the bounce back - and that even the threat of a global banking crisis isn't dampening the enthusiasm of PE firms, which have other sources of capital. [+]
UAE sovereign wealth fund "targets $2.5bn Diaverum"
Abu Dhabi sovereign wealth fund Mubadala Investment Co is considering the acquisition of $2.5bn Swedish pan-European dialysis group Diaverum, according to reports. [+]
Is the deals dam ready to burst?
Economic uncertainty and a slew of global problems led to an M&A slowdown at the end of last year, and into 2023. Could we see a flood of deals in Q2? [+]
Icade reaches agreement to sell healthcare real estate to Primonial REIM
French real estate investment trust Icade has signed an exclusivity agreement on the sale of its minority stake in Icade Santé, part of its healthcare real estate portfolio, to France-based pan-European real estate investment firm Primonial REIM, and is arranging the sale of the asset portfolio owned by Icade Healthcare Europe (IHE). [+]
French radiology and teleradiology consolidation set to heat up
The long awaited consolidation of French imaging is set to ramp up, especially in the attractive fields of radiology and teleradiology, according to French sources. [+]
Interview: Pretty Mubaiwa, Director of Corporate Affairs, Africa Resource Centre
How is it you can find Coco-Cola in remote villages in Africa, but not much needed healthcare supplies? HBI catches up with Pretty Mubaiwa, South-Africa-based director of corporate affairs at supply-chain expert advisory group the Africa Resource Center (Arc), to find out more. [+]
$1.3bn+ Ramsay Sime Darby sale revived
Ramsay Sime Darby, the South East Asian branch of multinational Australian hospital giant Ramsay, may be up for sale again. The previous sale process to Asia’s largest multinational hospital group IHH Healthcare Bhd was ditched back in September. [+]
Doctors offered substantial referral bonuses to recruit colleagues
In the increasingly competitive battle for top talent, some private hospitals in the UK - including some of the US-owned hospitals in London - are putting referral schemes worth thousands of pounds in place for doctors who refer potential colleagues to for-profit groups. Golden hellos are also being deployed. HBI speaks to London analysts and a workforce expert to find out more. [+]
Europe's biggest health care real estate deals in 2022 - Infographic
Real estate consultancy Knight Frank has released its 2022/23 UK Healthcare Property Market Overview. But don't let the name fool you - the report includes some great data from across the whole of Europe! In this week's infographic we look at major health and care real estate transactions. [+]
Controversial GPs out-of-hours system could see Hungarian doctors leave the country
The Hungarian government has increased the intensity of its attacks on the doctors association (MOK) as it seeks to enforce its out-of-hours system for GPs. This could trigger the mass exodus of Hungarian doctors, and have a knock on effect on for profit operators. [+]
Private sector nurses go on strike in Portugal for the first time
On Thursday, March 16, private sector nurses in Portugal participated in a nationwide strike for the first time in history. The union is demanding better compensation, capped working hours, and better working conditions. [+]
US$1bn merger bid between Australia's second and third largest labs groups
Two of Australia’s largest diagnostic groups by revenue may about to merge: pathology chain Australian Clinical Labs (ACL) has made a A$1.52bn (US$1.02bn) offer for Healius, a larger rival which has diagnostic imaging capacity as well. [+]
AI is about to change everything
For those old enough to remember the latter years of the 1990s, consider the following curiosity about this period: despite the Internet (or the World Wide Web, as it was known back then) being so much the rage that it led to a stock market bubble - and crash - with businesses across a range of industries expending significant resources trying to find ways to cash in on it, most ordinary people had never used it. [+]
Ultrasound the ‘biggest opportunity in UK imaging’
Ultrasound represents the biggest opportunity in diagnostic imaging in the UK market, according to a major operator in the sector. Portability, lower costs and larger volumes compared to X-ray, CT and MRI make it particularly attractive for agile for-profit providers in a sector long-dominated by the NHS. [+]
Interview: Sam Gray, Apposite Capital
London-based PE group Apposite Capital is among the most active investors in health care in Europe. HBI chats with managing partner Sam Gray about the state of the market and pricing, how he sees that changing, and the investment opportunities piquing his interest at present. [+]
The future of telehealth is partly in bricks and mortar
With Covid hopefully on the wane, the firm foothold digital health established in many markets is looking a little less stable. What next for groups like Swedish telehealth firm Kry? HBI speaks to two experts and Kry itself to find out why telehealth is getting physical. [+]
Inflow of nurses to top five European markets - Infographic
This week, HBI looks at the annual inflow of nurses from abroad to the big five Western European markets - the United Kingdom, Germany, France, Italy, and Spain - using public data from OECD. Those looking for an outlier need look no further than the UK. [+]
Watch out! Here come the heavyweight tech disrupters
HBI does not often report on deals taking place “across the pond” so when something does make our pages, it’s significant, and a portent of things to come. Amazon’s staggering $3.9bn acquisition of One Medical which we covered earlier this month certainly fits the bill in both regards. Here come the tech disrupters. [+]
Cinven looks to take Synlab private as Covid boost falters
Frankfurt-listed Synlab could be about to be taken private following a non-binding full takeover offer earlier this week. With its full year results released yesterday and facing questions about its plans, HBI asks market experts what they think of the move. [+]
Private sector price increases likely as budget offers no reprieve for UK NHS
The UK budget on Thursday, March 16, offered no reprieve for a cash-starved NHS, meaning for-profit demand is here to stay. HBI speaks to a UK-based consultant to find out more. [+]
Could Orpea's creditors derail a 'done deal'?
Orpea is trying to put a year of scandal, scrutiny, and scathing headlines behind it, but disgrunteld creditors worried about share dilution are attempting to derail its carefully crafted transformational plan. HBI speaks to a market expert to weigh up their prospects for success, and find out more. [+]
African healthcare's do it yourself plan
The pandemic exposed the fragility of supply chains in emerging markets, and their overdependence on international networks. As delegates at the IFC’s conference in Cape Town, South Africa heard last month, there is a renewed appetite in Africa for self-sufficiency and a coordinated shift towards regionalisation. [+]
Japanese investors target African health care
An increasing number of Japanese investors are looking to invest in African health care. As Africa strives to increase accessibility to care and increase insurance coverage, we speak to an investor who things the Japanese model is a good fit. [+]
EMR boost in Germany and Sweden
Sweden is looking to centralise more data – primarily to boost the efficiency of its electronic medical records (EMR). Meanwhile German health minister Karl Lauterbach is making the German patient medical records an opt-out system to boost uptake. HBI speaks to experts to find out how these developments will affect healthcare services. [+]
Max Healthcare and KKR left in the race for Care Hospitals in India
India-based hospital group Max Healthcare and PE firm KKR are the bidders still left in the race to acquire another India-based hospital group, Care Hospitals. [+]
Interview: Tony Veverka, Y1 Capital and Transform
UK-based Transform Hospital Group has gone through its own transformation recently. Historically a medical aesthetics, cosmetic and weight loss surgery-focused business, the group went into administration last year and was bought by a team including former CEO Tony Veverka who is reshaping it into a leaner, broader healthcare services provider. HBI catches up with him to find out more. [+]
Virtus grows in Denmark, targets international patients
Australia-based fertility specialist Virtus Health has a new showpiece clinic in Copenhagen. HBI hears it is targeting both locals and medical tourists, and speaks to a source to find out more about the appeal of the Danish market. [+]
Cinven looking to take Synlab private
London headquartered global PE firm Cinven has submitted a non-binding offer to fully take over Europe's largest lab group Synlab, the company confirmed today, following speculation it was looking to take the group private. [+]
Is there still fertile ground for medical tourism?
As European law homogenises and countries across the continent fall into step, does this mean an end to the once lucrative medical tourism trade enjoyed by countries with softer regulation? Perhaps surprisingly, HBI hears not completely – or at least not yet. [+]
Interview: Simon Miller, Headspace
HBI speaks to Simon Miller, Headspace’s international partner lead, about the company’s long-term vision to create a digital mental health platform offering a personalised service across a wide continuum of care. [+]
UK for-profit demand stays high as cash-starved NHS faces tough choices
For-profit demand in the UK is likely to remain high, as the UK government stalls on its plans to increase public sector capacity. HBI speaks to a UK-based consultant to find out more. [+]
FutureLife acquires again in Spain
Czechia-based fertility group FutureLife continues to expand in Spain with its latest acquisition. HBI chats with a European fertility operator to find out what is making the Spanish market appealing to investors. [+]
Ireland to fund fertility for the first time
The Irish government is set to fund fertility treatment for eligible patients for the first time. HBI speaks to an Ireland-based operator to find out more. [+]
Merger strengthens Medigold's occupational health offering
Medigold, one of the UK’s largest occupational health care providers, is acquiring Health Management, a major competitor, in a deal that will make it the UK's largest provider of occupational health in terms of number of employees covered. [+]
German PE crackdown could actually be surprise boost for bigger groups
German health minister Karl Lauterbach’s attempt to stop “locust investors” from owning outpatient facilities could actually end up benefitting large PE firms. HBI speaks to sources in Germany to find out more. [+]
Reconciling payor-provider tensions
Relationships between payors and providers can be notoriously tricky. As attendees at the recent IFC conference in Cape Town, South Africa heard, the difference is often over how value is defined - and as providers grow, the balance of power is shifting. [+]
How do university hospitals best work with medtech?
The relationship between Big Medtech and university hospitals can be tense. Often, medtech is accused of opaque pricing, of selling Ferraris to physicians, of disguising a short-termist approach based on quarterly sales targets under the banner of partnership. But is there an alternative? Here we talk to Neil Wright, commercial director at Guy's and St Thomas' NHS Foundation Trust, a major London trust, about a different, longer-term approach. [+]
KPJ Healthcare exiting Indonesia citing rules imposed on foreign operators
KPJ Healthcare Bhd, Malaysia’s second largest for-profit hospital group by revenue, is to sell its Indonesian hospital operations to rival Columbia Asia Healthcare. This will mark its exit from the country. Luxembourg-based PE firm CVC Capital Partners is reportedly considering buying a minority stake in the group. [+]
Covid put mental health in the spotlight - for a while - Infographic
In this week's infographic we look at survey data collected by digital health company Headspace for its 2022 Workforce Attitudes report. According to the data, a majority (71%) of UK employees think their company increased its focus on employee mental health in response to Covid, but only a quarter think their company has retained this focus over the past year. [+]
Spire returns to profit, but shares still fall
Shareholders did not give UK hospital group Spire’s full year results a warm reception, despite a return to profit, generally strong financials, and the continued viability of the UK market. HBI talks to market experts to find out why. [+]
Ramsay bounces back from sale saga with strong H1 results
The half-year results of Australia-based multinational hospital group Ramsay Health Care were received positively by investors as revenue, profit and EBITDA all saw a jump. [+]
Affidea-backed Fortius Clinic buys London Schoen Clinic orthopaedics hospital
Affidea subsidiary Fortius Clinic, which is the UK's largest orthopaedics company, is acquiring Schoen Clinic London, an orthopaedics hospital in central London which is part of Germany-based Schoen Clinic Group. [+]
How to plug the brain drain
A substantial part of the global workforce is born, raised and trained in emerging markets - and then promptly leaves to work elsewhere. How can you plug the brain drain? [+]
Amazon completes acquisition of One Medical for $3.9bn
Retail tech giant Amazon has completed its $3.9bn acquisition of US primary care chain One Medical, after The US Federal Trade Commission gave the deal the green light. For the first time ever, a big tech company will now be involved in the delivery of clinic-based health care services. [+]
Key themes and takeaways from the IFC's Emerging Markets conference
Last month, thought leaders from private healthcare systems across the globe gathered in Cape Town, South Africa, to network, share their findings, and consider how emerging markets can become more resilient. HBI was there, and these are our key themes and takeaways. [+]
SE Asia’s pushes to primary care - but volumes and logistics are key
Providers in Southeast Asia have made a pronounced push towards primary care in recent years - but it hasn’t been all plain sailing with logistical challenges and high costs to contend with. Singapore and the Philippines are leading the way, as attendees at the recent IFC conference in Cape Town, South Africa, heard. [+]
Government pressure could see mass resignations of Hungarian doctors
The Hungarian government has demonised the Hungarian Medical Chamber (MOK) after the doctor's union warned its members not to sign up to an on-call system for GPs. It sparks fresh concerns of a workforce exodus at a time when patients are increasingly turn to private care - and could be a boon for for-profits. [+]
Cloud-based reporting could transform diagnostic imaging
The landscape for diagnostic imaging has fundamentally changed over the last two decades, as imaging has shifted out of the hospital and teleradiology has taken off. Are cloud-based enterprise reporting platforms the answer? We speak to an enthusiastic reporting platform CEO and a more sceptical imaging operator to find out more. [+]
Biggest hospital chain in Philippines may IPO for $1bn
Metro Pacific Hospitals, the Philippines' most expansive hospital chain with 12 hospitals and seven medical centres across the country, is considering going public at a valuation of up to $1bn in a revival of a plan that was initially shelved in 2019, according to reports. [+]
Shareholders unconvinced by "future Fresenius"
Michael Sen, CEO of multinational healthcare conglomerate Fresenius, finally set out his long-awaited plan for a “Future Fresenius” at the group’s end of year results this week. But is it a radical shake up, or PR puff? HBI investigates why shareholders appear unconvinced. [+]
Which countries can claim to have universal health coverage? - Infographic
In this week's infographic we look at OECD data on health coverage across several countries and compare it to survey data on the percentage of people satisfied with the availability of quality health care in the area where they live. [+]
Anti private sentiment - winds of change, or just hot air?
This week, reforms in Germany see us taking another look at the plans of Germany’s controversial health minister Karl Lauterbach. He really doesn’t seem to be a fan of for-profit investors! Are the winds of change coming to flatten the investor landscape – or is he full of hot air? [+]
Employers driving up Scandi PMI
Despite its reputation for excellent public healthcare and an economy as close to socialist as a capitalist country can be, private medical insurance (PMI) is on the up in Scandinavia. HBI speaks to three operators to find out more. [+]
Korian share price plummets after release of 2022 results
Korian, Europe’s largest nursing home operator by revenue, has seen its share price plummet 23% after it published its full-year results on Wednesday, February 22. The results revealed a 62% fall in net profit for 2022, due largely to inflation, but analysts tell us the company faces bigger problems related to the French elderly care sector's scandal, and debt refinancing. [+]
Legal challenges may derail German investor crackdown
HBI hears German health minister Karl Lauterbach’s plan to stop “locust investors” from buying up outpatient facilities may be shot down by a double whammy of legal and political considerations. HBI speaks to a Germany-based lawyer and healthcare expert to find out more. [+]
Good growth but profit problems for Terveystalo and Attendo in 2022
Elderly care group Attendo and outpatient group Terveystalo, two pan-Nordic giants with over a billion in revenue, struggled to turn a profit in 2022. This was despite strong (organic) revenue growth, set against a backdrop of rising inflation. HBI looks at the newly released results of both groups to find out more. [+]
Interview: Saul Kornik, Founder & CEO, KENA Health and cofounder of HEALTHFORCE
HBI caught up with Saul Kornik, CEO & Founder at South-Africa-based KENA Health, at IFC’s Global Private Health Conference in Cape Town. KENA has an app which allows patients to talk directly to a nurse, doctor or mental health professional using text, voice or video. [+]
Danish outsourcing deal ‘has broad consensus’
Last week we reported that some operators had expressed concerns after the Danish government made a new outsourcing agreement with the private hospital sector. This week we hear from operators more supportive of the development, who are keen to share a different perspective. [+]
If quality comes at a price, why bother?
