1017 results and Covid 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.comIndian government defends its health spending record as the country goes to the polls
The voting began in the world’s largest democracy today with 970 million eligible voters. Health ranks among the top three voter priorities in this general election. [+]
UK ophtha market heating up, whilst Germany’s remains cool
The UK’s for-profit ophthalmology sector is heating up, with multiple groups likely to come up for sale this year. This is being driven by the long term increase in the amount of cataract surgeries the NHS is outsourcing. Meanwhile deal activity in Germany’s sector is still on pause, due to a decrease in cataract surgery post Covid. [+]
Luz Saude IPO to finally go ahead
Luz Saude, Portugal’s second largest private hospital group by revenue, will become a listed company once again, six years after it was taken private by its insurer-owner, Fidelidade. The company has confirmed an IPO on Portugal’s Euronext Lisbon exchange will go ahead, almost a year after reports of plans to relist initially began circulating. [+]
The new era in holistic health care delivery
In this Guest Post, Charles Dalton and Raju Narayan advocate for a shift towards a patient-centric, holistic healthcare delivery system to enhance efficiency and accessibility in emerging economies.
[+]
French private hospitals to strike over measly 0.3% tariff rise
Private hospitals and clinics in France will go on strike from June 3rd, in protest of tariffs only rising 0.3% for 2024 - well below inflation. Public hospital tariffs are projected to rise by 4.3% for the year. [+]
Recare secures €3.2m for expansion of digital discharge management in Germany amidst healthcare digitisation push
Recare, a Berlin-based health tech company, has successfully raised €3.2 million in fresh capital to expand its digital discharge management marketplace in Germany. [+]
UK care home sector reaches strongest position in years
Whilst the care home market across much of continental Europe is still reeling from the triple hangover from Covid, the Orpea scandal and inflation, the UK’s care home sector is currently in the best state it's been in for years. [+]
AXA UK acquires HBSUK
Insurance company AXA UK has acquired healthcare services provider HBSUK. It shows how the group is pursuing a wider remit than traditionally expected of insurance companies. [+]
Interviews: CCO and Wellbeing Director at Riverstone
Resting somewhere at the intersection between hospitality and care sits the burgeoning niche of luxury retirement villages. HBI sits down with the wellbeing director and chief commercial officer at London-based independent living facility Riverstone to learn more about this budding market. [+]
UK government's £20,000 golden hellos "not enough" to lure dentists back to ailing NHS
The UK government has announced plans to improve dental access, including offering dentists who set up NHS-serving practices in medical deserts £20,000 “golden hellos”. Five expert sources explain what this means – or doesn’t mean – for business. [+]
UK pharmacists given green light to prescribe as primary care can't cope
Pharmacists in the UK now have the right to prescribe for common ailments such as sore throats and earaches. In France, Ireland and Portugal pharmacists also have some prescribing rights and similar initiatives may be introduced in other European countries in the near future. Is this a solution to the GP workforce shortage? And will it be a good thing for private hospital and private primary care groups? [+]
Bankrupt English councils a worry for care operators
As increasing numbers of local councils in England declare themselves bankrupt, fees are giving care home operators cause for concern. HBI catches up with two market experts to understand why more insolvencies are on the way, and what this could mean for the sector’s future. [+]
Interview: Alberto de Rosa, President of Ribera Salud
Have public-private partnerships had their day? Who better to answer this than Alberto de Rosa, president of Spanish hospital group Ribera Salud which was forced to pivot away from PPPs to fight off political opposition, and meet the demands of a shifting Spanish healthcare environment. HBI asks him how the model, in any form, might survive. [+]
Interview: Rebekah Cresswell, CEO, Priory
With a workforce on its knees, it is little surprise that the prospect of ‘care as a career' is becoming an increasingly difficult reality. HBI speaks to UK mental health and social care provider Priory’s CEO Rebekah Cresswell about the government’s latest reforms, and how staff retention can be improved even when times are tough. [+]
Four things to look out for in 2024
As we celebrate the new year, here are four predictions for 2024. [+]
Strikes and workforce malcontent set the tone for 2024
One week into the new year, and it’s already painfully clear that personnel problems persist. As a tide of industrial action by healthcare workers sweeps across the UK, HBI speaks to two market experts for their predictions about the workforce crisis going into 2024. [+]
Emerging markets may have an AI advantage
‘Moore’s Law’ suggests that the number of transistors on a microchip doubles about every two years, while the cost of computers halves. It's an old observation, but the idea that computing power tends to increase exponentially over time still resonates. Today the idea is most frequently applied to artificial intelligence, and with rapidly advancing developments in generative AI, 2024 is poised to become one of the most transformative years on record. [+]
EU hospital markets comparison: A tale of squeezed margins and surgical delays
With ballooning energy bills still eating into profits, and workforce woes creating hospital staffing headaches, HBI speaks to experts from across Europe to ask how the big five EU hospital markets are faring as we look forward to 2024. [+]
Orpea'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? [+]
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. [+]
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. [+]
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: 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 do about Federal Health Minister Karl Lauterbach’s proposed reforms - but whatever the outcome there are opportunities as well as challenges ahead. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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? [+]
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? [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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). [+]
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. [+]
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. [+]
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. [+]
$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. [+]
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 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: 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? [+]
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. [+]
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. [+]
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: 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: 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: 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 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 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: 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: 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 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: [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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: 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. [+]
€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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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). [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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? [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
Optegra sale on hold
HBI understands from multiple sources that the sale of UK-based ophthalmology group Optegra is on hold. [+]
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. [+]
€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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
Waiting for the Tsunami...
Fear, uncertainty and doubt stalk the sector. Batten down the hatches and hope for the best! [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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). [+]
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: 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. [+]
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: 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: 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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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. [+]
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? [+]
Interview, Kirsty Bashforth, Chief business officer, Diaverum
Chronic Kidney Disease is a continuing to rise, further impacted by COVID and the wider economic burden. We discuss how digitalisation, improving health literacy and a more holistic approach could make a difference to the outlook in this sector with Kirsty Bashforth, chief business officer, Diaverum, ahead of her How to Build a Brand workshop at HBI 2022. [+]
INVL buys three sanatoriums in Baltics
INVL Baltic Sea Growth Fund is acquiring three sanatoriums in the Baltics. [+]
RNA Covid vaccines could have adverse non-specific effects
A new meta-analysis study examining the results from Covid vaccine trials suggests a worrying possibility: that mRNA Covid vaccines, despite protecting against Covid, could reduce the immune system's overall ability to fight infections. On the other hand, the study’s findings also suggest the adenovirus Covid vaccines could have the opposite effect. To many this will sound far-fetched, or even the stuff of conspiracy theory, but University of Southern Denmark’s Professor Christine Stabell-Benn, who led the research, explains to HBI that epidemiologists have known for decades that vaccines can have such ‘nonspecific’ effects and emphasises that regulatory frameworks are in dire need of being updated to reflect this. [+]
Rutherford Health to go into liquidation
The for-profit oncology group which holds roughly half the UK's proton beam capacity and has invested over £240m in capex is to go into liquidation, thanks to the pandemic and NHS indifference. In the UK just 1% of acute cancer patients get proton compared to 10% in Europe and 20% in the USA. What is likely to happen next? [+]
NHS primary care dissatisfaction hits record high, pushing patients private
Increasing numbers of patients are choosing to pay for primary care in the UK, driven by record levels of dissatisfaction with NHS primary care. Patients appear to be especially frustrated about access - and a lack of GPs in Germany and France is also creating problems. HBI chats with primary care operators to find out more. [+]
Interview: Ulla Näpänkangas, CEO, Coronaria Eye Health Finland
HBI catches up with Ulla Näpänkangas, CEO at Finland's Coronaria Eye Health ahead of her appearance at HBI 2022 and hears how innovation in ophthalmology is as much about patient pathways and business models as it is about the tech. [+]
The monitoring revolution is happening now
Perhaps the most striking conversation we had at the EIT Health conference in Stockholm this week was with Hans Danneels at Belgian startup Byteflies which sells digital monitoring solutions for Covid, coronary and epilepsy that enable patients to stay at home. [+]
Brits adopting wide range of lifestyle changes to improve health - Infographic
This week we look at figures from Bupa UK which has published a new survey on the health of the UK's population: the Bupa Wellbeing Index. 8,000 adults have been surveyed. [+]
Aetna International winding down business and passing clients to Allianz
US insurance giant Aetna is winding down its international private medical insurance (IPMI) arm, Aetna International, after a failed sale attempt. It is looking to pass its health insurance customers outside of the Americas to rival Allianz Partners. [+]
What we learnt at the EIT Health conference
Has Covid reset the pace of change in healthcare and the appetite for reform in Europe? The EIT Health conference in Stockholm was a good opportunity to answer those twin questions. [+]
UK parliamentary committee to examine NHS’ progress on digitalisation
A UK parliamentary committee headed by former health secretary Jeremy Hunt has launched an enquiry into digital transformation in the NHS. MPs will look at how digital technology is currently being used and consider what could be improved. This will include an evaluation of possibilities for greater cooperation between the NHS and the private sector and how this could boost innovation. [+]
Interview: Zeinab Ardeshir, CEO, PillSorted
Zeinab Ardeshir has worked in pharmacy for 17 years in multiple countries, but although she has generally enjoyed this experience, she found that a lot of her time was spent on mundane repetitive tasks which seemed like a waste for someone with her medical knowledge. [+]
Orpea employees strike over decision to not pay bonus
Employees at nursing homes across France operated by beleaguered elderly care group Orpea participated in a strike on Tuesday, to protest the company’s decision to not pay incentive bonuses this year. [+]
Social bond finances for-profit diabetes prevention
A Swedish pension fund is investing via a social bond in a programme that aims to stop unfit 50-60 year olds in Stockholm developing diabetes 2 and other expensive conditions. The scheme, run by a start up, is set to roll out more widely in Sweden and internationally. Bogi Eliasen, Director of Health at the Copenhagen Institute For Futures Studies says that Scandinavian countries, Qatar and Saudi Arabia are all keen to up prevention spend and are looking at similar schemes. [+]
Warsaw hub model set to spread across CEE
A new Warsaw Health Innovation Hub in Poland has seen 30 big pharma and medtech contribute brains and money to tackle healthcare projects, extending the cooperation which developed during Covid between the government and the private sector. Healthcare providers are set to join. The model is likely to be adopted by other CEE countries. [+]
A new threat emerges as Covid recedes
At the start of the year as people increasingly learned to live with the threat of Covid, there was a general feeling of optimism. Deals were being done. Travel resumed. It was business as usual - with some pent-up demand to boot. But with medical costs rising, a new row is brewing that could derail all this good will. [+]
Vitaldent acquisition shows shift to aesthetics
Spanish / Italian dentistry network VitalDent has incorporated its latest acquisition, 73 clinics previously owned by Smysecret. The acquisition marks a deliberate move to aesthetics targeting the 18-35 age group and adds significantly to its burgeoning business. [+]
Inflow of doctors to Europe's top five healthcare markets - Infographic
Migration of health care workforce frequently makes headline news, but in this infographic we use OECD data to take a closer look at the inflow of doctors in to the top five European healthcare markets since 2015. We then provide a breakdown of country of origin for those countries in the last reported year. [+]
Inflation hikes up care home costs
How will the care home sector cope with the wave of inflation now hitting it as staff, energy costs and rents soar? We talk to operators and advisers across Europe. [+]
Interview, Sneh Khemka, SimplyHealth
HBI speaks with Sneh Khemka, HBI 2022 panellist and CEO of UK-based cash plan group Simplyhealth, to hear why he thinks it is time for groups like his to step out of the shadows. [+]
German health minister plans to introduce 'health kiosks' across country
German health minister Karl Lauterbach plans to expand roll out 'health kiosks', currently in some German cities, across the country as part of his plan to prepare for the next Covid wave. [+]
Interview: Joe Stringer, partner, Octopus Ventures
Joe Stringer, healthcare investment specialist, and partner at Octopus Ventures which invests in and supports start-up businesses across Europe, talks to HBI about his approach to investment ahead of his panel appearance at HBI 2022. [+]
Interview: Stéphane Pichon, founding managing partner, Your Care Consult
HBI catches up with Stéphane Pichon, founding managing partner, Your Care Consult, and chair of the Investing in Healthcare Property session at HBI 2022 on June 21, to find out how the healthcare property market fared last year, and prospects for the future. [+]
Bupa Australia accuses Ramsay of strategic price hikes as Ramsay terminates partnership
The Australian branch of multinational hospital giant Ramsay Health Care has terminated its partnership with insurer Bupa, meaning Bupa-insured patients in Australia will have to pay out-of-pocket for its care. Bupa Australia subsequently accused Ramsay of “unreasonably high" price increases, claiming this was done to increase the group’s value in light of its on-going sale process. Meanwhile, Ramsay has reported poor financial results and analysts from investment bank Citigroup have said limited additional value could be squeezed out of the group, and that a higher bid than KKR's is therefore unlikely. [+]
Two new rival hospitals open in central London
This week UK healthcare charity Nuffield Trust opened a hospital in its first central London site, located within the grounds of Barts Health NHS Trust’s St Bartholomew’s Hospital site, while Cleveland Clinic last week opened a large facility in Grosvenor Place, also in central London. [+]
Sri Lankan healthcare sector in crisis as government hikes medicine prices to combat shortages
Sri Lanka’s government has increased the price of several pharmaceutical products that are in short supply by 40%, as the country’s healthcare system is crippled by the on-going economic crisis in the country. [+]
Diaverum launches holiday booking platform
Global renal care provider Diaverum is launching a digital platform for holiday dialysis booking. HBI speaks with Bruno Pamplona Polizio, director of global communications at Diaverum, to learn more. [+]
A common challenge - but is the obvious answer really unachievable?
Almost everywhere we look in healthcare we find workforce challenges, whether it is lack of supply or burnout (or both, especially during Covid) and it doesn't matter whether we are talking public or for-profit. [+]
Unilabs invests €45 million in its Portuguese imaging operation
Pan-European diagnostics services provider Unilabs has invested €45 million in its Portuguese imaging operations. HBI speaks with Luíz Menezes, CEO at Unilabs Portugal, to learn more. [+]
Telehealth growth pushing valuations and multiples to new heights - Infographic
Whilst the number of M&A transactions in the telehealth sector hasn’t seen huge growth, the sector has seen a meteoric rise over the past few years, especially since Covid. In this week’s infographic we look at the growth in revenue of Europe’s largest five telehealth providers and at how the revenue multiples from the valuations telehealth companies receive in M&A transactions has changed. [+]
Hungary facing four more years of Orbanomics
After the crushing victory of national-conservative Fidesz, led by Viktor Orban, the Hungarian healthcare sector awaits another four years of “Orbanomics”. HBI speaks with a Hungarian contact to learn more. [+]
Interview: Katya Zubareva, Partner, L.E.K.
HBI catches up with Katya Zubareva, partner at L.E.K. Consulting, ahead of her appearance on the fertility panel at HBI 2022. In a wide-ranging conversation, she tells us that despite workforce being a consistent challenge to the healthcare services sector, there are some big opportunities. [+]
Orpea opens mental health centre for elderly in Madrid
Elderly care giant Orpea’s hispanic branch, Orpea Iberica, is opening its first mental health centre catering exclusively to over 65s in Madrid. [+]
Back to black: APAC providers returning to profitability, and investing in innovation
As L.E.K. Consulting publishes its APAC report entitled Asia-Pacific Hospital Priorities: Strategic Implications for Healthcare Providers, HBI catches up with its Shanghai-based partner Stephen Sunderland to discuss key trends in the region. [+]
Affidea bought by Groupe Bruxelles Lambert
Groupe Bruxelles Lambert (“GBL”) has signed definitive agreements to acquire a majority stake in European imaging and cancer treatment provider Affidea from B-FLEXION, the private investment firm of the Switzerland-based billionaire Bertarelli family. GBL will invest up to €1bn of equity for the transaction which is its first substantive healthcare investment. [+]
Karl Lauterbach u-turns on voluntary quarantine and loses mandatory vaccine vote
Last week was a rough one for German health minister Karl Lauterbach. First he made an embarrassing u-turn on his decision to end mandatory Covid quarantines and then his government's proposal to introduce mandatory vaccinations, which he has been championing since entering office, was rejected by legislators. [+]
Spanish nursing home bed boom forecast
According to new research, the Spanish nursing home market is forecast to grow by 6.5%, increasing to over 400,000 beds over the next 18 months to two years. HBI speaks with Alberto Fernandez, CEO at Healthcare Activos, a Madrid-based health and long-term care real estate investor, who questions whether the report goes far enough. [+]
Ardian "looking to sell Inovie stake"
Last week we reported that French lab group Inovie is currently in the process of looking for a new majority shareholder. Could private equity fund Ardian be looking to sell its (minority) stake. [+]
Interview: Simon Turton, Gensmile
At the height of Covid, NHS-focussed dental practices calmly told HBI that their revenues were covered by government payments, and their dental activity targets had been slashed or temporarily abandoned. It was a good time to have a strong NHS patient bias. HBI speaks to Simon Turton, CEO and co-founder of UK dental chain Gensmile and panellist at HBI 2022, to hear how the tide may be turning in favour of private funding. [+]
Medica returned to form in 2021 thanks to elective care rebound
After a rough 2020, the UK’s largest teleradiology company, Medica, achieved strong results in 2021, with sales reaching £62m (a 68% increase from 2020 and a 33% increase from 2019), and a healthy 19.5% operating margin. We speak to CEO Stuart Quin to find out more. [+]
€4bn Inovie looking for majority shareholder
French lab group Inovie is looking for a new majority stakeholder off a €4bn+ enterprise value, HBI hears. Inovie is currently working with financial advisers to determine interest from potential buyers. [+]
An NHS bias could become a post-pandemic kick in the teeth for dentists
During the pandemic, we've had a lot of conversations with dental operators in the UK with NHS focussed businesses. Universally, they have been happy with their lot. "We're getting paid in full" they told us - subject to a small clawback - "and we don't have to see patients". [+]
Interview: Dirk Knüppel, Meine Radiologie
Imaging and radiology is hot at the moment - especially in Germany. The next five years are going to see a huge amount of consolidation according to Dirk Knüppel, CEO at EQT-backed Meine Radiologie & Blikk Holding (MRBH) and HBI 2022 panellist. HBI caught up with him to find out more about his group's plans to expand across Europe. [+]
Most major healthcare stocks see fall in Q1 - Infographic
Eleven out of 14 major listed healthcare groups saw their share values decrease in the first quarter of 2022, in spite of (or perhaps in some cases because of) Covid restrictions being lifted in multiple countries. [+]
Is the EU speeding towards FDA-style regulation?