How much does quality matter? And how do you prioritise it when it actually costs more? This week HBI was at the IFC conference in Cape Town where there were strong views on the subject. [+]
Denmark plans hospital outsourcing hike - and tariff cuts
The Danish government has set out plans to increase its use of the private hospital sector. Those plans will see for-profit operators allowed to treat publicly-funded patients more, but also include significant tariff cuts. [+]
Covid led to massive boost in social spending - Infographic
The OECD has released new data on social spending across OECD countries, going right up to 2022. All OECD countries saw a massive increase in social spending as a result of the Covid pandemic, with social expenditure rising from around 20% to around 23% of GDP on average between 2019 and 2020. [+]
Dubai Healthcare City and Moorfield Eye Hospital Dubai to expand services
Dubai Healthcare City (DHCC) celebrated its 20th anniversary at Arab Health trade show in Dubai with an agreement with Moorfield Eye Hospital Dubai to expand its services by 20%. [+]
Mayo promises to support loss-making London centre
US-based nonprofit American academic medical centre Mayo Clinic has offered "unconditional" financial support - at least until January 31, 2024 - to its London facility, despite the latter losing millions. Meanwhile, Cleveland Clinic continues to expand in the UK capital. [+]
Interview: Norberto Jannuzzi, Partner, Patria
HBI caught up with Norberto Jannuzzi, partner at Brazil based private equity group Patria Investimentos and 'Making smart investment choices' panelist at IFC’s Global Private Health Conference in Cape Town this week. [+]
Interview: James Tugendhat, CEO, HC-One
James Tughenhadt, CEO at UK nursing home group HC-One, joined it in the eye of the Covid storm. As the UK wrestles with the largest healthcare workforce strike in recent history, he sat down with HBI to discuss the importance of investing in staff, and his group's ongoing response to the staffing crisis. [+]
For-profits under fire at massive Madrid health care protest
Several hundred thousand people participated in a protest in Madrid against the regional government’s management of the health care system on Sunday, February 12. [+]
When health care is a risky business
It seems like every week, we print a story or two which reminds us that elderly care – whether residential or homecare – can be risky business. [+]
Fresenius to deconsolidate FMC
Michael Sen, the new CEO of multinational health care conglomerate Fresenius, is making preparations to deconsolidate struggling dialysis subsidiary Fresenius Medical Care (FMC). The plans fall short of full divestment and may not be radical enough to appease investors. [+]
Over a third of 2022 health care M&A deals were in services - Infographic
M&A advisory firm Ciesco has published a review of global M&A activity in 2022 across the technology, digital, media and health care sectors. In this week's infographics we look at the split across health care sub sectors by deal volume and value. [+]
Four Seasons - still for sale, still unsold
The sales process for the remaining bulk of financially troubled UK care home operator Four Seasons' assets has not been quick. HBI speaks to a market expert and to the group's property advisors to ask why the sale is taking so long. [+]
Humana’s share price plummets after allegations
Pan-Nordic Swedish care company Humana Group has seen its share price plummet 57% since the end of January, after Sweden’s health care inspectorate temporarily revoked its licence to provide personal assistance in Sweden. [+]
Competition concerns around Portman / Dentex merger
The UK Competition and Markets Authority (CMA) has said the proposed merger between dental groups Portman Dental Care and Dentex Healthcare raises competition issues, and will be investigated further unless suitable undertakings are received. [+]
All change at the top for mydentist and DD
Tom Riall is standing down as CEO of UK-based dental group mydentist, and will take up the role of executive chairman from April 1. His replacement has been announced. [+]
Convivo facing bankrupcy
The holding company behind German nursing home operator Convivo is filing for bankruptcy. HBI understands low occupancy rates, a shortage of skilled workers and rising energy costs are among the reasons. [+]
TFP up for sale
HBI hears UK-based pan-European fertility group TFP is up for sale, and speaks to two well-placed sources to find out more. [+]
Linde healthcare sales growth down despite great results
Global chemicals company Linde reported a 1% year-on-year drop in sales growth for healthcare, despite double-digit sales growth in all its other end markets. [+]
Norwegian hospitals struggle in the face of government outsourcing hostility
The Norwegian private hospital market is stagnating because of government unwillingness to outsource care to the private sector – despite growing waiting lists for public patients. [+]
Dubai sets out its plans for value-based health care
The Dubai Health Authority (DHA) has further set out its plans to introduce a value-based model of health care across the emirate. HBI spoke to the DHA to find out more at Arab Health. [+]
Orpea strikes debt deal as CDC takes charge
After months of scandal and speculation, under-fire French elderly care group Orpea has struck a deal to restructure its debt with the help of new investors including French public sector financial institution Caisse des Dépôts (CDC). [+]
Healios expands to meet "crisis" needs
Healios, which provides digital mental health and neurodevelopmental services for young people and children in the UK, is planning major expansion in the UK in the face of unprecedented demand. [+]
Valencia: Not be as hostile to private market as feared
Spanish hospital group Imed has begun building work on its new hospital in Alicante, Valencia. But is it foolish to invest further in a region so hostile to healthcare services? HBI speaks to a Spanish consultant to find out more. [+]
Stagnant tariffs stifle innovation and could close small Italian hospitals
The head of digital transformation at Italy’s largest for-profit hospital group tells HBI stagnant NHS tariffs combined with a push towards country-wide electronic health records could force smaller players to close. [+]
UK uni hospitals unite to sell abroad
Five of the largest UK university hospitals, with a total revenue of £6.2bn, have come together to compete more effectively in the international market for hospital and medical consulting as the King’s International Consortium (KIC). But will they be able to compete with the big US academic medical centres which dominate international tertiary medicine, or with Korean and Indian players who offer lower cost and more flexible hospital management? [+]
Gap growing between public and private pay for doctors and nurses
The gap between doctors pay in the public and private sectors is rising steeply, according to international recruitment agencies. In some cases doctors are getting almost twice as much in the latter. [+]
What did we learn at Arab Health?
Four days of enjoyable mayhem milling around 3,000+ stands with 50,000+ attendees taught us a few things about the GCC health care market. [+]
Saudi boom creating billion dollar opportunities
Sources at the Arab Health exhibition confirm that the ambitious Saudi 2030 project which will see the country transfer most health care service delivery to the for-profit sector is still on. What are the implications of this? [+]
Al Borg eyes franchising and reference markets
Big Saudi lab group Al Borg plans to use franchising to grow rapidly with a consumer-led offer which includes imaging and primary care. It is also constructing two enormous reference labs in Riyad and Jeddah with the aim of seizing a market where Saudi spends billions. The group is also still eyeing a stock market listing. [+]
DomusVi robustly denies wrongdoing, while Orpea ramps up recruitment
France's third-largest elderly care operator by revenue, DomusVi, tells HBI it robustly rebuts allegations of wrongdoing made in sections of the French press this week. As rival Orpea looks to rebuild its own reputation in the face of serious allegations and fend off its creditors as its deadline looms, HBI chats to DomusVi and two French market experts to find out more. [+]
Not every NHS is created equal
As we update our hospital reports on HBI Intelligence, it becomes increasingly clear that not all NHS systems are created equal. While some systems incentivise the private sector to muck in and help out, in others, private hospitals are seen as costly alternatives to the NHS run by avaricious groups. Take the following four diverse countries: [+]
What's behind Europe's variation in excess death rates in 2022? - Infographic
In this week's infographics we look at monthly excess death rates across EU countries (plus Switzerland) throughout 2022. Surprisingly, the huge variation in excess death rates between countries is not explained by variations in the number of physicians or nurses per capita, nor in variations in health expenditure per capita, nor in variations in the proportion of private expenditure between countries. [+]
Acibadem eyes up UK opportunities
IHH-owned Turkish hospital group Acibadem has opened a contact centre in the Harley Street medical area in the UK and has an eye on market opportunities. HBI speaks to an operator and an advisor to find out more. [+]
HCA launches one number, ambulance backed acute admission service
Hospital group HCA UK has launched a 24/7 concierge and ambulance service to ease acute admissions to its four London hospitals. It says it has seen over 100% revenue growth in the last year as a result. Is it trying to provide an alternative to the crowded NHS A&E departments across the country? HBI investigates. [+]
Contrasting fortunes for Spanish and Italian hospitals reliant on public payments
Stagnant NHS tariffs are pushing Italian hospitals towards private pay, while in Spain dirt cheap PMI premiums are making the NHS more attractive. [+]
Has the RAD-x sale stalled?
The sale process for pan-European radiology group RAD-x may have stalled, with no statements on progress from any of the parties involved. A well-placed German imaging operator tells HBI that the sale will no longer go ahead, while the group itself is giving nothing away. [+]
Fleeing freelancers cause headache for Dutch elderly care groups
Nursing home employees in the Netherlands are fleeing full-time, permanent jobs in droves in pursuit of more lucrative and flexible alternatives. As operators facing stiff competition from digital freelance platforms poaching their labourforce, HBI speaks to three Dutch market experts to better understand the threat. [+]
Interview: Barry Mulholland, MBI Healthcare Technologies
Barry Mulholland is founding partner at MBI Healthcare Technologies, a UK digital health company that uses artificial intelligence (AI) to find and fix data inaccuracies in hospital administration systems. He tells us how he believes AI platforms can help solve the elective care crisis. [+]
How investors can tackle emerging market workforce issues
HBI reports this week that the number of licensed UK dentists in January 2022 was down 9.2% compared to the end of 2020. The government’s solution is, unsurprisingly, to encourage dentists from emerging markets to immigrate. However, this can sometimes leave the country of origin with a brain drain – and discourage investors who might otherwise buy a hospital group in that country. [+]
UK government targets emerging markets to end dentist drought
The dentist drought which has plagued the UK market for years looks set to end, as the government prepares to welcome a flood of qualified emerging market dentists. HBI speaks to a market expert to find out more. [+]
German labs accused of lobbying to profiteer from Covid
A group of journalists from German broadcasting companies Westdeutscher Rundfunk (WDR) and Norddeutscher Rundfunk (NDR) and German daily newspaper Süddeutsche Zeitung (SZ) has accused Germany’s private labs groups of lobbying the government in order to protect their Covid testing profits. [+]
AXA IM debuts in Spain with ESG nursing home deal
Global investment manager AXA IM Alts (the alternative investment arm of AXA IM) has joined forces with Spanish real estate investor Grupo Lar to invest in Spanish health care real estate assets, marking its launch into the Spanish health care market. [+]
Interview: Richard Storah, CFO, mydentist
HBI chats with mydentist CFO Richard Storah about the UK-based dental group’s history, its plans for 2023 and beyond, and how he sees the post-pandemic market. [+]
German reforms "could kill PE outpatient investment"
German health minister Karl Lauterbach offered a politicised Christmas present in December with an announcement he would stop “locust investors” buying up outpatient medical practices. A German VC source tells HBI this could “kill” private equity investment in German healthcare, and push innovation elsewhere. [+]
German hospital financial crisis could increase imaging / radiology outsourcing
Germany’s for-profit imaging and radiology sectors face multiple economic and regulatory threats, but could benefit from the financial crisis in the German hospital sector. HBI hears hospitals struggling to remain afloat may be more likely to outsource their imaging needs. [+]
EU approves new digi-physical primary care service in Ireland
The EU has given the green light to a joint venture between Centric Health, Ireland’s only major private primary care chain, and Irish Life Health, one of Ireland’s four private health insurers. The joint venture will provide a new digi-physical primary care service to Irish Life Health customers. [+]
French government-backed CDC could bail out Orpea - for a price
HBI hears that French public sector financial institution Caisse des Dépôts and institutional investors are willing to invest in under-fire French elderly care group Orpea - at a price. The group wants control. With time running out, three France-based analysts share their views. [+]
Public nursing home crisis could lead to privitisations
It’s been a particularly rough start to the year for public nursing homes in France. A staggering 85% of those who took part in a recent survey ended 2022 in the red and the deficit is now leading to calls for reform - and billions in additional funding from the government. HBI talks to two French market experts to find out more about what this means for the market. [+]
CVS mulls splashing $10bn+ on primary care chain
CVS, the largest pharmacy chain in the US, is reportedly considering buying listed primary care chain Oak Street Health for $10bn, as part of its strategy to gain control over the entire patient pathway. Oak Street’s shares rose 33% after the news broke on Monday, January 9, giving the company a market cap of over $7bn at the time of writing. [+]
Spanish group rubbishes rumours of sale
Multiple sources tell HBI Spanish for-profit hospital group Grupo Recoletas is up for sale, and rival HM Hospitales could follow if it hasn't already. Recoletas outright denies there is any process. [+]
End to French labs strike as agreement struck with government
The unions representing French labs groups called an end to their strike on Tuesday, January 10, after reaching an agreement with the government on tariff cuts for 2023. The agreement specifies that up to €250m of labs’ funding can be cut in 2023, but that no further cuts will be made during the year. While this deal ends the immediate problem, HBI hears it has only delayed further conflict. [+]
Sanoptis targets Spain for expansion
Sanoptis, Germany’s second largest ophthalmology group by revenue, is looking to expand in Spain, and beyond, and looking at targets to buy. [+]
Winning the workforce war: Evercare expands training facilities
Many emerging market hospital groups seem a hot ticket at the moment. They have the stability which comes with hospitals, married to far more growth than you might expect in Europe, but the workforce war is making investors think twice. HBI speaks to two experts to learn more about how in-house training is proving to be a solution to workforce woes. [+]
Pihlajalinna sells dental clinics to Hammas Hohde
Pihlajalinna, one of Finland's largest for-profit health and care providers, has agreed to sell all 16 of its dental clinics to up-and-coming pure play dental chain Hammas Hohde. [+]
Korian acquires Spanish mental health provider
French pan-European elderly care giant Korian has acquired Grupo 5, a Spanish provider of mental health services, from Spanish private equity firm Corpfin Capital, after receiving the green light from Spain’s competition authority. The acquisition is part of Korian’s strategy to develop its health care offering and to build a pan-European mental health platform. [+]
HBI’s Team Predictions for 2023
Drawing inspiration from prediction lists that make the rounds this time of year like this one from our sources, we asked some of our team here at HBI to pen down some of their thoughts on what we can expect over the next 12 months and beyond. So here are our top picks for news and trends HBI expects will colour 2023 - across hospitals, labs, elderly care, fertility, dentistry, coronavirus, digitisation and more. [+]
Eight predictions for for-profit health care in 2023
2022 was a tumultuous year for for-profit health care. The year began with a sense of things returning to a new normal, after the major disruption of the Covid pandemic throughout 2020 and 2021. But then, not even two months in, Russia invaded Ukraine, and this quickly led to an energy and economic crisis throughout Europe. For the first time in decades inflation reached double-digit figures across almost every OECD country and the era of near-zero interest rates came to an abrupt end. The second half of the year saw major worries about a looming recession and a potential debt crisis, rapidly falling investment and M&A deal volumes slowing to almost a standstill. [+]
How optimistic are US insurers and operators about 2023?
Accounting and Consultancy firm Deloitte US' industry outlook survey of health care operators and investors reveals what 71 c-suite executives of health systems and insurance with $500m+ revenue think 2023 will hold. [+]
UK warns off Turkey after deaths
The UK Foreign and Commonwealth Office (FCO) has issued a travel warning following the deaths of 22 British nationals who sought medical treatment in Turkey. The country has recently seen a tsunami of patients taking the trip due to a failing NHS in England and the promise of more affordable cosmetic surgeries. HBI speaks to three Turkey-based analysts to understand whether the safeguarding concerns are warranted and what impact the warnings could have on the medical tourism industry. [+]
Portuguese competition authority goes after labs
Portugal’s competition authority (AdC) has opened an investigation into collusion it suspects took place between several of the country’s major labs groups during the years 2016 and 2022. The accused groups include Affidea, Synlab and Unilabs subsidiaries. [+]
Morocco's largest hospital group's share price tanks after successful IPO
Africa-focused private equity firm Mediterrania Capital Partners has made a successful exit from Akdital, Morocco's largest for-profit hospital group, with the biggest IPO on the Casablanca Stock Exchange since 2008. But despite being heavily over-subscribed, the share price has since fallen by 9%. [+]
Baltic PE investor completes acquisition of Lithuanian wellness clinics
INVL Baltic Sea Growth Fund, one of the largest private equity investors in the Baltic region, has completed its acquisitions of two Lithuanian assets: Wellness provider Nemunas and post-acute care treatment centre chain Eglės Sanatorija. [+]
Atrys offloads 25% of Conversia amid stock slump
Spanish based diagnostic labs group Atrys has sold 24.9% of its stake in regulatory compliance subsidiary Conversia to Arragio NW Segundo for €20m. The move comes after a disappointing year where the firm has seen its share price fall 39%. [+]
Softened Hungarian reform still risks workforce exodus
The Hungarian government has removed from its proposed new health care law the requirement that private doctors would need to work at least 20 hours a month in the public sector. However, the rest of the controversial reform remains unaltered. [+]
If technology is the answer to an elderly care crisis, why is adoption so slow?
The elderly care market is ripe for a technological revolution, but investment is lacking and adoption has been slow. Lars Dahle, founder and former CEO of healthcare tech group Dignio, candidly explains why he feels the market is frustratingly slow to take up what appear to be obvious solutions. [+]
Wide-sweeping reforms could change the face of German healthcare
German health minister Karl Lauterbach has set out detailed reforms which would change the face of German healthcare, sound the death knell for small hospitals, and signal an end to overactivity. [+]
Reflections on 2022 - deals and delays, revolts and reform
As 2022 comes to end, it seems appropriate to look back at some of the winners of the last year – and those who fared less well in a trying environment. [+]
VC interest in digital health investment remains strong
Despite economic downturn and inflationary pressure, venture capital interest in healthcare, and specifically digital health, remains strong. HBI chats with UK investment company Albion VC to find out more. [+]
Orpea rescue plan meets opposition
Under-fire French elderly care operator Orpea could have a shareholder revolt on its hands. Unhappy with plans for massive share price dilution as the group looks to meet its debts, a group of disillusioned shareholders has suggested an alternative and is looking for support. HBI speaks to two French health care experts to learn more. [+]
PPP and PMI opportunities in Hungarian healthcare in 2023
2023 may be a big year for Hungarian private healthcare as finance minister Mihály Varga has promised PMI and private healthcare providers they will have “a lot to do” in the coming year. [+]
Out of pocket expenditure compared across Europe - Infographic
Here we look at household out-of-pocket payments - direct payments for healthcare from a household's primary income or savings, where the user pays at the time of purchase. The figures on this chart are displayed as a percentage share of the total current health expenditure for the countries listed. [+]
Eugin enters Portugal
Spain-based fertility provider Eugin Group, part of Germany-based hospital group Fresenius Helios, is entering the Portuguese market. [+]
Amanat to merge Sukoon and CMRC
Dubai-based listed health care and education investment firm Amanat Holdings is merging two of its post acute care providers in the GCC region, Sukoon and Cambridge Medical and Rehabilitation Center (CMRC), in the latest move in its plan to build the region's largest post-acute care platform. [+]
Spire acquires Doctors Clinic Group and expands primary care footprint
Spire, the UK’s largest for-profit hospital group, has acquired Doctors Clinic Group, one of the UK’s only pure play private-pay primary care chains. The acquisition is part of Spire’s plan to build up its primary care offering. [+]
Blackstone ‘out of the running’ for Care Hospital deal
Multiple news outlets say private equity giant Blackstone is the sole remaining bidder for Indian hospital chain Care Hospital. Sources close to the company tell a different story. [+]
Pressure grows to restrict investment in German health care
Pressure is growing for a change in German law restricting who can invest in healthcare. If enacted, it could effectively see some outpatient operators “banned”, and restrict who can do telehealth. Is such a development likely? HBI speaks to a trio of German healthcare experts to find out more. [+]
Care Fertility expands international footprint to Spain and US
UK-based group Care Fertility continues to expand its international footprint following its acquisition by PE firm Nordic Capital in February, with acquisitions in Spain and the US. HBI chats to Alfa Chan, partner at Nordic, to find out more. [+]
Middle Eastern hospital stocks outperformed European counterparts in 2022 - Infographic
In this week's infographic we compare the stocks of the five largest (in terms of revenue) listed hospital groups in the Middle East with the five largest listed hospital groups operating in Europe. [+]
At-home testing can help with prevention
In an ideal world you wouldn’t have to pay for preventive care measures such as at-home tests, but with increasing pressure on healthcare services and in particular a lack of funding for preventative measures, increasing numbers of people are doing exactly that. [+]
Tiny tariff rises will see waiting lists soar in France
French hospitals are in crisis as statutory health insurer (SHI) tariffs have not risen enough to meet rampant inflation. HBI speaks to industry sources to find out the risk to hospitals if this continues. [+]
Hungarian reforms risk mass doctor exodus to private pay, and abroad
Around 4,500 Hungarian doctors have threatened to resign en masse, after the government announced controversial reforms which include an option to reduce wages based on vague performance metrics. HBI hears this could drive large numbers into Hungary’s growing private sector. [+]
TVM Capital Healthcare raising outpatient SE Asia fund
Dubai and Singapore based private equity firm TVM Capital Healthcare is raising a new emerging market fund which will invest in non-hospital health care assets in the South East Asia region. The fund has a target of $200m and is expected to make its first investment in the first half of 2023. [+]
Health care companies must learn to deal with cyber attacks
Cyber attacks on health care are on the rise, and operators focused on preventing attacks need to think more about developing resilience to ensure critical care is protected. HBI speaks to Trevor Dearing, director of critical infrastructure solutions at cybersecurity firm Illumio, to find out more. [+]
BMA targets ‘unregulated’ at-home diagnostic tests
In October the British Medical Association (BMA) reported it had found cases of private labs groups offering direct-to-consumer at-home diagnostic tests with ‘misleading’ claims about their accuracy, claiming some of these tests are unregulated. The NHS says such tests risk overburdening GPs with patients who have received misleading information. HBI speaks to Kevin Dryhurst, CEO of private labs operator DAM Health, who argues privately provided direct-to-consumer tests have a role to play in providing some of the preventive care which the NHS is failing to deliver. [+]
Quick departures always raise questions
When a CEO steps down, journalists raise half an eyebrow. Is this a planned departure, in the works for months, with a readymade successor ready to step out of the wings? Or does it have a whiff of a hastily scrabbled jump (with, or without a push) suggesting possible malcontent, ill will, a clash of styles, or something else? [+]
UK task force boost to NHS outsourcing
The UK government has set up a task force to look at increasing NHS outsourcing to the private sector, as part of its plan to increase capacity and bring down the elective care waiting list. Could this provide a boost for for-profit providers, and will it tempt them to do more NHS work? [+]
FMC CEO leaves after just two months in post
Global renal disease specialist Fresenius Medical Care has parted ways with its new CEO just months after announcing her appointment, and scarcely two months after she took up her post. HBI looks at the surprisingly quick turnaround and tries to work out what happened. [+]
Due diligence begins for KIMS sale
KIMS Health, one of the largest hospital groups in South India, is up for sale. Due diligence has begun after a first round of bids which HBI understands included India's fourth largest operator Max Healthcare, as well as big international PE investors Blackstone and CVC Capital. Binding bids are expected next month. [+]
How do private providers view UK opportunities? - Infographic
How confident are UK providers about different payor models? The Independent Healthcare Providers Network (IHPN) has released its third annual industry barometer, showing how independent providers view opportunities in the UK. [+]
Opportunity for Spanish REITs to cash in on elderly care
Spain is facing a serious shortage of nursing home beds, and appetite to invest in Spanish healthcare property is on the rise. With REITS looking to plug the long-term housing gap, HBI speaks to Alberto Fernandez of Madrid-based REIT Healthcare Activos to find out more. [+]
Chris Toth, CEO, Varian, a Siemens Healthineers Company
In April last year, medical device giant Siemens Healthineers acquired Varian Medical Systems in one of the largest all cash MedTech transactions in history. HBI catches up with Varian CEO Chris Toth to find out more about the deal, and Varian’s plans for the future. [+]
Ribera Salud buys big in Murcia
Spanish hospital group Ribera Salud has acquired the largest private healthcare group in Murcia, consolidating its presence in the region. [+]
New regulations target Turkish health tourism agencies
Turkey is taking steps to regulate its health tourism sector. Agencies acting as a go-between for tourists and health tourism operators will need to submit two separate licences to two ministries. [+]
Viamed chooses Synlab to run in-house labs
Spanish hospital group Viamed has chosen Synlab to run its in-house diagnostic labs in many of its hospitals, meaning less outsourced business for Eurofins. [+]
Pressure piles on Dutch government to act as elderly care groups risk bankruptcy
Elderly care in the Netherlands is at breaking point - fending off high costs, low margins, and perilously poor staff retention. HBI speaks to a market expert who is confident the government will act to stave off bankruptcies. [+]
Don't believe the hype?
Why bother with telehealth? For all the huge sums raised, the high valuations and in some cases the spectacular IPOs, it's actually quite rare for them to make any money. Or latterly, for them to hold their share prices. Teladoc doubled its revenue, and Babylon quadrupled its revenue in 2021 - yet both have seen share prices drop 90% over the last two years. What gives? [+]
Affidea subsidiary IMI denies cartel involvement, whilst Unilabs accepts fine
Portugal’s competition authority has accused the country's four largest teleradiology groups of involvement in a cartel for public hospital teleradiology tenders during the years 2015 to 2018. The companies involved include Unilabs subsidiary Dr. Campos Costa, which has admitted involvement, and Affidea subsidiary Imagens Médicas Integradas, which denies involvement. [+]
UK homecare group Optimo Care expanding
UK homecare provider Optimo Care is pursuing an aggressive growth strategy through acquisitions. It has just bought Colchester-based complex care provider My Life Choice. This follows the acquisition of Mayday Homecare, a provider of homecare services in Bolton and Bury, in August. The company plans to make several more acquisitions in 2023. [+]
Interview: Jalil Allabadi, co-founder of MENA's biggest digital health platform Altibbi
MENA-based Altibbi has come a long way from its humble 2008 beginnings as a printed medical dictionary. HBI chats with co-founder Jalil Allabadi about the region’s largest digital health platform. [+]
Spanish hospitals bringing labs in-house
Major Spanish hospital groups are bringing their diagnostic labs testing in-house, in a trend which stands in direct contrast to what is happening in other countries. [+]
Penta buys one for the future in Poland
Czech-Slovak investment group Penta has acquired Polish hospital group Grupa Nowy Szpital (GNS). With this, Penta is making further inroads into the tricky Polish market. HBI asks, given the state of the Polish market, is now really the right time to buy? [+]
Spanish PMI premiums set to soar
Spanish PMI is set for a massive price hike, as hospitals facing increased demand struggle to make ends meet on current insurer tariffs. [+]
MidEuropa buys Optegra
UK, Czechia and Poland-based ophthalmology company Optegra has found a buyer - PE firm MidEuropa has reached a definitive agreement to acquire a majority stake while management and current owners H2 will retain minority stakes. [+]
Interview: Ryan Richards, Knight Frank
UK property consultancy and estate agency Knight Frank has released its annual report on the state of the UK’s elderly care sector. We speak to lead author, senior analyst Ryan Richards, about the sector’s recovery from Covid, the impact of the cost of living crisis and inflation, and reputational risk. [+]
Orpea pledges to pay in full as restructuring rumours continue
French elderly care giant Orpea continues to hit the headlines for all the wrong reasons. Over the last week, dozens of facilities were raided by the French authorities, talk continues to be rife about restructuring and potential exits, and contrary to previous assertions HBI understands the group now intends to pay back the full €56m owed to the state. [+]
Time to get heretical?