There is a new threat to healthcare companies across Europe which, HBI hears, has the potential to be more impactful than either Covid or Brexit as far as costs are concerned. [+]
Google nudges into booking and scheduling space
Could the bubble be bursting for digital scheduling companies as Google nudges its way in with a new booking feature specifically for healthcare? We take a closer look at what Google's latest plans might mean for the industry. [+]
Healthcare Activos targets Portugal, Germany and Italy as it seals long-term investor deal
Healthcare Activos has new investors as of today - and big plans for tomorrow and beyond. HBI catches up with its clearly enthused founder and executive chairman Jorge Guarner and CEO Albert Fernandez to find out more about their plans for expansion. [+]
Interview: Tim Clover, Rayner
HBI catches up with Tim Clover, CEO of UK-based ophthalmic medical products specialist Rayner, ahead of his appearance as a panellist at HBI 2022. He is excited about the Covid bounceback and hot new tech, but warns new regulations will impact heavily on everyone's costs. [+]
Shanghai lockdown will hit premium providers the most
As China's biggest city Shanghai faces a staggered Covid lockdown, HBI catches up with a Chinese healthcare expert who tells us that premium international operators could be significantly hit. [+]
Doctolib France's biggest Unicorn
Now the largest unicorn in France, Doctolib is valued at €5.8b, three years after it reached unicorn status, despite still making a loss. HBI speaks to a French healthcare consultant and expert to find out how. [+]
Subscription Healthcare: Seizing the Opportunity, HBI 2022
Almost every healthcare operator wants to move from delivering episodes of care to more continuous care delivery with much more constant patient touch. Ultimately that enables the sale of a continuous subscription and so much higher quality earnings. That is one reason why outpatient chains like Terveystalo and Medicover trade considerably higher than hospital groups. [+]
Will record results for Synlab precipitate Cinven sale?
Almost a year after its IPO, lab giant Synlab has posted strong FY21 results bolstered by Covid, but not, it says, dependant on it. Management say extra cash will be used as a springboard for growth. Could it also lead to private equity majority shareholder Cinven selling its remaining interest? [+]
Ramsay makes eye-watering bid for GHP
Ramsay Santé, the European branch of multinational hospital giant Ramsay Healthcare, has made a bid for listed Swedish specialty care provider GHP Specialty Care. [+]
Spanish nursing home market recovering well from Covid cooling
Ever-busy Colisee is set to rent five Spanish care homes from Adriano Care Socimi. HBI speaks with Carlos Araoz, a partner at Adriano, to find out more about the market. [+]
UK self-pay "almost doubles" to a potential 15m
The self-pay market in the UK is growing much faster than other parts of the private sector. Justin Ash, CEO of the UK’s second largest for-profit hospital group, Spire Healthcare, tells us it almost doubled to 15m people in the past two years, and will only continue to grow in the face of the NHS backlog. [+]
Consolidating German outpatient rehabilitation market
Gimv-owned rehaneo has just completed its seventh acquisition in 18 months. What are the attractions of the German outpatient rehabilitation market? [+]
India's Unicorns and Soonicorns - Infographic
India’s health startups have attracted crazy levels of investment, creating five unicorns in a year, with more to follow. HBI takes a closer look. [+]
Orpea and Korian's share prices boosted by hidden camera exposé
Both Korian and Orpea’s share prices increased more than 10% after the release of investigative TV show Cash Investigation’s hidden camera episode revealing scenes inside a Korian nursing home. Meanwhile Orpea’s expansion into Russia has been halted after last week’s invasion of Ukraine and French public investment bank Bpifrance pulled out. [+]
Covid disruptions reduce Ramsay profits by 30%
Australian multi-national hospital group Ramsay saw steady sales but sharply decreasing earnings in the last six months of 2021. The company says this was due to Covid disruptions, whilst underlying demand for healthcare services remains strong. [+]
Health care tourism market recovering fast in Thailand
Thai healthcare tourism is set to recover in 2022, after the dive caused by the restrictions in international traffic caused by the COVID pandemic, say analysts. We look at the results for listed hospital group Bumrungrad, which has built its business on medical tourism and cares for over 1.1m patients a year from 190 countries, and talk to Kasem Prunratanmala, Head of Equity Research at Principal Malaysia Titans Plus Fund. [+]
Eurofins to build lab hubs
After a strong performance in 2021, international lab group Eurofins plans to build diagnostic lab hubs, which will enable it to increase the volume of tested samples. HBI talks with the source close to the company to find out more. [+]
Brazil, the only way is vertical! - Infographic
Payor/provider vertical integration is the most successful strategy in Brazil according to our experts. 2022 February finally saw the merger of the two Brazilian giants of vertical integration, Grupo Notredame Intermédica (GNDI) is now a wholly owned subsidiary of Hapvida. Together they became the second largest health care company in the southern hemisphere and currently have a market cap of US$17.2bn and approximately 17% of the Healthcare Plan insurance market, according to experts. [+]
Pihlajalinna shares fall on results
Finnish outsourcing specialist Pihlajalinna posted some reasonable looking financials, on the face of it, for the full year to January 31, 2021 on Friday last week - so why have its shares dropped around 11% at the time of writing? [+]
Finnish SOTE reform 'could create more outsourcing opportunities'
In July 2021, Finland’s leftist parliament passed the long-awaited SOTE reform to its healthcare system, which amalgamated 309 municipal health authorities into 21 much larger ‘welfare regions’. HBI speaks to analysts and operators to find out what impact the reform is having on the for-profit sector. [+]
Covid and Sweden boost Terveystalo
Terveystalo, one of Finland’s two for-profit healthcare giants, saw strong growth in 2021, helped by its recent move into Sweden and a Covid boost. We speak to Terveystalo’s head of investor relations and two analysts, to analyse growth drivers. [+]
US lab giants see steep downturn as Covid ends
Labcorp and Quest saw big drops in fourth quarter revenue as Covid testing fell and warned of 60-75% declines in 2022. [+]
New homecare to hospital platform launches in France
A major French operator, the Doctegestio group, has launched a new platform called Avec which combines everything from dentistry and primary care to hospital and nursing homes. We talk to Bernard Bensaid, the entrepreneur behind Avec. [+]
Interview: Klaus Boehncke, Partner, L.E.K.