This week saw the leaking of minutes from a September meeting of senior NHS Scotland managers in which a serious suggestion was made that the founding principle of free at the point of use care for all be abandoned. [+]
Bill Gates-backed Evercare sells Kenyan hospital stake
US PE Evercare Health Fund has sold its 1bn Kenyan shilling (€7.8m) stake in the Metropolitan and Ladnan hospitals in Nairobi. The PE fund is owned by the Bill & Melinda Gates Foundation and the International Finance Corporation (IFC). [+]
Simplyhealth launches £60m VC fund undaunted by poor economy
Insurance plan group Simplyhealth have launched a £60m VC fund for early-stage healthcare start-ups in the UK. Its CEO says his firm is well placed to invest sensibly due its contacts, and the current state of the economy. [+]
Amazon launches telehealth platform
Amazon has launched its own telehealth platform, Amazon Clinic, on which patients can connect with health care providers in their area and book appointments. [+]
Economy makes Fresenius breakup unlikely
Speculation persists over the break-up of bloated conglomerate Fresenius by new CEO Michael Sen, but HBI hears that looks increasingly unlikely given the current economic climate. So, what are Sen's options? HBI talks to a well-placed investment banker to find out more. [+]
Scanmed buys Ars Medical
Polish multi-specialty healthcare company Scanmed has bought Polish oncology firm Ars Medical. [+]
Babylon CEO admits to stock market disaster
Ali Parsa, the charismatic healthcare entrepreneur who founded digital health company Babylon Health, has branded the company’s stock market performance an “unbelievable, unmitigated disaster” in an interview with the Financial Times. [+]
Scotland NHS bosses discuss making wealthy pay for care
Scotland NHS bosses have suggested making some wealthy patients pay for care, in what would amount to an abandonment of the NHS’ core founding principle of free at the point of use care for all. [+]
Optegra sale on hold
HBI understands from multiple sources that the sale of UK-based ophthalmology group Optegra is on hold. [+]
Is Orpea's bold plan enough to save the business?
Plagued with well documented allegations and investigations, and saddled with €9bn+ debt, on Tuesday Orpea presented its plan for recovery to the creditors who last month gave it just four months to clean up its finances. Has it done enough? We speak to a range of market experts to find out if it can weather the storm. [+]
The current state of interest and inflation rates - Infographic
The current macroeconomic environment is slowing down health care services M&A, as inflation eats into margins and debt financing dries up. In this week's infographic we look at the state of interest rates and inflation rates in major economies across the world. [+]
Going somewhere new? Go digital
There's an air of confusion around digitalisation / telehealth. Everyone knows it is important. But as a standalone prospect, it takes time to make a profit. Babylon's stock crash, and Kry's withdrawal from Germany and continuing layoffs do little to dispel digital doom, and many patients insist on a hybrid model of care. But for healthcare companies looking to expand to pastures new, going digital can offer a cheap way to test the water. [+]
Scottish dental group "up for sale"
HBI hears that Scottish dental group Clyde Munro is about to go up for sale, and speaks to an operator and an investor source to find out more. [+]
Affidea expands Spanish offering with further acquisition in Madrid
European imaging and cancer treatment provider Affidea has acquired outpatient specialist Clínica Algete in Madrid. [+]
EDG sale "in early stages"
HBI understands that the sale of pan-European and dentist-led European Dental Group (EDG) has begun, and is in its very early stages. [+]
Portugal's heavy hitting hospitals look to expand
As the Portuguese NHS continues to flounder, hospital groups such as Luz Saude and CUF are looking to expand their coverage into untouched regions in the country. [+]
Macroeconomic conditions dampening debt financing but not equity financing
Macroeconomic conditions are not causing deal flow to halt completely. HBI hears that health care M&A deals financed entirely with equity are still taking place, whilst a dearth of willing lenders and rising interest rates are making debt financing - and therefore larger deals - increasingly unfeasible. [+]
UK teleradiology booming due to NHS backlog
The UK’s teleradiology sector will see continued sustained growth over the next decade as the NHS attempts to deal with its elective care backlog and outsources more and more radiology work. [+]
Helios makes digital-only presence in Kenya and Colombia
Curalie, the digital health subsidiary of German hospital group Fresenius Helios, has launched new digital-only operations in Kenya and Colombia. Experts tell HBI this is a good way for Helios to access new markets, but likely won’t lead to a hospital boom any time soon. [+]
How do you know when it's time to go?
The problem with being the founder (and often also CEO) of a company is that it’s difficult to know if you're doing a good job. Or - even if you are - when it might be the right time to make way for someone with fresh ideas. How do you know when it’s time to step down? And how does it feel when you do? [+]
Medanta's parent IPOs
Global Health Ltd, the parent company of Indian hospital chain Medanta, closed subscription for its IPO on Monday, with a valuation of 22,060m rupees ($274m). The share price has been set at 319 Rs ($3.96). The IPO will consist of new shares worth 5,000m Rs ($62m), and an offer-for-sale of up to 50.8m Rs ($0.63m) worth of shares. [+]
€8bn to save German hospitals, but no relief for labs
The German government has pledged an €8bn support package to help hospitals and care homes tackle inflation and rising energy costs, and promised to end Germany's flat-rate DRG tariff system, but other parts of the the country's under pressure health care sector - particularly smaller lab groups - are struggling to stay afloat. [+]
Walgreens pharmacy splashes on $9bn outpatient merger
Walgreens, the US’ second largest pharmacy chain, is expanding its outpatient network with the acquisition of urgent and primary care chain Summit Health, for $9bn. Evernorth, a subsidiary of Cigna, one of the US’ largest health insurers, is also taking a stake in the merger, effectively creating a major new integrated payor-provider with a national footprint. HBI speaks to three experts on the US health system to understand the implications. [+]
Portuguese government finds renewed appreciation of PPPs as Ribera wins contract
Spanish hospital group Ribera Salud has won an eight year, €800m contract to manage the Cascais Hospital in Portugal in a private public partnership (PPP). HBI understands it may have been the only bidder in a climate where PPPs look to have been falling out of fashion. [+]
Interview: Lars Dahle, founder, Dignio
Having spent the last 10 years of his life building a multi-million revenue company, Dignio founder Lars Dahle has found the last week since he stepped down as CEO rather quiet. HBI catches up with him in reflective mood, as he chats about how he built the business up, and how he really feels about leaving his company's future in others' hands. [+]
Inflation hits margins for Medicover and Terveystalo
Poor results have seen big share price drops at two of the sexier listed health care service groups. Medicover, the pan-emerging markets outpatient operator, saw shares fall 11% on Q3 figures showing a net loss of €18.4m and Terveystalo, the Finnish and Swedish outpatient group, fell 23% to €6.23 after revealing a net loss of €19.6m. Since the start of the year both have seen their share prices halve or worse. Inflation, labour shortages, Ukraine and a big shift in how health care is delivered post-Covid are behind the poor results. [+]
Deals postponed and at risk
Deal flow is slowing rapidly. HBI hears CVC has postponed the sale of Finland-based occupational and outpatient specialist Mehilainen. The Trilantic sale of Berlin-based mental health specialist Oberberg, and the Nordic sale of European Dental Group are both at risk too. But we hear that the sales of ophtha group Optegra and diagnostic group Rad-X are likely to proceed. [+]
The UK care home sector - Infographic
Following our brand new intelligence report on the UK elderly care sector, we look at the size of the for-profit and public/non-profit sectors. [+]
Care Hospitals target of $1bn+ bidding war
Indian hospital chain Care Hospitals is the subject of a US$1bn+ bidding war between PE firm KKR, Singaporean state holding company Temasek Holdings, and Indian hospital chain Max Healthcare. [+]
Not that safe
Back in June, Hedley Goldberg, who heads up health care services at Rothschild, told HBI 2022 attendees that healthcare investors shouldn't be too worried about the macroeconomic outlook. Yes, inflation was higher than it had been in decades. Yes, a recession was undoubtedly on the horizon. But health care services would be resilient and able to pass on cost increases to payors. But now multiple listed groups are reporting net losses for Q3 and many investors are getting cold feet. Is this just a temporary blip or a sign of worst to come? [+]
French labs take collective action to fight sector cuts
French labs groups have stopped sharing Covid test results with the government in protest against the €250m proposed annual cuts to the sector. The president of national lab syndicate Les Biologistes Médicaux says lab groups are preparing to go on strike in mid-November, which would mean all labs being entirely shut down, if their demands are not met. [+]
Sub-scale NHS can't deal with private insurers
NHS England private patient units are too small to deal with private medical insurers. That is likely to be behind recent friction between NHS entities and private medical insurer Bupa. [+]
Kry cuts another 10% of workforce and withdraws from Germany
Kry, the Swedish-based multinational telehealth and primary care unicorn, is laying off 10% of its 3,000-strong workforce, marking the second time it has done so this year. It is also pulling out of Germany as it tries to move faster towards profitability. Meanwhile peer Babylon has seen its value fall 20-fold. [+]
Interview: AXA reinsurance CEO on healthcare's "iPhone moment"
Unlike the majority of his peers, Laurent Pochat-Cottilloux, the CEO of AXA Life and Health Reinsurance, isn’t convinced insurance will lead the charge towards prevention. [+]
Foreign doctors more vulnerable to overworking and abuse
African and Asian doctors have been brought to the UK from “red list” countries, from which “active recruitment” is banned, and forced to work illegal hours, according to reports. [+]
Cancer vaccine could lead to a diagnostic, laboratory & drug producer revenue explosion
Work being done to create viable cancer vaccines will lead to huge opportunities for diagnostic, laboratory & manufacturing firms, HBI hears. [+]
Polish healthcare normalising after refugee influx
Both for-profit and public healthcare operators in Poland have been struggling to cope after a large influx of Ukrainian refugees. HBI speaks to contacts in Poland to find out more. [+]
Orpea forced to take drastic steps to fix finances
Orpea has four months to clean up its finances and reach a new agreement with its creditors on debt restructuring. The conciliation period which it has agreed with the courts has bought it time to consider its options in the face of rising costs and interest rates, and a cooling real estate market. The main proposal under discussion is a debt/equity swap which would result in a drastic dilution of existing shares, but it is hard to see how the numbers could add up. HBI hears from analysts about the tough decisions facing the group. [+]
Optegra for sale
UK-based ophthalmology group Optegra is for sale, with three groups through to the second round. HBI speaks with three sources to find out more. [+]
Creditors face Hobson’s choice when groups face default
French elderly care giant Orpea has been given four months to fix its finances and placate its creditors. Could it learn from GCC hospital group NMC’s similar experience? [+]
Interview: Paresh Patel, CEO, OCL Vision
HBI chats with Paresh Patel, the new CEO of UK-based OCL Vision and former MD of UK, Czechia and Poland-based ophthalmology platform Optegra, about his new role, and the ophthalmology market in general. [+]
Top 10 EMEA labs groups made almost €8bn extra revenue in 2021
It's no secret that the diagnostic labs sector benefitted immensely from testing during the Covid pandemic. But now that 2021 revenue figures are available for many of the largest groups, it is clear that the scale of the testing windfall has been larger than anyone in the sector imagined. [+]
Swiss Medical Network subsidiary to become country's first payor-provider
Hôpital du Jura Bernois, a subsidiary of Switzerland's second largest hospital group Swiss Medical Network, is to become the country's first integrated payor-provider, after health insurer Visana bought a 32.4% stake. From January 1 2023 it will offer insurance alongside its hospital and outpatient services to inhabitants of the Jura Arc region. [+]
Four Seasons facing breakup, final portfolio sales may not conclude until H2 2023
HBI understands a portfolio of homes owned by troubled UK elderly care operator Four Seasons will likely have to be split for sale, and some of these homes are not expected to sell until H2 2023. [+]
PMI premiums set to spike as medical costs soar
PMI premiums are set to spike in 2023 according to a new report. HBI speaks to contacts around Europe to find out more. [+]
Focus, Agility and the importance of No
How do you best build innovation and work with tech start-ups inside a university hospital? UK hospital Guy's and St Thomas' NHS Foundation Trust (GSTT), took the unusual step of appointing as Director of Innovation & Strategic Industry Partnerships , Nadine Hachach-Haram, a physician who is also a successful entrepreneur, Founder & CEO of Proximie. We look at how GSTT has now developed its own innovation accelerator with a linked venture capital fund and at its overall strategy to encourage innovation. [+]
Is Elliott stake a step towards Helios breakoff?
American investment management firm Elliott has taken a minority stake in Fresenius Helios, the largest hospital group in Europe by revenue. The move prompts fresh questions about Fresenius' new CEO's intentions for the company. [+]
More bang for the buck could lead to US investor influx
Issues with the plummeting pound – slightly aided by the departure of the UK’s shortest-lived prime minister – and the fall of the euro against the dollar mean it’s a great (cheap) time for our north American cousins to holiday in Europe. But it’s also a great time to buy into healthcare services. [+]
Buurtzorg expands into nursing homes
Netherlands-based medicalised homecare specialist Buurtzorg is expanding into nursing homes. HBI catches up with a Dutch healthcare expert to find out more. [+]
The price of keeping up with care costs? - Infographic
Care is getting more expensive. Insurance premiums are set to go up 10% internationally next year. People are living longer, more sedentary lives, and these are unsurprisingly characterised by an increase in chronic diseases. You might expect that as a population ages healthcare spending as a percentage of GDP will have to go up. There are, after all, surely limits on the efficiencies which can be made. This, it seems, is not necessarily the case. [+]
Attendo Stockholm contract will not be extended after court convictions
Pan-Nordic listed care provider Attendo has lost one of its contracts with the City of Stockholm to provide nursing home care. This follows the conviction of two Attendo employees earlier this week for violating whistleblower protection law when they reprimanded a carer employee for speaking to the press about the state of care in one of its homes during the height of the first Covid wave in 2020. [+]
Dollar Investors are ready and waiting to buy cheap European healthcare firms
The slump in healthcare listed stocks and downward valuations of private businesses are encouraging potential buyers to examine enticing European healthcare enterprises. [+]
Opportunities abound as Saudi Arabia plans $13bn private healthcare expansion
Saudi Arabia’s health ministry is making $13bn (SR48bn) plans for 100 healthcare projects that will involve the private sector. The public-private partnership proposals include constructing two new medical cities, a project to provide 900 beds for medical rehabilitation, and long-term care services, and it looks like foreign investors are actively being courted. [+]
Transform Hospital Group closes clinics and lays of staff to secure its hospitals' future
Transform Hospital Group, a financially troubled UK-based medical aesthetics, cosmetic and weight loss surgery-focussed business, has been forced to lay off staff to secure its future. [+]
CBPE Capital buys rapidly expanding UK varicose vein treatment chain
Dermatology is hot right now. UK private equity firm Palatine has sold its stake in Veincentre, the UK’s largest chain varicose vein treatment provider, to CBPE Capital (another UK private equity group). This follows the acquisition of Dutch dermatology group Mauritskliniek last month. [+]
Interview: Dr. Charles Armitage, CEO and founder, Florence
Dr. Charles Armitage used to be a surgeon. Working for the NHS in various parts of the country he experienced first-hand the severe workforce issues the health sector faces. Six years ago he started a digital health company called Florence with co-founder Dan Blake to help solve the problem. [+]
FutureLife enters Spain and Italy
FutureLife, the Czech Republic-based fertility company, has entered Spain and Italy with its latest acquisition. Owned by PE companies CVC and Hartenberg holding, the group has acquired Institut Marquès (IM), an assisted reproduction company based in Barcelona with clinics in Spain and Italy. [+]
M&A health care deals slow on debt fears
After a heady 2021, activity in European health care M&A is slowing down. Big ticket auctions have been withdrawn and processes are often run more cautiously as dual track, rather than general auctions. But underlying demand for health care assets is strong, with PE sitting on trillions of recently raised dry powder. Listed groups look cheap. HBI catches up with bankers from across Europe for their take. [+]
To build or to buy?