Precisely how is digital and telehealth changing the way health care is being delivered? We catch up with LEK's digital guru Klaus Boehncke who is full of examples! [+]
Staff exodus could be a lasting legacy of Ukrainian conflict
The threat of armed conflict continues to loom over Ukraine. Any escalation could have devastating consequences for the region, threatening lives and livelihoods - and yet the local contacts HBI has spoken to remain remarkably sanguine. [+]
Lusiadas Saude for sale
HBI hears Lusiadas Saude, Portugal’s third-largest hospital group by revenue, is for sale. Meanwhile, imaging and labs may be affected by the surprise re-election of the leftist Socialist government. HBI speaks with a healthcare consultant in Portugal to find out more. [+]
New Czech government set to liberalise health care market
The new centre-right Czech government will try to liberalise the healthcare market, could introduce supplementary insurance and may even reintroduce hugely unpopular co-pays. HBI talks with Dr Oldrich Subtr, the founder of Program Health Plus, a private polyclinic based in Prague. [+]
Interview: Jürgen Laartz, founder, and Alexandra Cosma, COO, EDU Malta
A five and a half year education (Batchelor + Masters) as a doctor for just €100,000? That is what is on offer from EDU Malta, a for-profit educational institute with statutes which commit it to working for the public good. It is working closely with Fresenius Helios and other German hospitals and is looking for hospital partners in other countries. So how does it work, what are EDU’s plans and what role could this play in dealing with the massive world shortage of doctors? [+]
Romanian outlook positive, as for-profits benefit from pandemic outsourcing
Regina Maria, the largest hospital group in Romania, is acquiring Bucharest-based fertility clinic Columna Medical Center. HBI talks to Fady Chreih, Regina Maria CEO, to find out more about the group's overall business strategy and Romanian market in general, while Matthew Strassberg, the CEO of owner Mid Europa, tells HBI that the business is not for sale. [+]
Controversial new German Minister of Health ‘performing well’ so far
Six weeks after a new government took office in Germany, HBI catches up with Dr. Stephan Rau, partner at McDermott Will & Emery in Germany, to find out how things are going for the new and somewhat controversial Federal Minister of Health, Karl Lauterbach. [+]
Clinisys merger creates global player as public labs lag behind in automation
Clinisys claims to have created the world’s largest player in lab information management and lab order comms and results software with a three-way merger which creates a platform across diagnostics and environmental tests. So how does CEO, Michael Simpson, see software changing the sector over the next 3-5 years? And what does an independent consultant with many years experience in the field think about the sector and its growth? [+]
UK care homes focus on self funders as care crisis looms
Additional capacity is sorely needed in UK care homes, but many operators tell us they are only building facilities for privately paying residents. Local authority places do not pay enough to make it worthwhile, they say. HBI talks to three operators to find out more about this looming crisis. [+]
Opportunities and challenges in Nigerian healthcare
The Nigerian healthcare market presents a unique series of challenges and opportunities. HBI speaks to Afolabi Adetola, managing director of Cedar Advisory Partners, to find out more. [+]
Voyage Care bought by Kuwaiti sovereign fund
Voyage Care, the UK’s largest provider of support for people with learning disabilities by revenue, has been acquired by Wren House Infrastructure, a London-based subsidiary of the Kuwait Investment Authority, Kuwait’s largest sovereign wealth fund. HBI explores the multiple paid, and the thinking behind it. [+]
Covid conquered? What next for nursing homes
Nursing homes were in a dark place in 2020. One operator candidly told us earlier this week that they were seen as "places where you went to die". At the time, the reputational damage and the knock to occupancy looked substantial. But now we hear - across Europe - that care homes are not just as safe as houses. They are safer. As for Covid, people, apparently, have short memories. [+]
Nursing homes: Recovering from the Covid crash in Europe
Nursing homes were firmly in the spotlight for all the wrong reasons as the pandemic hit at the start of 2020. Mortality rates were high, morale was low, and huge reputational damage was done. Two years on, HBI speaks to three European operators to find out how the market is recovering. [+]
UK fertility provider set to sell
HBI can exclusively reveal that a substantial UK-based fertility provider looks set to come to market later this year. HBI speaks to sources about possible pricing and buyers. [+]
Genetics: the M&A drive
The big diagnostic lab groups are on a frantic M&A drive to capture capacity in genetic testing. The deals reflect the hunger for specialist genetic doctors, biologists and counsellors in a manpower intensive field which is seeing explosive growth. We look at recent deals and name the new competitors who are entering the market. [+]
Intermedica and Hapvida's get green light for merger
Two giants of Brazilian healthcare, listed HMOs Hapvida Participacoes e Investimentos SA and Grupo Notre Dame Intermedica Participacoes (GNDI), have received approval to merge from the country's antitrust authority CADE. The merger will create the country's biggest provider of health insurance policies, with around a 20% share of the for-profit market by number of users, and a 10% share of revenue. [+]
NHS makes new deal with private sector
The NHS has signed a new three month deal with major private hospital groups that will see their staff and facilities put on standby to be used as surge capacity in case the Omicron wave overwhelms the NHS system. [+]
Private sector doctors ordered to fill public hospital shortages in Greece
The Greek government has ordered doctors in the private sector to help public hospitals deal with the current Omicron surge, via a civil mobilisation order issued last Friday. [+]
Galician hospitals sue government for pandemic losses
Ten private hospitals in the Galicia province in northwest Spain are suing the regional Ministry of Health for rejecting their request for compensation for losses they incurred whilst helping the public sector in the first months of the Covid pandemic. [+]
Greek consolidation ramps up ahead of Ethniki decision
The Greek health care services sector continues to consolidate as rivals face up to near certainty that CVC, which owns the largest hospital group in Greece, Hellenic Healthcare Group, will finally get the green flag for its acquisition of Ethniki Insurance. That would create a dominant payor/provider. So how does that affect number two hospital player Athens Medical and Bioatriki, the largest lab network? [+]
Bain and CVC 'buying Boots'
Buyout firms Bain Capital and CVC are reportedly joining forces to put in a multibillion pound bid for UK pharmacy, health and beauty retailer Boots, which also has a presence in Thailand, Norway, Republic of Ireland, Netherlands, Malta and Indonesia. [+]
Omicron pressure making outsourcing to for-profits increasingly essential
Countries across Europe are turning to outsourcing to relieve the rapidly ramping up pressure on their public healthcare systems, as Omicron cases and staff absences mount. HBI hears the opportunities for for-profits to step in and help and substantial, and growing. [+]
HBI's most searched sectors and terms of 2021 - Infographic
What were you searching for in 2021? According to our word cloud, collated from the 500 most searched for terms on our website last year, it was largely - though not exclusively - the sectors most affected by Covid. [+]
Mediclinic Middle East acquires homecare group
Mediclinic Middle East is acquiring Ayadi Home Healthcare (Ayadi), which provides home healthcare services to patients in Abu Dhabi and Al Ain. The acquisition is a further step towards becoming an integrated healthcare provider. [+]
What is behind Korian property deals?
Care group giant Korian has signed a second property deal with another big institutional investor, in this case, BAE Systems Pension Funds. This partnership leaves Korian in control of its property whilst giving the investor protection from the volatility of the stock market and guarantees on minimum returns. [+]
Life Science and Labs are hot
Life sciences property is hot, hot, hot. Just announced is a deal which saw Nordic property group Niam sell Thermo-Fisher’s Finnish offices and labs to Intermediate Capital Group. Meanwhile Life Science REIT (the first publicly quoted trust in Europe dedicated to the sector, which floated in London in October) has already closed five deals. Elsewhere Icade has snapped up five Portuguese hospitals. And we are told that 2022 will be the year the big European property REITs target UK nursing homes and hospitals. [+]
Synlab and Unilabs go head to head for Dutch Covid testing contract
HBI hears the Dutch Ministry of Health is looking to give a Covid testing contract reportedly worth up to €2bn to Unilabs, after previously agreeing to give the contract to Synlab. Synlab tells HBI the tender process is ongoing. [+]
2022: Reason for optimism
In many ways, 2021 appears at first glance to have been a false dawn. Far from being put to the sword by vaccines, Covid is still very much with us and still the topic on everyone’s lips, and rightly so. And yet there remain reasons for optimism in the market. [+]
New Egyptian GP hotline service getting 500 callers a day
MENA’s largest telehealth group, Altibbi, has launched a new telephone service in Egypt, with the aim of increasing access to GPs amongst poorer and more rural populations. We speak to CEO Jalil Allabadi to find out more. [+]
Polarising politician becomes German Federal Minister of Health
Germany has a new government - and a new Federal Minister of Health in Karl Lauterbach. HBI talks to two Germany-based sources who agree he is a politician embraced more by the public than his own party, and considers what his appointment might mean for the sector. [+]
WHO says pandemic pushing back against decades of progress to universal coverage
Two decades worth of progress towards achieving universal health coverage across the world could be halted by the pandemic. The WHO claims this is a likely outcome in light of new data it has collected and presented in two new reports, authored in tandem with the World Bank. HBI talks to the WHO and International Finance Corporation to find out more. [+]
Altibbi launches healthcare hotline in Egypt
Middle East digital health platform Altibbi is launching a premium telephone hotline to put patients in touch with a doctor, with payment taken by the minute as phone credit. [+]
Effect of Covid on waiting times for elective surgery - Infographic
Long waiting times for elective surgery have been a problem across much of Western Europe for years, but Covid has unequivocally compounded this, opening the door to outsourcing to for-profits to get waiting times down. [+]
Interview: Prof. Daan Dohmen, Founder, Luscii Healthtech
Covid has been good for Dutch digital health player, Luscii, which creates virtual wards at home, keeping patients out of hospital. Its platform has processed almost 25 million registrations for both chronic conditions, and patients undergoing episodic care. Active in the Netherlands, the UK, Ireland and several African countries, it is now moving to Germany. [+]
Southeast Asian groups target telehealth as Covid curbs medical tourism
Large groups in Southeast Asia are turning to telehealth as Covid takes its toll on medical tourism. HBI catches up with Max Healthcare in India, and takes an in depth look at what Bangkok Dusit is doing in Thailand. [+]
Centene set to sell its €2bn plus international arm
Big US managed care company Centene has stated that it is conducting a strategic review of its international arm - Circle Health in the UK and Grupo Ribera Salud in Spain and elsewhere in Europe. [+]
Being a super courier helps you get ahead in healthcare
With the sale of Unilabs hitting the headlines this week, and Synlab having listed back in May this year, labs would be very much in the spotlight even if Covid was no longer a threat. When you look at who has just bought Unilabs and why it says it made the purchase - and consider the man at the helm of Synlab, an interesting coincidence appears [+]
$7bn Indian insurance IPO fails to cover book
Indian private health insurer Star Health has seen just short of four-fifths of its IPO offer subscribed in the past three days of book building. However, local press reports that the listing will still go through thanks to a downsized secondary offer. [+]
Relax investment rules to avert German care crisis, says report
Private investors are an essential component in tackling the shortage of nursing home beds and carers in Germany over the next decade – and strict investment rules should be relaxed to make investment more appealing. [+]
Russian oxygen supplies dwindle
Parts of Russia are facing significant oxygen shortages as the treatment of Covid patients continues to chip away at reserves. [+]
Booster blunder puts staff at risk
The Indian government's slowness to approve booster shots is putting lives at risk - particularly those of front line medical staff whose immunity is waning. HBI speaks to a disappointed operator source in the country to find out more. [+]
Rising costs force EBITDA crash for hospitals
EBITDA has crashed among most of Europe's biggest hospital groups despite high single-digit revenue growth. Last-minute cancellations, supply chain issues and rising energy prices are all among the culprits. [+]
South African hospitals recover despite no state support
The South African government made almost no use of private sector capacity during the pandemic, HBI hears, sending less than 100 COVID patients to be treated in the private sector. However, results point to a bounceback for the ‘Big Three’. [+]
Icon Group targeting Europe after A$2.4bn EQT buy out
Australia's largest oncology provider Icon Group has been bought by EQT's infrastructure arm for AUS$2.4bn. Its CEO Mark Middleton tells HBI that the group now has its sights set on Europe. [+]
French municipalities seek to privatise care homes
Municipality-owned French care homes are in crisis. Tired, old buildings, with low tariffs and now, following Covid, far lower occupancy rates are leading many to consider the unthinkable: privatisation. [+]
The three bidders for Unilabs compared
Two strategics and a private equity player are bidding for Unilabs, the Pan-European, Mid East and LaTam lab and imaging group. So who is likely to win? [+]
NHS England reform 'won't increase outsourcing' despite tough winter ahead
The UK has just passed a new law that stands to shake up the procurement of healthcare services. The for-profit sector has hoped it could drive more patients to their businesses, especially against ballooning waiting lists and winter pressure, but experts tell HBI there's little chance it will increase outsourcing. [+]
Not-for-profits dominate Europe's adult care - Infographic
Adult social care, a major sector in the UK and Nordics in particular, has traditionally been dominated by the not-for-profit sector in Europe. In this week's infographic, we look at the for-profit, not-for-profit/public split across select countries in Europe. [+]
Second round bids in for Unilabs
Global lab and imaging group Unilabs is in the second round of its sales process, HBI hears, with four bidders made up of private equity and strategic buyers. [+]
What's the growth story for labs?
The Unilabs sales process is well underway, in what will likely be the biggest deal in healthcare services since EQT unexpectedly snapped up Cerba earlier this year. Virtually all of Europe's big private labs have traded this year - so what's the wider growth story? [+]
Romanian hospitals up 60% from COVID overflow
Romania's public hospitals are overrun with COVID patients. The 3,400+ beds owned by the private sector aren't being used for infected patients but instead as an 'overflow' for the otherwise ill. HBI speaks to the CEO of Regina Maria, who says visits to its ER are up 25% and looks at the results of rival Medlife, where revenue is up 57% in the first nine months. [+]
New Cera Care tech to diagnose flu in minutes
UK homecare group Cera Care is expanding its network with 15 digital healthcare hubs across the UK to deliver telehealth and medication services. The tech-savvy operator will further launch a digital flu tracker and treatment system. HBI talks with Igal Aciman, Chief Commercial Officer at Cera to find out more. [+]
Biogroup acquires Analiza/Cerba Internacional
Biogroup, the fast consolidator of the French lab market, has moved into the Iberian peninsular for the first time by acquiring two assets: Analiza and Cerba Internacional. HBI hears the multiple looks very, very low. [+]
Elderly care occupancy returning in Nordics
Occupancy levels in the Nordic elderly care sector are starting to normalise, according to the latest results from Ambea and Attendo. [+]
Thailand open for vaxxed medical tourists
Thailand has re-opened for medical tourists without quarantine as the country seeks to revive its ailing medical tourism sector. We look at the impact that the 18-month ban has had on the country's big hospital groups Bumrungrad International Hospital and Bangkok Dusit Medical Services (BDMS). [+]
Excess deaths force cost cutting at Fresenius Medical Care
Dialysis patients are dying from COVID at increasingly high rates at Fresenius Medical Care, forcing the provider to slash 5,000 jobs and target €500m cost savings annually by 2025. The group has seen 18,200 more patients die than expected since the beginning of the pandemic, representing over 5% of its total base. [+]
NHS England to require COVID-19 jab for job
All 1.2m of NHS England's staff will have to be vaccinated against COVID-19 from next year, reports say, with an official decision expected from the government imminently. Similar laws elsewhere in Europe have only led to minor problems for healthcare workforces but data shows that UK private providers expect to replace on average 8% of their workforce. [+]
Dentistry: Rodericks Dental, KonfiDents sell
Two more dentistry platforms have been grabbed by two different private equity firms. NHS focused UK dental group Rodericks Dental has sold, HBI hears from multiple sources, and so has German-based KonfiDents. We name the buyers, the multiple, and consider why this development might shake up a stagnating market. [+]
Is Eurofins' share price drop an overreaction?