To build or to buy? When looking to build trust in the telehealth sector, Amazon decided building its own company with Amazon Care wasn’t worth it. So, it closed Amazon Care and bid on AI/big data player Signify Health instead. [+]
CVC to buy back Quironsalud?
Rumours circulate that Quironsalud, the Spanish hospital subsidiary of hospital chain Fresenius Helios, may be sold to private equity firm CVC or KKR, HBI hears. But others say the new CEO of Helios' parent, Fresenius SE, is unlikely to go for the strategy and suggest the dialysis arm could be put on the block instead. [+]
UK CMA gives Rodericks-Dental Partners merger green light
The CMA (the UK's competition authority) has given the green light to the merger between NHS-focussed UK dental group Rodericks Dental and rival Dental Partners. [+]
Insurers moving from payors to players
Should insurers be payors or players? Should they move from treatment to prevention? How do insurers get better data? These three questions were top of the agenda at the Global Health Insurance Conference in Prague last week. [+]
Insurees health concerns, by age - Infographic
At the recent healthcare insurance conference in Prague, HBI heard about insurees' concerns by age demographic - and how insurers were striving to address them. [+]
French labs pushing back against €250m cut
French labs are presenting a united front pushing back against the €250m worth of annual cuts proposed in the 2023 Social Security Budget. All of the sector’s representative bodies have voiced outrage, and a joint letter from the directors of four labs syndicates sent to l’Assurance Maladie’s (CNAM) general director demands tariffs be indexed to inflation saying the sector cannot support further cuts. [+]
Opportunities in Irish dentistry
The dental market in Ireland may not be the largest in Europe, but it is largely (80% plus) a private market with very little consolidation. So why haven't we seen more consolidation? HBI speaks to a market expert to find out more. [+]
Interview: Frederic Llordachs, CEO, and Carmen Pauline Rios Benton, COO, Doctomatic
HBI catches up with co-founders Frederic Llordachs, CEO, and Carmen Pauline Rios Benton, COO, of new chronic disease monitoring group Doctomatic, a remote patient monitoring solution for chronic conditions like diabetes, hypertension, COPD and heart failure, which uses AI to help detect problems at an early stage. [+]
Don't argue with us, or we'll stop sending you patients
Speaking to elderly care providers has become an increasingly depressing way for HBI journalists to spend their time - with a few notable and perennially optimistic exceptions. [+]
Germany only big 5 country to spend more on outpatient than hospitals - Infographic
Germany's health minister Karl Lauterbach is planning to shift as much as 25% of care which is currently done on an inpatient basis to outpatient, in the country's biggest health care reform in 20 years. But Germany is already unique amongst the big 5 in that it already spends slightly more on ambulatory care than inpatient care. [+]
Germany to reduce inpatients by a quarter, as hospitals face insolvency
German health minister Karl Lauterbach is to implement the country's first major health care reform in 20 years. From 2023, hospitals will aim to reduce spiralling costs and remedy the workforce crisis by shifting as much as 25% of their inpatient activity to outpatient and, eventually, closing some clinics and hospitals. HBI chats to German sources to find out more about what this means for for-profit operators. [+]
UK nursing homes: "We pushed back on fees, they stopped sending patients"
Are local authorities paying the right rate to the for-profit operators looking after our elderly - and what happens when operators push back and demand more? HBI catches up with Sanjeev Kanoria, the outspoken chairman and co-founder at private care provider Advinia Health Care. [+]
AcalisCare acquires in Scotland with plans to be one of UK’s largest operators
Scottish nursing home group Balhousie has been acquired by Belgium-based elderly care group AcalisCare. HBI speaks to Lieven Baten, partner at AcalisCare and the new chairman at Balhousie, about plans for growth inside and outside of Scotland. [+]
Saudi healthcare insurance boom
According to the Saudi Central Bank, gross healthcare insurance premiums in Saudi Arabia rose 32% to SR25.1 billion (€6.78 bn) between 2017 and 2021. Healthcare now totals as much as 59.7% of total insurance in the rich oil state. [+]
Gulf PMI gets lift from Qatar’s World Cup
Ahead of the World Cup in November the Qatari authorities have issued a proclamation demanding that some 1.5 million Gulf and other international football fans must have healthcare insurance of at least 50 Qatari riyals (€12). This is a boon to Gulf and other international private medical insurers (PMI) of at least QR75 million (€18m). [+]
Burjeel sets price for "29x over-subscribed" IPO
Major UAE hospital group Burjeel Holdings has chosen to set its IPO price at just 2 dirhams ($0.54) per share. It plans to sell 11% of its share capital (550.7 million shares) when it goes public on Monday, October 10, which will raise 1.1bn dirhams ($299.51m) at this price. [+]
Spanish "health robot" telehealth start-up to go international
Spanish digital health start-up Homedoctor is looking to go international. The company is reportedly looking for an equity investor to fuel expansion, with the aid of professional services firm KPMG. [+]
More funding for health and care but less for labs in French Social Security budget
The French government is to increase allocated funding for the health and care sectors overall in 2023, including hiring an additional 3,000 carers and investing €370m into a shift to care at home, but decrease funding for labs by €250m, as detailed in the 2023 Social Security budget, published on Monday September 26. [+]
Orpea CEO blames “unethical” former managers following €269m H1 loss
Laurent Guillot, CEO of French multinational elderly care group Orpea, has partially blamed the company's net loss of €269m in the first half of 2022 on "unethical behaviour" by the company’s former managers. But the company's finances appear to be in better shape than the headline figure suggests. [+]
Three key takeaways from the Pan-European Procurement Summit
A common refrain at the Pan-European Procurement Summit in Brussels was that price and quality are the two biggest concerns for procurement professionals. HBI heard plenty on price – especially price transparency – but rather than quality, attention turned to the growing concerns of sustainability and digitalisation. [+]
Indian M&A roundup
Indian health care is seeing a flurry of activity. Evercare-owned Care Hospitals is reportedly up for sale in India, while IHH Healthcare Bhd has expressed renewed interest in India after the Indian Supreme Court passed judgement in relation to its contentious dealings with Fortis. Meantime, the largest shareholder in India's second largest eye hospital has sold its stake. [+]
Is private equity becoming uninterested in healthcare services?
As a sector more resilient than most to recession, it’s no surprise that private equity and others are interested in getting involved in healthcare services. It also gives a great opportunity for a diversified portfolio as healthcare provision covers such a wide base - pharma, medtech, life sciences and services. And yet despite the economic environment and the relative safety and benefits, it seems that private equity may not be as interested as they could be. [+]
Infographic: The state of private pay in the UK - Infographic
The UK's Private Healthcare Information Network (PHIN) has released its private market update for September 2022, showing the state of private pay in the UK. As is expected with NHS backlogs at a record high, private healthcare is performing very well compared to pre-pandemic levels. [+]
French doctors want tough measures to stop patients missing booked appointments
French doctors calling for tougher measures for patients who miss appointments - including online where patients are often booking on multiple platforms and keeping only the earliest appointment they get - and sometimes not even that. [+]
Interview: Dieter Zocholl, founder and CEO of XMED iQ
Dieter Zocholl is a man on a mission. On the first day of the healthcare procurement conference in Brussels, the founder and CEO of procurement specialist XMED iQ argued passionately for more price transparency in the procurement of healthcare devices. But while the host of the recent Procurement Conference in Brussels poked gentle, good-natured fun at him, Zocholl presented an interesting problem. [+]
ESG now ‘essential’ for health care companies
Last month we discussed whether ESG has the ability to transform capitalism, or whether it amounts to little more than a corporate PR exercise. Two people who may be able to help us answer this question in relation to health care specifically are Guyon Stams, director in the healthcare sector team, and Joost van Dun, director of sustainable finance, at Dutch multinational bank ING, both of whom focus on supporting health care clients align their ESG strategies with their financing. Stams tells us ESG has become an ‘essential’ consideration for health care companies. [+]
Meloni's promise to boost Italian healthcare could benefit for-profits
Italy's new right-wing alliance under Giorgia Meloni promises direct and indirect benefits for Italy’s private healthcare businesses. [+]
Dutch labs consolidation hampered by hospital reluctance to outsource
Last month we reported that there is a growth opportunity for bigger and more efficient for-profits in the largely unconsolidated Dutch labs market, as Covid testing winds down and financial pressures return to the sector. But a consultant who has previously run a Dutch hospital lab tells us a major barrier remains: a stubborn reluctance within hospitals to outsource. [+]
Is the PE tap being turned off?
Economic uncertainty could well mean a slowdown in M&A from private equity houses. Could we be facing a repeat of the dark days of 2009, and a halving of deal flow, or is there light on the horizon? HBI has been chatting with consultants and advisers over the last couple of weeks to see if there is a consensus. [+]
Is Bridgepoint looking to sell Diaverum in Q4?
Swedish pan-European dialysis group Diaverum could be up for sale in Q4. Reports suggest PE owner Bridgepoint has reportedly appointed American investment bank Citi to review strategic options for a sale. [+]
Vitaldent-led new Spanish dental group looking abroad for expansion
There's a new major player on the Spanish dental scene - by name at least - and it looks set to take the number one spot by revenue. Vitaldent is combining with three other players and rebranding as Donte Group according to Javier Martin, the CEO of the new holding company and former Vitaldent CEO. [+]
Nordic PMI grows in tandem with waiting lists
Private medical insurance (PMI) plans are on the increase in the Nordic nations, Sweden, Denmark, Norway and Finland. Longer public health waiting times and incentives in employment contracts are the main reasons. HBI investigates. [+]
Interview: Julien Samson, CEO, Groupe Maisons de Famille
Julien Samson, recently appointed CEO of the European care homes group Groupe Maisons de Famille, has some creative ideas on how to manage the business. In the face of industry-wide criticism and concern following hard-hitting headlines about rivals Orpea and Korian, he still believes the industry can find ways to cope with the persistent pandemic, the energy crisis and inflationary recession. [+]
Blog: Price and quality top considerations for procurers, but when will sustainability come in?
When procurers look at supplies, they focus overwhelmingly on quality and price. However, many at the recent Healthcare Procurement Summit in Brussels argued that these can’t be the only two benchmarks – sustainability has to come into a much greater focus too. [+]
Tariff cuts to return to French labs sector
The French statutory insurer is reported to be seeking tariff cuts for the labs sector which could exceed €200m. Any cuts will be announced on Monday, September 26, in the government’s Social Security Budget. [+]
First round bids for Four Seasons’ 110 care homes due by "early autumn"
HBI catches up with Christie & Co, the business broker in charge of the sale of UK-based Four Seasons’ 110 care home, to find out more about the timescale of and interest in the sale. [+]
Estonian waiting lists likely to skyrocket in recession
Despite inflation rates of over 20%, Estonia's national health service has not suffered significant ill effects, HBI hears, at least not yet. Looming recession could, however, result in waiting lists as bad as those currently seen in the UK. HBI speaks to a local expert to find out more. [+]
Hungary’s private provider revenues surge - yet losses mount for many
The fast growing for-profit healthcare market in Hungary is scaling new peaks. HBI hears it could be worth as much as HUF 450-500bn (in excess of €1bn), and talks to a local operator to find out more about why revenue growth is not always translating into profit. [+]
Could the PE tap be turned off?
Changing macroeconomic conditions - specifically a reduction in the availability of credit and increases in interest rates, could well impact M&A activity over the coming months. [+]
Infographic: The challenges elderly care faces
With an aging population, it's no surprise that elderly care has quite the challenge on the horizon in order to meet patient needs. [+]
New Swedish government’s health policies could benefit for profit providers
A right-wing coalition government is still to be formed in Sweden, under probable prime minister Ulf Kristersson. It is expected to encourage for-profit health providers to help the public system reduce waiting lists. Multi billions of extra funding will also be allocated to the national, regional and local authorities to bolster the system. [+]
EDG for sale, while Dentex sells
As exclusively predicted by HBI at the start of August, pan-European and dentist-led European Dental Group (EDG) is up for sale. [+]
Orpea share price falls further in wake of new allegations and H1 preliminary results
French multinational elderly care group Orpea’s share price fell further on Wednesday, September 14, to its lowest level in years following new accusations of resident mistreatment, this time in Austria, and the company released disappointing H1 results. [+]
KKR-Ramsay deal looks to be off (again)
The seemingly ill-fated takeover of Australia-based international hospital group Ramsay seems to fallen apart after the consortium led by PE firm KKR refused to amend its second offer which Ramsay called “meaningfully inferior”. [+]
NMC CEO standing down
Michael B. Davis, the CEO of the UAE's largest private sector healthcare provider, NMC Healthcare, is standing down. His last day with the group will be December 20, and he leaves having steered the group through the most trying years in its history. Once seemingly facing financial ruin, NMC came out of administration at the end of last year. [+]
Up to 70% of German hospitals expect to lose money
Around 70% of German hospitals expect a loss this year, according to a survey by management consultancy Roland Berger. HBI chats with a German operator source to find out more. [+]
Consultants ponder a three way marriage
WMC, the largest player in management consultancy in German hospitals has formed a partnership with healthcare specialists Mansfield in the UK and Antares in Spain. WMC is backed by Nordic Capital. So does this mean a merger? [+]
Interview: Stephanie Martlew, CEO, Psyomics
HBI speaks to Stephanie Martlew, CEO of digital mental health company Psyomics, about its Censeo platform, a digital triage tool which helps mental health professionals make better decisions. [+]
Consolidation conundrum - is it ok to own all a pathway?
Pharmacy chain CVS’ latest acquisition - home care provider Signify - has led to an outcry in certain quarters asking, given that it already owns the drugs price negotiator and a private insurance company, whether such wide reaching consolidation is good for shareholders or for patients. [+]
CVS' Signify takeover raises competition concerns
CVS Health, a US retail pharmacy giant, beat Amazon in an $8bn total, $30.50 per share bidding war for home healthcare services company Signify. [+]
Virtual fertility clinics - fad or trend?