The share price of global lab group Eurofins is down 18% since a high at the end of September. Is it all an overreaction? A raised revenue guidance - but not EBITDA - points to falling margins for the group. [+]
Cyberattack hits Fullerton’s vendor partner
A cyberattack on the Agape Connecting People network, a vendor that helps Singapore-based healthcare major Fullerton Health to manage patient appointments and bookings, has resulted in a data leak of Fullerton's patients’ personal information. [+]
Lab share prices drop from Covid created peaks - Infographic
In this week’s infographic we take a closer look at the lab market stocks, mapping the percentage change from March 2020 to date for six of the largest players in the sector globally - Medicover, Sonic Healthcare, Synlab, Dian Diagnostics, Diagnosticos da America (DASA), and Grupo Fleury. What does it show? [+]
Africa’s healthcare to benefit from projects worth $140m
Two African healthcare improvement projects worth $140m are in the pipeline, one of which could see Africa's first 250-bed single facility specialist hospital in West Africa built. HBI speaks to Dr Egbe Osifo-Dawodu, partner at global healthcare strategic consulting firm Anadach Consulting, to find out more. [+]
PIS isn't poor when it comes to health care
Law and Justice, (PIS) the governing party in Poland has had a problematic relationship with private health care. After all it was PIS that ran TV adverts showing a dystopian future in which ambulances were shown refusing uninsured patients. And PIS which confiscated inbound PPE for private operators switching it to the NHS. So is surprising to hear a major operator lauding PIS as a good partner. [+]
Lessons for future pandemics
As the world becomes increasingly interconnected, the likelihood of future pandemics is alarmingly high. The consensus among medical experts appears to be that Covid 19 will settle down but reamin a “seasonal nuisance”. There are lessons operators - and governments - must learn for future pandemics. [+]
Mediclinic stock jumps after a strong six months
Mediclinic, the largest South African hospital group by revenue, saw its shares jump by 7.5% to 346.4p on Friday, after the company reported a “material recovery” in profit margins. This is above the groups previous 2021 high of 344.6p struck in June. [+]
Builder of Swiss Covid system offers it free to World Health Organisation
Getting the over-75s and the immune-suppressed to the front of the queue in Switzerland and 18 of its 23 cantons was the task for Romain Boichat and his team at Soignez-Moi faced last winter. The urgency is shown by the pace. Given the go-ahead on December 23, 2020, the online booking system for mobile phones was up and running on January 4. But the official sign-off awarding the contract didn't arrive until March 31, 2021. Boichart is now keen to offer the software to developing countries and is offering it free to the World Health Organisation. [+]
Top Doctors raises $13m to boost growth
Top Doctors, the third biggest doctor-booking platform in private healthcare after EU-based Doctolib and global player DocPlanner, has raised $13m to improve its digital tools and grow in key sectors. HBI chats with Alberto E. Porciani, CEO of Top Doctors to find out more. [+]
NHS telehealth contracts up for retender next year
Around half of the 183 contracts between NHS trusts and telehealth provider Attend Anywhere are expiring in March 2022. The upcoming tender process is expected to be competitive, with rivals including eConsult, which currently focuses on primary care, looking to increase market share in outpatient consultations. [+]
Interview: Dr James Mackay, medical director, Everything Genetic
UK genetic testing provider Everything Genetic has launched a new at-home predictive genetic testing service. HBI catches up with Dr James Mackay, medical director, to talk about the company’s plans for growth and the at home testing market. [+]
Medanta hospital chain to IPO
Global Health Limited, the operator of Indian multi-speciality hospitals under the Medanta brand, is seeking market regulator approval for an initial public offering (IPO). This comes amid high investor interest in healthcare facilities after the Covid pandemic. [+]
HBI 2021: Strict data laws threaten future provision in DACH
Strict, politically-driven, laws on the use of data in Germany means that the healthcare sector is struggling to equip itself sufficiently for the future demand of healthcare, delegates heard at HBI 2021 in a panel led by Stephan Rau, partner with McDermott, Will & Emery. [+]
Another one bites the dust
Healthcare specialist REIT Icade Sante is the latest victim of capital markets apathetic for European healthcare services. In fact, the sector has not had an overwhelmingly successful big IPO in years. [+]
Mental health demand rockets due to COVID - Infographic
Demand for mental health support is set to increase alarmingly over the next five years. The attached infographic formed part of a presentation by Hedley Goldberg, managing director at Rothschild & Co, at HBI 2021. It paints a worrying picture. [+]
HBI 2021: How long will rehab be acute's poorer brother?
Rehabilitation has often been seen as the low-margin, poor brother of acute care. Often underfunded and overlooked, a panel at HBI 2021 sensed that the tide is turning and that, at last, the benefits of this Cinderella sector are being appreciated. [+]
HBI 2021: Covid drove cultural workforce change in large platforms
Covid drove large operators to define their culture and decide how to communicate it to staff, according to a panel at HBI 2021 discussing the power of big platforms. [+]
HBI 2021: Political risk lower in emerging markets than regulated Germany
Covid's impact looms large on the regulations horizon, especially in Western European countries, a panel considering political risk concluded at HBI 2021. [+]
HBI 2021: Partnership and integration the key to telehealth
The revolution in home testing and monitoring fuelled by the pandemic, and how partnerships could better integrate technology, and how to get patients to engage with it, were two of the core digital topics at HBI 2021. [+]
HBI: Lessons learned from COVID in South Asian Hospitals
South Asia’s healthcare systems were hit hard by Covid. A panel of advisors, investors and operators at HBI 2021 shared their experiences of reacting to COVID and discussed how it had presented opportunities to do things differently. [+]
HBI 2021: Political risk shakes up Nordic markets - except robust Finland
Does political risk loom large in Nordic markets and how does the Finnish healthcare system differ from other Scandinavian countries? These were two of the hot topics at the Nordic panel at HBI 2021 as it considered the best opportunities in the region. [+]
HBI 2021: True value-based health is still a long way off
The pandemic has dramatically accelerated the speed of policy making, and some of the shifts in policy that have been seen will have permanent effects on the health sector. But as a panel at HBI 2021 looking at the new Covid-19 policy making landscape confirmed, the biggest unresolved issues remain how to actually measure outcomes and quality, and how patient data should be handled. [+]
HBI 2021: Private sector 'should build digital' with €50bn EU funds
In response to the pandemic, EU funding for healthcare has grown substantially and the subsidiarity principle - which says that the raising and spending of these funds has to be done at the national level - is being loosened. What does this mean for the private sector across the EU? [+]
HBI 2021: Bright future for subscription model in Central and Eastern Europe
As Central and Eastern Europe gets richer, demand for healthcare services is growing faster than government spending, so there is a large opportunity for the private sector to fill the gap with private-pay. There is a lot of hope around the growth in popularity of the subscription model, which many employers seem to have a preference for over traditional health insurance. [+]
HBI 2021: Technology and PPPs could solve Africa's biggest problem
As the continent recovers from the pandemic and many countries in the region strive for universal coverage, Sub Saharan Africa remains hampered by labour shortages and the challenge of attracting investment. Panellists at HBI 2021 were enthusiastic about the possibilities created by technology, public-private partnerships and the removal of unnecessary red-tape. [+]
HBI 2021: "This is the strongest M&A market I can remember"
"This is the strongest M&A market I can remember," Hedley Goldberg, managing director at Rothschild & Co told hundreds of attendees at HBI 2021 as he talked about the IPO landscape and how post-COVID M&A is shaping up. [+]
Voyage Care 'about to sell'
HBI hears from multiple sources that the largest special adult care provider in the UK, Voyage Care, is about to be put up for sale. We look at how, why and when its longstanding private equity (PE) owners could make an exit. [+]
Nine things we learned at HBI 2021
Last week delegates descended on London for the first in-person HBI conference since the beginning of the pandemic. Here are a few of the things we learned. [+]
HBI 2021: Pandemic drives up to 40% more cash payments in LatAm
Increasing demand and rising costs are putting pressure on LatAm’s healthcare system. A regional session at HBI 2021 heard that out-of-pocket payments are on the increase, especially in Mexico. [+]
HBI 2021: GCC investment approval now 'takes five minutes'
Is healthcare in the Middle East and North Africa (MENA) the next big investment opportunity? According to a panel at HBI 2021 on the MENA region the answer is an emphatic yes, and the region is 'open for business - though not a market for the faint of heart. [+]
HBI 2021: 40% of elderly care in France is short-stays
Four in ten nursing home residents in France are on short-stays according to an EU-based operator at HBI 2021. Covid-driven trends as the elderly care sector recovers was the other hot topic of conversation. [+]
HBI 2021: More dentists seeing value in platforms
Demand for and interest in dental services from patients and investors continues to rise, with increased respect for dental platforms and a heightened awareness of aesthetic procedures. [+]
HBI 2021: Fertility resilient to Covid with huge scope to consolidate
Infertility is up, maternity in many regions is down - and the global fertility market is continuing on an upwards trajectory largely untouched by Covid. It remains a hot ticket when it comes to M&A - though issues with regulation and staffing are causing some headaches. [+]
HBI 2021: Testing numbers will drop, but Covid tests are here to stay
Analysts and strategists in the diagnostics sector have been racking their heads over what business will look like in a post-Covid world. There is a lot of uncertainty over how much of the current Covid testing volume will remain, and how much growth will be seen in B2C demand for other disease testing. [+]
HBI 2021: Emerging markets need new business models
Providers in emerging markets must better explore new business models - like subscription-based wellbeing and capitated primary care - if they want to fill the gap left by the public sector, panellists agreed at HBI 2021. [+]
HBI 2021: The mental health pandemic running alongside Covid
The long term impact of COVID on mental health and psychiatry is unknown as demand is increasing, a panel of European experts at HBI 2021 conference said. They discussed polyaddiction and new symptoms, mental health tech, and the impact of the pandemic on healthcare workforce. [+]
HBI 2021: Nine in ten elderly want to stay at home as long as possible
Demand for homecare services is vast, but recruitment constrains operators, how do you meet this challenge? An panel at HBI 2021 considered this thorny problem and others, including how to maintain quality, and whether price increases are possible. [+]
HBI 2021: Wage inflation biggest concern in Europe
Wages typically make up 50-75% of healthcare service business’ costs, and the prospect of wage inflation in Europe over the coming years is particularly worrying for the sector, especially in the face of stable or even decreasing tariffs. A well-qualified panel at HBI 2021 was divided over whether efficiency gains from digital will offset the hit to margins. [+]
HBI 2021: Covid driving smaller adult care operators to sell
The Covid pandemic is driving smaller adult care providers in the UK to look to sell, said speakers on the HBI 2021 adult care panel. Is this an opportunity for consolidation in a rapidly growing sector? [+]
HBI 2021: Korian CEO 'doesn't want to take company global'
Sophie Boissard, the CEO of pan-European elderly care group Korian, does not want to take the group into a multiplicity of markets, she told delegates at HBI 2021. The stance is in contrast to Bupa and Helios, who are building asset-light digital touchpoints to reach more global customers. [+]
Clove on track for record quarter despite Covid
India's largest dental chain, Clove Dental, is hitting record revenues and on track for its best quarter ever despite Covid. HBI caught up with Clove chairman and co-founder Louis Shakinovsky at HBI 2021 to find out more. [+]
German election threat to whole healthcare system
Potential winners of Germany's upcoming elections are pledging to abolish private medical insurance (PKV). The move could spell disaster for the whole healthcare sector: it accounts for 37% of all expenditure. [+]
Specialist care in France in a "race to the bottom" on pandemic pricing
HBI hears that a pandemic fuelled price war is raging in France in specialist (elderly) care. This is according to operator attendees at HBI 2021. [+]
UK NHS dental activity may never return to pre-Covid levels
There were strong opinions at HBI 2020 on the key question as to whether NHS activity in the UK will ever return to pre-pandemic levels; UK CEOs and investors at HBI 2021 were less than optimistic about its chances, but double digit private growth is filling the gap. [+]
Sweden’s new budget has money for care, but organisational issues remain
The Swedish government proposed a new budget totalling €7.3bn (SEK74bn) to the parliament, Riksdag, on Monday (September 20). Roughly SEK2.5bn (€247m) is being allocated to elderly care to help the sector recover from COVID. Despite improvements, HBI hears lack of level-playing field between municipalities remains a real struggle. [+]
What will B2C diagnostics sector do post Covid?
The direct-to-consumer or B2C diagnostics sector began well before Covid. Over the past decade, increasing numbers of people have used at-home testing kits to screen for a variety of diseases (cancers, cardiac diseases and STIs), as well as to evaluate genetic susceptibility and find out about their ancestry. [+]
Interview: Jalil Allabadi, CEO, Altibbi
Saudi Arabia’s largest telemedicine consultations platform Altibbi has managed to double its revenue for fifth consecutive year. CEO and founder Jalil Labadi shares the secrets behind this success with HBI, and talks strategy as the company develops. [+]
It's all systems go for HBI 2021 in London next week!
Here at HBI HQ we've spent the last few weeks chatting to the star-sprinkled selection of high-flying panellists set to take the stage next week at HBI 2021, paving the way for our annual healthcare services conference set in the heart of London. Last year's conference was largely virtual as the world reeled from Covid. But this year, there is an overwhelming and undeniable feeling of optimism as everyone prepares to meet in person for the first time in far too long. [+]
‘No jab, no job’ policy could decimate homecare staffing levels
A fifth of homecare staff could leave the sector if COVID vaccination becomes mandatory in the UK. HBI looks to mainland Europe, where similar restrictions are in place, to find out more. [+]
HBI Interview: Carlos Nueno, President, International, Teladoc
How fast is the world outside America adopting telehealth and digital care in all its forms? Who better to ask than Carlos Nueno, president International for Teladoc Health, which ties with Ping An from China for the title of the world’s largest telehealth operator. So, what new business models are being rolled out and when? And how are countries adopting the new technology? [+]
High profile resignations put Irish healthcare reform ‘in the balance’
Laura Magahy, executive director of the office charged with brining in Sláintecare - the blueprint for the future of healthcare in Ireland - resigned last week. So too did the chairman, Tom Keane. The Irish government has re-affirmed its commitment to the reforms which could have a significant effect on the way for-profit businesses operate in the country, but others say the process is “in the balance.” HBI talks to a local consultant to find out more. [+]
The new group building a hospital for millennials
Portugal has a new private hospital company which is building specialised acute care framed around the consumer behaviour of millennials. Why does the sector need a new player? Because the traditional operators have more difficulty in deploying good digital transformation, the project's CEO tells HBI. [+]
Dutch lab consolidation to resume after COVID blip
The consolidation of The Netherlands' non-profit outpatient diagnostics sector by for-profit groups is expected to pick up in the coming months after a delay due to Covid, a partner at Deloitte tells HBI. [+]
Market conditions right for Unilabs to sell
HBI hears rumour that pan-European laboratory and imaging group Unilabs could sell soon. We explore how its private equity owner Apax could make a much-anticipated exit. [+]
EU dermatology M&A slows
Investors in the US are pouring money into dermatology, while EU markets remain far quieter. To find out where and why deals are – and aren’t - happening, we round up the latest news from the sector in Europe, including the UK dermatology consultant-led business Dermatology Partnership, Sweden’s leading dermatology provider Diagnostiskt Centrum Hud, and Dermatologikum Hamburg in Germany. [+]
Spire H1: revenue soars but profitability flat
UK hospital group Spire Healthcare's revenue in H1 2021 jumped 13.5% versus 2019, with self-pay up a whopping 47%. But profitability was still lower than two years ago and, despite the top-line growth eclipsing guidance, the group is still trading well below Ramsay's improved offer price that 30% of shareholders rejected. Will they regret that? [+]
Greece's private workforce survives compulsory jabs
Around 5% of healthcare workers in Greece's private hospital sector have been suspended after the state made COVID-19 jabs mandatory, an operator tells HBI. [+]
Boris breaches election pledge with £12bn tax hike for health and social care
On Tuesday, September 7, Prime Minister Boris Johnson and his UK government announced a new health and social care tax to fund both the NHS and social care. While it is hard for operators to be ungrateful for extra funding in social care, many are asking whether the plan goes far enough. HBI talks to market experts to find out more. [+]
Promedica24 continues expansion - sale 'on the table'
Pan-European homecare group Promedica24 tells HBI that long-term investor ForeVest is considering an exit in the next 1-2 years. Tomasz Brzeziński, CEO and CFO, says that the group has plans to move into Switzerland and Austria as well as diversify its revenue sources in Germany. Brzeziński is one of 100 speakers at HBI 2021, Sept 20-22, the global CEO-level event focused on for-profit healthcare. [+]
How outsiders grabbed the holiday COVID-19 testing market
While sales and profits at Europe's largest traditional players swelled during the pandemic, the sector also saw an influx of non-traditional players. The trend has seen biotech companies start to sell their COVID-19 tests direct to the customer. [+]
Foundation Holdings buys Saudi primary care
GCC investment firm Foundation Holdings has bought a majority stake in Saudi primary care business Shifa Al Munthaza Polyclinic (SMP) and has plans to list it in the next two years. HBI speaks to CEO Abishek Sharma to find out about its growth plans. [+]
Outsourcing determines investor interest in SE European imaging
Growth in public sector outsourcing of imaging in Croatia and Slovenia has driven investor interest in the sector while Serbia has gone the opposite direction, with Affidea pulling out of the private pay-reliant market. [+]
Europe’s carer-booking market to pick up with new entrants
Doctor-booking platforms is an established multi-million euro market in Europe. However, platforms that connect families with carers have so far lagged behind. That is starting to change with the emergence of new carer-booking platforms that want to internationalise. HBI speaks to one, Greece's grandmama. [+]
Greece suspends unvaccinated health workers
The Greek government is suspending healthcare workers who refuse to be vaccinated against COVID-19 without pay. [+]
Most pre-COVID sales processes now closed - Infographic
In August last year, just two of the big sales processes launched just before the pandemic had been agreed. A year later and most of the assets have now sold with a lot of the movement coming from the mid-market. [+]
We must make healthcare a more attractive job
We are all, unfortunately, seeing very clearly the devastating third wave of the COVID tragedy and its impact on health care systems. With cases rising as the number of health and care staff decreases, the sector is faced with an ultimatum: take urgent steps to make healthcare a more attractive job. [+]
One in ten of India's medical tourists are Afghans
Ongoing unrest in Afghanistan is cutting off medical tourism to Indian hospitals, where the cohort makes up 11% of international patients. Indian hospitals have previously done good business treating middle-class Afghans. [+]
Philippines in crisis as 40% of nurses quit
Two in five Filipino nurses have quit working in their home market over the past year leaving the hospitals in the grip of a care crisis. The country is already a high exporter of nurses globally but poor wages and working conditions may push even more to migrate. [+]
Homecare wages rise as vacancies jump sixfold
Wages in Europe's domiciliary care market have risen up to 15% as the sector scrambles for staff, driven by a sixfold jump in empty vacancies and better protections for governments. This will likely signal a care cost inflation across the continent as one operator tells HBI that the costs will be passed on to the customer. [+]
Interview: Dr Mohamad Hamade, CEO, Amanat Holdings
Dubai-based investment firm Amanat Holdings has managed to almost double its share price over the past 18 months. CEO Dr. Mohamad Hamade shares the secrets behind this success with HBI and talks strategy as the group develops what he calls MENA's first post-acute care platform. [+]
US homecare tech specialist buys Home Instead
US-based homecare tech specialist Honor Technology has acquired Home Instead, the global leader of franchise homecare services. The deal creates a global homecare group worth more than $2.1 billion in homecare revenue. HBI chats with sources including Home Instead's UK CEO to find out what the deal means for markets outside of the United States. [+]
Imaging AI investment booms post-Covid - Infographic
Investment in the imaging AI startup space has soared 33% in 2021 so far, with new fundraising rounds, buyouts and IPOs signalling a renewed post-pandemic appetite for the technology. Partnerships between solution providers have also ramped up, possibly signalling precursors to full-blown mergers. [+]