A UK-based "virtual fertility clinic" is raising money and boldly claiming it wants to become a leading European fertility player. HBI speaks to an operator source to find out whether virtual clinics are here to stay, or a passing trend? [+]
Veonet buys in Spain, looks abroad for expansion
HBI hears exclusively that large Germany-based ophthalmology platform Veonet is buying in Spain, and turning its attention generally to opportunities outside its domestic market. [+]
Countries with most and least affordable health care ranked - Infographic
Health care software company Radar Healthcare has ranked developed countries by the affordability of their health care, finding Luxembourg to be the most affordable and Greece to be the least affordable. [+]
IHH’s negotiation for Ramsay Sime Darby ends without agreement
Discussions between Asia’s largest multinational hospital group IHH Healthcare Bhd, multinational Australian hospital group Ramsay and logistics company Sime Darby Berhad over the acquisition of Ramsay’s Asian branch Ramsay Sime Darby by IHH have ended without any agreement. [+]
Is Circle BMI for sale or not?
The sale of UK hospital group Circle BMI rolls on - or does it? US care company Centene announced its intention to divest its foreign assets in December and has successfully sold its Spanish and central European subsidiary. HBI now understands from a source close to the company that the sale of Circle BMI is not currently on the cards. Why? [+]
UK dental deal set for green light from competition authority
The done deal between NHS-focussed UK dental group Rodericks Dental and its target, UK rival Dental Partners from London-based private equity August Equity, looks set to be rubber stamped after an investigation by the UK Competition and Markets Authority (CMA). [+]
Korian suing employee who wore ‘insulting’ t-shirt
France’s largest elderly care group Korian is suing one of its carer employees for ‘public insult’, after the employee wore a t-shirt with a distorted version of the Korian logo at a protest. [+]
Spire's self-pay revenue rockets
The H1 results for Spire Healthcare, the listed UK-based hospital group, shows the UK continues to be a fertile market for self-pay. [+]
Germany's fascinating ventilator market
"In the UK these people would probably get palliative care," says Prof Michael Isfort at the Deutsches Institut für angewandte Pflegeforschung. He is talking about the German ventilation market. An operator reckons there are 25,000 patients on intensive care for respiration, many of whom are on ventilators. That compares to 4,000 patients on ventilators in the UK at the height of Covid. Most German patients are in the outpatient sector and some are in for-profit centres run by private equity-backed businesses. Statutory insurers are trying to cut costs after a new law IPReG (Intensive Care and Rehabilitation Strengthening Act) was passed in October 2021. Meanwhile, Opseo, one of the three big players may sell this autumn for a price tag of €1bn. [+]
Orpea to pay France €25.7m
French multinational care group Orpea has agreed to pay back €25.7m of the €55.8m which the French government says it is owed. The company has also decided to sell €2bn of property. Its shares continue to bounce around €20-25, down from over €100 pre-scandal. [+]
Health care real estate investors in ‘wait and see mode’
Health care real estate has become an increasingly attractive asset class for investors in recent years. But will this continue in the face of rising inflation and interest rates? [+]
Recchi replaced at Affidea
Giuseppe Recchi is stepping down as CEO of Affidea, Europe’s largest imaging company. The new CEO will continue the company’s ambition to expand into more European markets. [+]
Nurse migration in UK, Germany, Spain, France and Italy 2011-2021
We reported last week on the UK's deal with Nepal to hire nurses so in this week's infographic, we thought we would take a closer look at the migration patterns of nurses across the major European markets UK, France, Germany, Spain and Italy. We look at the totals from 2011-2020/1 and the most recent available year to see if there are any significant differences. [+]
German nursing homes: safe as houses?
For many years investors have piled into German nursing homes attracted by the long-term care insurance payment model which guarantees future budgets. But the current wave of inflation may swamp many operators. [+]
NHS wage rise to cut tech budgets
The UK’s NHS technology budgets are being cut to fund £1.8bn worth of cost of living-fuelled wage increases, a consultant has told HBI. [+]
Swedish telehealth soars but losses mount
Swedish telehealth companies have experienced a surge in revenue since Covid. But the treble whammy of relatively low fees, expansion costs and the inflationary economic downturn have compounded losses. [+]
Euromedica probe may scupper Henry Dunant deal
The Greek and US governments are investigating vulture fund Farallon's purchase of Euromedica back in 2020. That could scupper Euromedica's planned merger with Imithea – the parent company of Greece’s largest single private hospital Henry Dunant. [+]
Is Uber Health über or unter?
Uber Health, essentially a taxi service to help non-urgent patients get to hospital appointments, has launched in Australia. But how much will it change healthcare services? [+]
Amazon to bet $12bn on health care
Amazon is among the bidders in the $8bn auction of AI/big data US player Signify Health. That comes just over a month after it bought loss-making US primary care chain One Medical for $3.9bn. The tech giant is also closing its existing telehealth arm, Amazon Care. [+]
Waiting for the Tsunami...
Fear, uncertainty and doubt stalk the sector. Batten down the hatches and hope for the best! [+]
Major UAE hospital group entering Saudi with $1bn investment
Burjeel Holdings, a major private hospital group in the UAE, is entering the Saudi Arabian market, saying it will invest up to $1bn in the country by 2030. [+]
German hospitals face tariff squeeze
German hospitals are struggling with inflation as there has been very little sign payors will raise tariff prices, a German operator told HBI. [+]
UK plans to hire nurses from red "do not recruit" country
The UK has signed a preliminary labour agreement with Nepal to allow recruitment of Nepali healthcare professionals in the UK health sector, starting with nurses. This has been questioned by a workforce expert. [+]
Wheels come off UK hiring model
The recent UK-Nepal healthcare professional recruitment agreement smacks of desperation. Nepal is one of the poorest countries in the world, with purchasing power parity per capita GDP roughly the same as the Congo, according to the IMF. Yes, the UK is in a unique position post-Brexit and is known for its unusual and innovative health care labour agreements. But even so it is a strange move! [+]
Sen brings break up smarts to Fresenius
Michael Sen, the new CEO of Fresenius SE, was previously hired back by Siemens to lead the break up IPO of Siemens Healthineers. So will Sen, currently the CEO of Fresenius’ infusion, transfusion and clinical nutrition subsidiary Kabi, be for revolution or continuity? [+]
Interview: Erick Galinkin, Principal AI Researcher, Rapid7
Ransomware attacks on health care providers have grown exponentially in recent years, with data indicating it is now one of the most targeted industries. HBI speaks to Erick Galinkin, security and AI researcher at Rapid7, a US-based cybersecurity firm, about the new trend of ‘double extortion attacks’ in which attackers threaten to leak sensitive patient data, and what operators can do to protect themselves. [+]
PMI patients won't jump Sweden's queues
Proposed Swedish legislation will prevent patients with private health insurance from getting swifter access to Sweden’s public health system. The privately insured population has risen seven fold since 2000. [+]
Right shift could boost Swedish for-profit
Less than three weeks ahead of the September 11 elections, Swedish parties are neck-to-neck in the opinion polls. The question is whether the centre left Social Democratic Party will remain in power. In its favour is the relative popularity of Prime Minister Magdalena Andersson, who in the polls is well ahead of opposition leaders. [+]
Ramsay rejects new KKR bid after poor results
The acquisition of multinational Australian hospital giant Ramsay Health Care by a consortium led by US PE firm KKR looks likely to fall through, as KKR lowered its offer almost immediately after Ramsay reported disappointing FY2022 results and Ramsay then rejected the new offer. [+]
€1bn for ventilator patient business
Opseo, a German company whose core business is keeping patients alive on mechanical ventilators, is to be sold this autumn. Other players in this uniquely German sector may follow. [+]
German labs sector ‘to grow strongly’
Opportunities for consolidation in the German diagnostic labs sector have almost dried up, according to a large lab operator. But the market as a whole will continue to grow strongly post-Covid, with revenue up as much as 4-5% per annum, he said. [+]
What does Kiwi deal tell us about Bupa's plans?
Bupa appears to be selling off its New Zealand nursing home arm. What does this mean for the rest of its huge health care services portfolio – which generated revenue of £3.74bn in 2021 – and of its long-term strategy? [+]
Patient choice or analysis paralysis?
Patient choice is now viewed less as a buzzword and more as a KPI, but how are patients making choices? [+]
Consolidation opportunity in post-Covid Dutch labs sector
The Netherlands' diagnostic labs sector is being held back by low tariffs, which are resulting in low margins meaning there is little incentive to invest in the sector. HBI speaks to an operator who thinks as Covid support wanes, we may see a lot of consolidation. [+]
Domitys tempts residents with promise of exotic holidays abroad
French elderly care and assisted living specialist Domitys is set to offer residents the promise of exotic holidays abroad, jumping onto a bandwagon already embraced by the likes of rival Korian. [+]
Netherlands to end free choice in health care
The Dutch government is seeking to end free choice within health care by removing the obligation on health insurers to reimburse care from any provider. The proposal is part of the cabinet’s plan to shake up the Netherland’s health care system, and will make it much harder for new entrants to compete with established providers. HBI chats with two market experts to find out more. [+]
KKR exits Max Healthcare
US private equity player KKR has solid its entire stake in India-based hospital chain Max Healthcare, marking its exit from the group, for around Rs9,200 crore. The deal marks its largest exit from an Indian firm, and is the largest single block deal done by any PE firm in India. [+]
Lusiadas deal still on as seller carries cost of muti-million fine
The planned acquisition of Lusiadas Saude, Portugal's third largest hospital group, by France's third largest hospital group Vivalto Sante, will not be impacted by the €34.2m fine that has been handed to Lusiadas by Portugal's competition authority. [+]
Bupa and Ramsay Australia resolve tariff tiff
Insurer Bupa and the Australian branch of multinational hospital chain Ramsay have managed to reach an in-principle agreement over price increases, ensuring Bupa-insured Australians will be able to continue to receive care in Ramsay hospitals for the next three years. [+]
KKR may switch to private credit to finance IVI RMA takeover
Facing an increasingly volatile market, American buyout / investment firm KKR may switch to direct lenders to finance its acquisition of fertility company IVI RMA Global, despite agreeing €800m of underwritten financing from four investment banks. [+]
Four Seasons seller happy to split group for sale
Potential buyers of Four Seasons Health Care Group’s (FSHC) 110 homes must place their bids before the end of September, insists Christie & Co, the business broker in charge of the sale. [+]
Are UK NHS dentists facing extinction?
On July 5, 1948, Aneurin Bevan established the core principles of the UK NHS, designed to meet the needs of all, and free at the point of delivery. Dentistry has been walking its own path for some time now, however, and NHS dentistry is unequivocally in crisis. [+]
Private pay health care growth slower and more volatile than public/statutory growth across big 5 - Infographic
Both private and public/statutory expenditure on health care grew substantially over the course of the 2010s across the UK, Germany, France, Italy and Spain. But public/statutory expenditure growth was both significantly higher and less volatile. [+]
Ramsay deal at risk due to French connection
The US$15bn KKR acquisition of Australia-based Ramsay may not go ahead, owing to consistent problems with the hospital group’s French subsidiary. HBI chats to an Australian analyst to find out more. [+]
Synlab still benefiting from Covid testing windfall
Europe’s largest lab group Synlab earned €618m from Covid testing in the first half of 2022. This was a 30% drop from H1 2021, but higher than what it had initially forecasted for the period. Revenue from underlying, non-Covid activity was strong, at 7.2%, helped by several bolt-on acquisitions. [+]
Pan European IVF provider acquires in London
Czechia-based Pan-European IVF provider FutureLife has acquired London IVF clinic The Centre for Reproductive and Genetic Health (CRGH). [+]
UK private pay dentistry booming, as available NHS dentists become rare as unicorns
Private pay dentistry is booming according to multiple sources in the UK, while finding a dentist free to take on new NHS patients is “like looking for a unicorn” as the profession collectively criticises reimbursement rates, and leaves for more lucrative private work. [+]
Tik Tok’s owner buys Chinese hospital chain
The Chinese owner of social media giant Tik Tok, ByteDance, has bought a hospital chain in China which specialises in women and children’s care, for $1.5bn. [+]
Dutch nursing home acquisition creates rival to Orpea and Korian
HBI hears that Dutch nursing home operator Domus Magnus has acquired competitor Valuas Zorggroep. [+]
Interview—Peter Karli head of Heal Partners, Budapest, Hungary
Peter Karli, the urbane owner and MD of Central and Eastern European-focussed M&A advisory firm Heal Partners KFT, expects “explosive growth in Hungary’s dynamic for-profit healthcare market". HBI chats to him to find out more. [+]
Babylon may pull back in Europe to focus on US market
As UK tech start-up Babylon Health withdraws from a couple of ten-year contracts with NHS Trusts eight years early, we speak to a digital health expert who tells us he isn't surprised as the US market is the place to be. [+]
Orpea selling 32 Dutch nursing homes and paying back €55.8m to French government
Orpea is selling 32 of its nursing homes in The Netherlands to Syntrus Achmea Real Estate & Finance (a REIT) for approximately €125m, as part of the asset disposal part of its plan to clean up its finances. The company, which is also trying to clean up its reputation in light of accusations of malpractice, has agreed to pay back €55.8m to the French government after public investigations following the suggestion it misappropriated public funds. [+]
WHO criticises prominence of for-profits in Bulgaria
A World Health Organisation (WHO) Report published in July chastises Bulgaria’s Health Ministry for allowing the for-profit sector to dominate the nation’s healthcare, while much needed reforms look to be on hold following the collapse of the government. [+]
A spurt in German Healthcare M&A deals ahead of uncertain winter
The German healthcare M&A market continues to be buoyant following the boom in 2021. But as autumn draws in, the pace of deals may abate and sellers may struggle to achieve previous heady price premiums, advisors warn. [+]
European Dental Group "up for sale soon"
HBI hears that pan-European and dentist-led European Dental Group (EDG) could be up for sale soon. HBI takes a look at the business and possible pricing at a time when dentistry continues to be a hot ticket. [+]
Covid testing windfall for lab groups coming to an end - Infographic
After peaking earlier this year, testing volumes for Covid in Europe have fallen back to almost the level they were at in the first months of the pandemic. [+]
Mediclinic accepts £3.7bn bid
The board of Mediclinic, the South Africa-based multinational hospital giant, have announced they have agreed acquisition terms with the consortium comprised of Remgro, the investment vehicle of the billionaire Rupert family and a long-time Mediclinic shareholder, and the Mediterranean Shipping Company (MSC). They have recommended these terms to shareholders. [+]
Can ESG transform capitalism - or is it just corporate guff?
ESG - Environmental, Social and Governance - is all the rage in corporate circles these days. Mention of ESG in S&P 500 quarterly earnings calls has increased almost a hundred fold since 2017. And it’s not just energy companies and other big polluters who are making attempts to incorporate it into their strategies. Since Covid, healthcare services companies are increasingly doing so as well. Many healthcare companies are choosing to focus particularly on the S part of ESG, emphasising their ability to improve access to healthcare and contribute to a healthier society. [+]
Interview: Peter Fish, CEO, Mendelian
HBI chats with Peter Fish, CEO of Mendelian, a company which combines patient medical records with the most-up-to date academic data on risk factors, using big data to uncover the patterns that doctors are missing and find the undiagnosed sufferers of rare diseases. [+]
Henry Dunant merger makes public sector acquisition unlikely
Henry Dunant Hospital, Greece’s largest private hospital, is now unlikely to be sold to the public sector after a merger between its parent company Imithea and Greek healthcare services multitasker Euromedica. [+]
Fresenius: "We're not selling"
Germany-based healthcare conglomerate Fresenius tells HBI it isn't currently looking to carve off parts of its business for sale, and despite mixed H1 results it sees plenty of opportunities for growth. [+]
Ramsay Australia suggests Bupa-insured switch insurer after tariff negotiations fail
Ramsay Australia, the Australian branch of multinational hospital group Ramsay Health Care, is no longer contracted with insurer Bupa after the two companies failed to come to an agreement in negotiations over tariff increases. Ramsay has advised the four million Australians insured by Bupa to switch to another insurer rather than pay out-of-pocket to receive care from Ramsay hospitals and clinics from October 2. [+]
Comparison of EU5 labs market plus 7 largest multi-national European operations
This week we take a closer look at how the lab services market stacks up in the five major European markets of France, Spain, Germany, Italy, and the UK. Here we compared the total, for-profit and public market revenues, seeing where operators took the biggest revenues. These figures are a snapshot of the 2021 figures in our labs report in HBI Intelligence. [+]
VPS IPO stalls
Abu Dhabi-based multinational healthcare group VPS seems to have quietly canned its planned IPO. [+]
Massive opportunities for M&A as French imaging sector consolidates
Almost 30 per cent of France’s €4.1 billion outpatient imaging market will consolidate in the next five years, an informed HBI source predicts. [+]
Kry keeps mum on valuation but is "unlikely" to be devalued
Kry, the Swedish telehealth company also known as Livi in the UK and France, has raised US$160m of debt and equity funding in Series D follow-on funding. However, the firm has kept a tight lid on its valuation and observers are conflicted as to why this is. [+]
CEOs change at Maisons de Famille
Philippe Tapié has retired as CEO of Maisons de Famille, the European elderly care and nursing home group. He remains on the board of the firm’s Italian division. [+]
British lab minnow takes on America
NVM Capital has bought a majority stake in Yorktest, the largest UK food intolerance testing lab. The company, which has doubled sales in two years, plans to expand in the USA where it faces Everlywell, which is valued at several billion dollars. [+]
Centene sells Ribera
US healthcare giant Centene confirmed it has sold its Spanish and Central European subsidiaries to French private hospital group Vivalto Santé, but has yet to find a buyer for Circle Health, the second largest UK hospital chain. [+]
How precision medicine and austerity will change health care
Here is how Prof Antony Rosen, vice dean for research at Johns Hopkins, sees precision medicine in its broadest sense changing the business model in a world where more and more payors are imposing arbitrary ceilings on what they pay providers. [+]
Ramsay deal may unblock
Media reports suggest that Ramsay Santé, the 53%-owned continental European arm of Ramsay Health Care, may relent and allow KKR to carry out due diligence which would enable it to complete on its AU$88 a share bid. But investors were not convinced with the shares languishing at AU$69.84 at close of play. [+]
HBI 2022: Everyone sees the benefits of sharing data, but not everyone is willing to share
In a recent survey, 90% of surveyed patients agreed that everyone can benefit from the sharing of patient data – but 23% said they would be reluctant to share their own data - even if it was private. Dr Nick West, chief medical officer, global medical affairs, Abbott Vascular, explained more about the benefit of sharing data at HBI 2022. [+]
Interview: Arjan Toor, CEO, Cigna Europe
HBI chats with Arjan Toor, CEO of Cigna Europe, about innovation in the insurance market against a backdrop of the pandemic, and a growing crisis in mental health. [+]
Private Chinese hospitals in good health
Consulting group L.E.K. has released the results of its analysis Hospital Priorities 2022 (China edition). The survey of 120 hospital executives explains the sector’s focus points and achievements thus far and the implications of these priorities for pharma and medtech firms. [+]
German hospital sector faces cliff
The number of hospitals losing money will more than double to 59% in 2022 and the situation is likely to get far worse as the Covid block payment comfort cushion has been removed. Meanwhile, statutory insurers face huge deficits, hospital productivity is falling and vacancies increasing. The annual 2022 hospital rating report from the Leibniz Institute of Economic Research and the Institute for Healthcare Business paints a truly dire picture. [+]
Blog: Who has the worst waiting lists?
NHS England's staggering 6.6m waiting list almost certainly had led to a 39% rise to 69,000 in patients paying to go private in the fourth quarter of 2021. What’s worse – only about two thirds of it is thanks to the pandemic. Ireland has an even worse per capita waiting list but what about other European countries? [+]
Infographic: UK and Ireland have the worst waiting lists
England’s staggering waiting list for elective care, which sits at 6.6 million people at time of writing, is unsurprisingly much worse than most other NHS-style systems and very close to the levels in Ireland. Eagle-eyed readers may have already noticed the lack of Bismarckian systems – a triumph of mandatory-insurers? Not necessarily. [+]
Wage inflation hit Medicover and Terveystalo
Terveystalo, the Finnish and now Swedish outpatient network for whom employers are the main customers, and Medicover, the Pan-East European and now Indian group, both saw falls in EBITDA in the second quarter, thanks partly to the tight labour market, which also limited growth. Drops in Covid test volumes hasn't helped either and Terveystalo said that volumes of other tests have not recovered quite as expected. Medicover shares rose 17 SEK to 148SEK on the day, with Terveystalo off €1.4 at €9.17 over the week. [+]
Reforms enable Ambea to raise its social care presence in Denmark
Ambea Group, a major quoted Scandinavian care provider, has been actively buying social care companies in Denmark. We look at why Ambea has been buying in a country which has a history of hostility to for-profit health care and now has a leftist, Social Democrat government. [+]
Amazon buys primary care network for 6x revenue
Amazon surprised markets by buying the loss-making One Medical US primary care chain for $18 a share, a 43% premium. In 2021 One Medical grew revenue by 64% to $623m, on which it lost $243.5m. [+]
Bid may undervalue Mediclinic
South African analysts say the 504p per share, £3.7bn proposed cash offer for Mediclinic International's equity, the South African, Swiss and Middle East hospital group may somewhat undervalue the business. The current offer equates to an enterprise value of £5.88bn. Analysts put the break up value on an enterprise value at between £5.5bn and £6.2bn. HBI reckons the equity alone could be worth £5.2bn. [+]
Portuguese hospital groups face €191 million fine
The Autorldade da Concorrencia (AdC), the Portuguese Competition Authority, has sanctioned and imposed fines of €191 million on several private hospital groups and the Portuguese Private Hospitals Association (APHP). [+]
Psychedelics could shake up mental health treatment - but will require a mindset shift
At the Psychiatry and Mental Health session at HBI 2022 we heard from Adrienne Rivlin (partner at strategy consultancy LEK) about how psychedelic therapy promises to radically transform the mental health sector. But how ready is the sector (not to mention society) for the shift in mindset that this will require? [+]
Four Seasons announces sale of bulk of care homes
UK-based elderly care providers Four Seasons Healthcare Group is for sale, again, this time putting 111 of its 130 care homes up for sale in two weeks time. [+]
A surprisingly good year for the HBI Top 100!
This EMEA Top 100 is extracted from HBI Intelligence which, as well as containing 470 reports on 33 countries and 23 sub-sectors, also includes a database of the top 5,000 health care services operators across Europe, the Middle East and Emerging Markets across Asia and Latin America. The Top 100 shows these companies’ sales relating to health care service activities in EMEA only. [+]
UK must urgently develop diagnostic centres to meet surging demand
The UK National Health Service (NHS) should unquestionably boost outsourcing to counter the acute shortage of diagnostic centres in the country, according to a panel at HBI 2022 focused on "Building Capacity and Care Pathways through Partnerships". [+]
Health care stocks resilient but not immune to darkening economic horizon - Infographic
Most major listed healthcare groups saw a fall in their share prices over the course of the first half of 2022, likely due at least in part to the ever-more-imminent prospect of global recession. The sector hasn't suffered as badly as some others, however. [+]
Icade Santé buys in Spain, and sells in France
French REIT Icade Santé is on a buying and selling spree. On June 30, the company finalised the purchase of Spanish care facilities for €60 million. Two days before it sold four healthcare facilities in France for €78 million. [+]
Romania’s MedLife on takeover trail since beginning of June
Listed Romanian operator MedLife has made six acquisitions between June and July this year. [+]
Ramsay may sell French subsidiary to ease the path for KKR takeover
The Australia-based multinational hospital group Ramsay may sell its share in French subsidiary Ramsay Santé so private equity firm KKR’s proposed AU$88 per share takeover of the group doesn't come under fire from France’s competition authority – but this raises issues with the deal. [+]
Interview: Chad Walkaden, OnTracka
HBI speaks to Chad Walkaden, the founder of OnTracka, a multipronged digital platform which can run decentralised clinical trials, collect real-world data from patients, and provide patients with a digital service which helps them to get the most out of their medicinal treatments. [+]
HBI 2022: Building digital health ecosystems
Covid-19 forced the increased adoption of technology to aid healthcare delivery. The HBI 2022 digital ecosystem panel said in some ways this was detrimental – digital without physical doesn’t lead to quality patient outcomes – but a robust digital health ecosystem must be a priority for the sector moving forward. [+]
Providers criticise Lancet study on correlation between NHS outsourcing and excess deaths
A new study published in the Lancet showing a correlation between increased outsourcing by the UK's NHS to for-profit providers with increased treatable deaths has been rubbished by several in the independent healthcare industry. [+]
HBI 2022: Digital tools and psychedelics could help address mental health crisis
Speakers at the Mental Health and Psychiatry session at HBI 2022 were in complete alignment on one thing: they all agreed that the challenge presented by rapidly increasing demand for mental health services requires radical innovation if supply is to have any chance of keeping up. [+]
HBI 2022: Who will win the Subscription War?
Subscription health models were a popular conversation and "subscription" a bit of a buzzword at HBI2022. A panel of experts looked at how three different companies are making these models work. [+]
HBI 2022: Integrated care is tricky - but worth it
Integrated care is well worth delivering. Not only can it help to break down the silos which get in the way of efficient healthcare delivery, but some very effective tools can only be used with integration. A panel at HBI 2022 asked: What do firms have to consider before they can deliver it? [+]
Mediclinic grants diligence access after latest consortium bid proposal
Mediclinic, the South Africa-based multinational hospital group, has granted due diligence access to the consortium which has made a bid proposal valuing Mediclinic at 504 pence per share, a rise of just 8.8% on the previous offer of 460p plus a 3p dividend. [+]
Patient vs. clinician perspectives on barriers to accurate diagnosis
This week, we look at barriers to accurate diagnosis in two infographics shared by Nick West, chief medical officer in the Vascular Division at US-based multinational medical devices and health care group Abbott, at HBI 2022. [+]
Vivalto Sante goes international with expansion into Portugal and Switzerland
Vivalto Sante, the third largest for-profit hospital group in France, is joining the likes of Fresenius, Ramsay and Mediclinic as it becomes the latest member of the highly select club of multinational hospital groups. As well as having bought a chain of three clinics in Switzerland, it is buying Lusiadas Saude, the third largest hospital group in Portugal. CEO Daniel Caille tells HBI that the decision to go international has nothing to do with opportunities for consolidation within the French market drying up. [+]
Interview with Kate Newhouse, COO and Executive Director of Kooth
HBI caught up with Kate Newhouse, COO and executive director of digital mental health care group Kooth, before her appearance on the mental health panel at HBI2022. [+]
Triton purchases majority stake in Esperi Care
European-focused private equity group Triton has bought a majority stake in Finland-based residential care provider Esperi Care Oy (Esperi). [+]
Unilabs acquires Grupo Centro Scanner, boosting its extensive diagnostic presence in Spain
Global lab and imaging company Unilabs has purchased Grupo Centro Scanner, a diagnostic imaging company in Andalusia. [+]
HBI 2022: Examining the emergence and necessity of affordable private care solutions
NHS systems in the UK and Spain are struggling. L.E.K. Consulting’s breakfast seminar at HBI 2022 examined the emergence - and necessity - of affordable private care as part of the solution. [+]
HBI 2022: How digitalisation is driving a service revolution
The arguments for digitalisation in healthcare services are well-established, and thanks to the pandemic, hybrid models are coming more and more to the fore. How is digitalisation being used to improve financial outcomes, and how is data being used to deliver unprecedented proactive and preventative measures? [+]
HBI 2022: Unlocking the true potential of AI
How can AI improve health outcomes? A panel at HBI 2022 entitled “The Truth about AI” presented solutions, and success rates that caught the eye. [+]
HBI 2022: Money alone isn't the solution to the workforce crisis
There is a global war for talent being keenly fought. Workforce is one of - if not the - most pressing problems in the healthcare sector. Providers at HBI 2022 uniformly fretted over the need to acquire, and retain staff, and shared their views on how best to do this. [+]
HBI 2022: Partnering with university hospitals
University hospitals and their twinned research institutes are the mainstay of health care delivery in EMEA. Their approach to partnering is becoming increasingly sophisticated. Here we look at what they want and at winning partnering strategies that create real value and innovation. [+]
HBI 2022: Is the only way to align incentives between payors and providers to integrate them?
Integrated payor-provider models offer the best hope for eliminating perverse incentives for doctors to over-treat, but it's not clear how easy it will be to implement such models. [+]
HBI 2022: Capitalising on the abundant opportunities in imaging and radiotherapy
There are huge opportunities in imaging and radiotherapy according to a panel at HBI 2022, given how much demand will grow and how many unconsolidated markets there are. But panellists had differing views on the best business model to capitalise on this. [+]
HBI 2022: Home care drastically reduces healthcare costs
“Healthcare professionals spend a lot of time on unnecessary activities,” explained Chris Malone, UK managing director at remote patient monitoring digital health company Luscii, to the Expanding Care at Home panel at HBI 2022. Both of the session's panellists presented cases for how moving towards providing a lot more clinical care in people’s homes, rather than in hospitals and clinics, aided by the use of the latest digital tools, can be used to tackle this issue. [+]
HBI 2022: How to tackle the primary care capacity crisis
Primary care is facing major capacity issues across multiple European countries, but digital innovations are already shaking up the sector. Speakers at the Primary Care Plus session at HBI 2022 explained how a digital and data-enabled move away from synchronous care can free up clinicians' precious time. [+]
HBI 2022: ESG important for property investors as well
Property investors have become increasingly attracted to healthcare assets in recent years, driven by a juicy combination of low risk and high yields. But recent scandals have highlighted the reputational risks of the sector, which property investors are not entirely immune from, and so a focus on ESG that goes beyond energy efficiency requirements for buildings has become essential. [+]
3R buys in Switzerland and looks at France
Naxicap-owned imaging group 3R Réseau Radiologique Romand has bought IRIS Radiologie and is eyeing up France. Germany and Italy are also possibles, HBI hears. [+]
Swiss labs suffer 10% cut, more may follow
Switzerland has chopped its diagnostic lab prices by 10% in a move that is billed as saving CHf 140m (€141). There could well be further crackdowns following a publication highlighting the massive differences between Swiss prices and those in France, Germany and the Netherlands. [+]
New pricing engine allows Spire to capitalise on self-pay
Spire Healthcare, one of the UK’s largest private hospital groups, unveiled its new ‘pricing engine’ at their capital markets day this week - a computer programme which calculates optimal prices based on data about competitor pricing, procedures, inflation, and location, to automate price changes much quicker than was possible previously. [+]
HBI 2022: Rosy future for dentistry, despite resurfacing threats
Pre-Covid, dentistry was seen as one of the hot tickets of healthcare services, largely unconsolidated, and attracting huge interest, not least from private equity. Covid took its toll but as the threat from the pandemic recedes in Europe, the focus has shifted back onto the opportunities in the sector – and onto other, longer-lasting problems like staffing, training, and the threat of recession. Despite these threats, according to a panel at HBI 2022, the future for the sector looks bright. [+]
HBI 2022: Resilient fertility a "ridiculously positive market"
Resilient, recession-proof fertility has a strong future ahead, but will face some challenges in the coming months according to an HBI 2022 panel. Demand is strong, patients came back quickly when clinics - and borders - reopened, and the threat of recession is not causing anyone to lose sleep. [+]
HBI 2022: Considerable scope for growth in the rehabilitation sector
Rehabilitation capacity and services are likely to increase considerably in the coming decade, according to a panel at HBI 2022. [+]
HBI 2022: Affidea on increasing performance while improving patient experience
A breakfast briefing session at HBI 2022 by Affidea, the largest pan-European provider of advanced diagnostics, outpatient and cancer care, took a deep dive into driving operational efficiencies and improving patient experience. [+]
HBI 2022: Panel sees a rosy future for ophthalmology
Ophthalmology continues to be a big area of investor interest, with considerable scope for consolidation in both healthcare services and also medical devices. As governments in the UK, Finland and parts of Eastern Europe in particular continue to increase outsourcing, the potential to unlock additional private pay services is increasing, and upselling of more complex lenses is on the rise. An expert panel convened at HBI 2022 to discuss the opportunities and challenges in the post-pandemic landscape. [+]
HBI 2022: Confidence in long term return on digital healthcare investment
The bear market volatility of digital and other health tech stocks may have unnerved investors, but an HBI 2022 panel is confident about long term return on investment and future expansion of digital healthcare. [+]
HBI 2022: Balance of power in MENA is shifting
There is a risk, when looking at healthcare markets in MENA, of lumping all the countries together as one - but each market has very specific requirements, and very specific characteristics. A panel at HBI 2022 chaired by Hamid Yunis, partner at global law firm McDermott Will & Emery, investigated challenges and opportunities in the region - and how rapidly the markets are changing and why overseas players now need to work harder to impress. [+]
HBI 2022: Dementia care clearly insufficient
The inexorable rise in the need for dementia care dominated the elderly care panel discussion at HBI 2022, whilst the global staffing crisis was also, inevitably, on the agenda. Is enough being done to prepare for the sharp rise in dementia patients expected in the coming years, and how are groups dealing with the war for talent? [+]
Elderly capacity nowhere near enough to meet growing dementia need
In this week's infographics, prepared by strategy consultancy L.E.K. for HBI 2022, we look at the massive growth that will be seen in the number of elderly people with dementia across major European countries by 2030 alongside elderly care capacity in those countries. [+]
Fresenius looking to split off Helios and merge it with competitor
Germany-based multinational healthcare group Fresenius SE is reportedly leaning towards splitting off hospital branch Fresenius Helios and merging it with a competitor hospital chain in order to grow the business and increase its profitability. A spokesperson for the group tells us any such deal would involve Fresenius SE staying on as majority shareholder. [+]
HBI 2022: M&A may slow in H2, but demand remains strong
“We are about to face a global recession,” conceded Hedley Goldberg, managing director at financial advisory group Rothschild, to a packed out audience at the plenary session on the M&A landscape at HBI 2022. “But it will be an unusual one with high levels of inflation and employment.” [+]
HBI 2022: Trade associations preferred way for sector to defend itself
There were some eye catching audience poll results at the start of the Regulatory and Political Risk session at HBI 2022. A significant majority thought recent negative media coverage of for-profit health and care providers had impacted investor confidence - and that it would lead to new regulations. [+]
HBI 2022: Germany's outpatient regulatory restrictions 'must change'
The attraction of the DACH region (Germany, Austria and Switzerland) for investors is clear, yet despite there being a willingness to pay for extra services across the region, the coming economic crisis does present a unique set of challenges to each country. [+]
HBI 2022: Is healthcare financially sustainable?
Daniela Hommel, CFO at healthcare communications firm Helios Global Health, starkly laid out the problem facing the healthcare sector at HBI 2022: “Healthcare is not financially sustainable if it continues along current trends. By 2050, 25% of GDP will have to go towards healthcare if these trends continue. This is not financeable." [+]
NHS bad, Bismarck good
There was profound pessimism about Westminster-style NHS healthcare systems on display at the European Healthcare Policy Group (EHPG). And even more pessimism about integrated healthcare, the latest buzzword from NHS England. [+]
Why Westminster NHS systems fail
Profound pessimism about NHS plans for integrated health and with NHS systems in the UK and Canada was on display from academics at the European Health Policymakers Group which celebrated its 21st year in an afternoon looking at what the group had learnt studying Beveridge (NHS) and Bismarckian (statutory insurer) models. [+]
Biogroup co-founder found dead in Paris, aged 52
Stéphane Eimer, president and co-founder of French laboratory company Biogroup, died on Wednesday, June 22. [+]
Pandemic increased willingness to self-pay - but cost of living crisis will decrease it - Infographic
In this week's infographic we look at survey data collected by strategy consultancy L.E.K. that was presented at HBI 2022. The data suggests that willingness to pay privately increased as a result of the pandemic, but could be about to decrease due to the cost of living crisis. [+]
Twenty things we learned at HBI 2022
HBI 2022, the year's largest CxO-level for-profit healthcare services conference, took place in central London this week. The conference stages and the floor were awash with interesting ideas, staggering statistics, suggestions for building a better business and the buzz of new friendships being formed. As always, there were new things to learn. Here are twenty of our top take aways from this year's event. [+]
HBI 2022: Lack of debt may hit M&A in second half
M&A deals in health care services such as the bid for British health and beauty retailer and pharmacy chain Boots are coming under threat as market uncertainty, interest rates and inflation soar. Massive deals may fail if debt dries up. This could lead to a further slow-down in M&A activity in the second half of 2022, following a record year 2021. [+]
Russians flock to Turkey for healthcare as other international options dwindle
Sources in Turkey tell HBI that Russians are coming to Turkey in unprecedented numbers for medical treatment, as sanctions imposed following the war in Ukraine continue to bite. [+]
Covid fears being replaced by familiar worries
As the threat posed by Covid largely recedes in most European countries and beyond, the collective attention of those working in healthcare services has returned to the familiar challenges which never went away, but were masked by the more immediate and headline-grabbing threat of the pandemic. Three immediately spring to mind following HBI 2022 this week: 1) Finances, and the threat of recession. 2) Where to find staff, and how to retain them. 3) The rise of the importance of the patient experience. [+]
IHPN: Independent hospitals under used for NHS backlog
Independent hospital providers in the UK say its NHS is not sufficiently using its capacity to deal with the elective surgery backlog, despite saying it would do so. [+]
Orpea may need to rebrand in Middle East expansion
Embattled French elderly care firm Orpea may need to rebrand its Middle East expansion, a source close to to the company tells HBI, but not everyone agrees. [+]
Major french hospital group moves into Canada
One of the largest French hospital groups has bought two facilities in Quebec where it says it will be able to build and open more for-profit hospitals something that is now impossible in France. [+]
US academic medical centres face squeeze
The 100 academic medical centres which make up the core of US healthcare delivery face a squeeze. University of Pittsburgh Medical Center and Mayo both notched up net losses due in part to hikes in labour costs and caps on tariffs. An AMC source said that the model as a whole was under threat as disruptors peel away the high profit margin services that AMCs use to help finance loss-makers like behavioural health. [+]
Korian and Club Med join forces with new luxury assisted living site
French elderly care giant Korian has opened a new senior living complex in partnership with holiday resort provider Club Med. The luxury complex will include a restaurant from Michelin star chef Pierre Gagnaire. [+]
HBI 2022: Digital massively reduces costs
Digital health and AI are finally demonstrably making huge savings in healthcare delivery costs in many ways, said several speakers at HBI 2022, citing examples of 50% savings in primary care and counselling. [+]
HBI 2022: Predicting telehealth company valuations is "like reading tea leaves"
According to a digital healthcare expert at HBI 2022, we may as well all stop trying to predict where telehealth company valuations are likely to go over the next couple of years. It simply isn't possible. [+]
HBI 2022: Rush to deal in data could see the hospitals who act fastest winning big
Hospitals are racing to cut deals to sell their data - and those able to package it and find the right partners quick enough could find themselves with a substantial market advantage. [+]
Spain "too reliant" on for profits to pull the plug
The Spanish government has put forward a draft bill to strengthen its NHS system, and wean it off the private sector. A well-placed source at HBI 2022 tells us that for-profits are so entrenched and vital to Spain's NHS system that attempts to remove them would be too catastrophic, meaning a wholesale removal is highly unlikely. The bill still needs to pass the legislature before it becomes law. [+]
Parsa: “We are at the threshold of biggest change ever to take place in healthcare”
At the HealthTech Summit in London, Ali Parsa, CEO of US-listed-telehealth group Babylon, clashed with Kevin Ryan, CEO of New York investment fund AlleyCorp, over the level of threat the current economic climate poses to digital health companies. [+]
For-profit health care at the cross roads
Next week is a real opportunity to assess where health care services is internationally at HBI 2022 in London. So what are the big questions? [+]
Saudi Arabia backs new $400m hospital for Jordan
The University College London Medical School (UCLMS) is joining forces with the Saudi Jordanian Investment Fund (SJIF) and UCLA Health in a new $400 million (€380m) university hospital in Jordan. [+]
Spain to ban health care outsourcing
The leftist Spanish government has put forward a draft bill to increase the ‘equity, universality and cohesion’ of its NHS system, which includes a decree to limit the use of the private sector. The bill has to pass parliament before it becomes law. The Spanish Private Health Alliance has said it could fight the law in the courts if necessary. [+]
Metropolis denies it is open to bidders
Metropolis Healthcare, the big Indian diagnostic and pathology group, is determined to forestall potential predators despite talk of a $1bn joint bid from hospital chain Apollo and conglomerate Adani Group. [+]
Atrys buys Bienzobas for €76.3m
Despite its recent share price falls, highly acquisitive Spanish laboratory diagnostic group Atrys Health is to buy Bienzobas for €76.3m, a Spanish company which provides oncology services to insurance companies and hospital groups. [+]
Operose faces accusations
Operose Health, one of the biggest GP providers to the UK NHS, is facing an accusation of mismanagement at one of its surgeries by an undercover BBC Panorama investigation. It blames a national lack of GPs. [+]
Interview: Christina Triantafyllou, head of improving patient experience, Siemens Healthineers
As patients are becoming increasingly savvy and well-informed healthcare consumers, the focus on patient experience has never been stronger, and the ongoing pandemic put this into even sharper focus. HBI catches up with Dr Christina Triantafyllou, Siemens Healthineers’ head of improving patient experience, to find out more. [+]
New report: International Investing in Healthcare and Life Sciences 2022
The latest report from global law firm McDermott Will & Emery (McDermott) looks at the international investment landscape in healthcare, and life sciences. HBI speaks to McDermott’s London head of healthcare, Sharon Lamb to find out more. [+]
Comparing European care markets - Infographic
In this week's infographic we take a closer look at the for-profit adult and elderly care market across Europe. We look at how the for-profit markets compare across the different countries as well as at the types of care, most predominant in those countries. We have compared the markets based on a Euro per capita basis. [+]
Kry self-reports Facebook data breach to Swedish authorities
Swedish telehealth provider Kry says it will co-operate with an investigation by the Swedish Authority for Privacy Protection (IMY) into the sharing of user contact information with Facebook - an 'error' which Kry has admitted to. [+]
UK government launches digital health strategy
The UK government has launched a new strategy for the use of digital technology and data in the health and social care sectors. Health secretary Sajid Javid gave a speech at the HealthTech Summit in London on the day of the launch about how the strategy will shake up the sector. [+]
Bridgepoint’s acquisition of Dentego falls through over price
Listed British PE firm Bridgepoint’s planned acquisition of Dentego, France’s largest dentistry group, has fallen through due to disagreements with the vendor over the price. [+]
Largest lab group in GCC likely to list
Al Borg Diagnostics with 64 labs across 8 countries in GCC and Africa and a dominant position in Saudi Arabia, its home market, looks set to finally list in 2022. We speculate (wildly!) on valuation. [+]
French imaging group Simago looks to sell stake
Privately owned French imaging services group Simago is looking to sell at least a minority stake, HBI hears. [+]
KKR mulls post-takeover Ramsay sale-and-leaseback deal
The consortium led by private equity firm KKR is reportedly planning sale-and-leaseback deals should its proposed US$15bn takeover of multinational hospital group Ramsay Health Care prove successful, and is looking for suitors. [+]
Did we get Covid vaccination wrong?
There will be many aspects of the world’s response to Covid-19 that will be debated for years to come. Were governments too rash and draconian in their imposition of lockdowns? Or were they too slow and hesitant, costing thousands of lives? Was it appropriate to more or less completely halt elective care for months on end? Or was this unavoidable to prevent hospitals overflowing? Was it right to ban relatives from saying goodbye to their quarantined loved ones, or to effectively put mental health patients in solitary confinement (as happened in many NHS trusts in the UK)? How effective were mandates to wear masks in public places? [+]
Comparison of EU5 hospital market plus 10 largest European operations - Infographic
This week we take a closer look at how the hospital market stacks up, specifically in five major European markets – France, Spain, Germany, Italy and UK. [+]