Comeback treatments squeeze payors
Claims on private medical insurance were higher than expected for some providers in the second quarter, hitting or even exceeding pre-pandemic levels for the first time. The picture is similar for public payors with AOK reporting double-digit growth in spending. Across the board, it's having an impact on the bottom line - and leaving some substantially in the red. [+]
Singapore doctor becomes a billionaire fighting Covid
Loo Choon Yong, executive chairman of Asia-based healthcare provider Raffles Medical Group, has become a billionaire after his company joined the effort to fight Covid-19 sending its profits and share price soaring. [+]
Reasons to be cheerful
"If NMC can turn it around, anyone can". That was the cheery comment of a formerly sceptical GCC-based source watching the oft-berated group rise phoenix-like from the ashes. For those still diligently beavering away at NMC there is much to be cheerful about with the group hitting the headlines for the right reasons for the first time in a long while. Elsewhere too, HBI finds reasons to be cheerful. Have we turned a corner? [+]
Livingbridge buys Everlight
London-based mid-market private equity investor Livingbridge is buying a majority stake in global teleradiology firm Everlight Radiology. HBI chats to a source with knowledge of the sale and a UK analyst to find out more. [+]
Top 15 companies add 4% market share in just two years - Infographic
The top five players in the hospital, lab and nursing home markets in Europe and the Middle East have consolidated between 2-4% of their markets since 2018. [+]
Cera Care expands into nursing services
UK homecare group Cera Care is expanding its homecare network into nursing services in the UK. [+]
Shift to outpatient in Germany may not increase for-profit opportunities
The shift from inpatient to outpatient care during the pandemic has been particularly visible in Germany, and it is widely accepted will continue post Covid. HBI catches up with two German healthcare experts to understand what this shift means for the market, and why an otherwise tempting outpatient investment proposition is less palatable than it would be elsewhere in Europe. [+]
From the brink of collapse, NMC shows signs of recovery
GCC’s largest for-profit healthcare operator NMC Healthcare has been hitting the headlines for all the wrong reasons for the last 18 months, but with stronger H1 results than expected announced today, and progress on exiting administration, there are signs that it may be turning a corner. [+]
Bupa shift towards digital could impact M&A
Bupa’s new CEO Iñaki Ereño has announced a new strategy for the international health insurer and service group including making 40% of customer care touchpoints Bupa-owned, and having 60% active digital customers. What does this mean for Bupa's M&A strategy going forward? We talk to consultancy Candesic to find out more. [+]
GCC hospital markets at a crossroads
Change is afoot for private hospital operators in the GCC with mandatory insurance rollouts and private sector-friendly reforms offset by squeezed margins and an exodus of foreign nationals. More big US non-profits have followed in the footsteps of their peers Cleveland and Mayo and investors are pouring money into new developments in some markets - but steering well clear of others. Here is our round-up after several weeks interviewing local sources for HBI Intelligence. [+]
Consortium buys German lab group amedes
German lab group amedes is selling to a consortium including Canada's OMERS Infrastructure, Goldman Sachs Asset Management, and asset manager AXA Investment Managers. [+]
Colosseum buys Curaeos, creating Europe's largest dental group
Pan-European dental group Curaeos has been sold by EQT and minority stakeholders to family-owned Colosseum Dental Group, creating Europe's largest dental group by revenue. HBI speaks to a Europe-based operator to find out more. [+]
EMEA's Top 100 largest groups by revenue revealed
HBI’s inaugural HBI Health Care Services Top 100 lists the largest 100 companies by EMEA health care services revenue. In total revenue their revenue came to over €105bn - and we've uncovered some surprising winners and losers. [+]
IVIRMA buys CREATE Fertility as it looks to expand abroad
Global reproductive specialist IVI RMA has acquired CREATE Fertility and low-cost specialist abc IVF in what it says is the UK's largest IVF deal. HBI speaks to Praful Nargund, CREATE's managing director, to find out more about its big plans for international expansion. [+]
Digital health's big players' valuations rocket
The heaviest hitters in Europe’s digital health market have valuations at an all-time high: Babylon is valued at $4.2bn, Kry at $2bn and Alan at €1.4bn. There remains, however, a huge disparity between the M&A and the fundraising markets, with most buyers of these start-ups opting for early-stage acquisitions. HBI gives an overview of the market. [+]
Malaysia redirects non-Covid patients to short-staffed for-profits
Short-staffed private hospitals in Malaysia are assisting public providers in the fight against Covid, by taking swathes of additional patients from public hospitals for capped fees. [+]
Governments curb costs of COVID-19 tests as PCR numbers plummet
Governments across Europe are slashing prices and volumes of coronavirus testing in a bid to curb one of the biggest health spends of the pandemic. Many are trying to push the costs of preventive tests back onto the consumer. [+]
UK domiciliary care workforce surges during pandemic
UK domiciliary care providers are seeing a rise in caregiver jobs, job applications, and hires driven by COVID. As lockdown lifts, HBI examines what is happening in the market. [+]
Nursing homes: Enter domiciliary care at your peril!
The opportunity for nursing home groups to move into domiciliary care looks obvious, and it is a sector many of the largest groups have entered, but is it always the right move? Domiciliary care (homecare) comes with a high level of inherent business and reputational risk, and there is a strong argument for saying it's more trouble than it is worth, particularly for smaller groups. [+]
Cerba acquires Lifebrain for €1.2bn
EQT-backed Cerba has acquired Italy's largest lab group Lifebrain in a move that will strengthen its position as Europe's third-largest operator. [+]
Spire takeover scuppered by revolting investors
The proposed takeover of UK-based hospital chain Spire is now off the cards, as global Australia-based group Ramsay failed to rouse sufficient shareholder support for the deal, falling short of the 75% minimum threshold (by value) it needed for approval. [+]
Overlooking the elderly will come back to bite governments
During the pandemic governments across Europe prioritised their hospital and national health services at the expense of the elder care sector. Will elderly care ever get the attention - and funding - it deserves? [+]
Blocks Group acquires the largest nursing home operator in Greece
Blocks Group has acquired Aktios, the leading operator of elderly and dementia care homes in Greece. We talk to Ilian Grigorov, Chairman and CEO of Blocks Group, about the deal and the group's future expansion plans in Southeast Europe. [+]
EMC shares priced at low end
Russian hospital operator EMC will go public at a 2020 EBITDA/enterprise value ratio of 11x after the group set its pricing at the bottom of the indicative range. The group has also revealed that Igor Shilov will remain the majority shareholder. [+]
Synlab raises earnings guidance
Synlab says its revenues will grow 20-25% this year, upping guidance from 17%, as the COVID-19 related tailwind shows no sign of dissipating. It expects to hit up to €3.3bn of sales. [+]
Oxygen shortage concerns in South Africa could lead to stockpiling
Worries of an oxygen shortage in South Africa and concerns about the Delta variant of Covid-19 might lead to operators stockpiling O2 tanks, and has led to them increasing storage tank capacity. HBI talks to a South Africa-based for-profit hospital operator to find out more. [+]
Occupancy loss and excess deaths during the pandemic - Infographic
A lot of discussion has taken place about the conduct of nursing homes in the pandemic. Today we look at the number of excess deaths among the over 65s in a population in 2020, and compare it to the loss in occupancy that operators suffered through that year. [+]
Pan-European nursing home groups expand as sector recovers from Covid
The three big pan-European nursing home players have all announced big acquisitions - and Orpea has boosted its growth forecast. Is this a sign that the tide is turning for nursing home operators, as vaccines roll out across the continent and pandemic restrictions continue to lift? [+]
Centric plans to continue expansion despite losses
Centric Health, the largest provider of primary care by revenue to Ireland’s 2.3 million privately insured patients, is planning to expand both domestically and abroad. Despite making a loss two years in a row, CEO Maurice Cox tells HBI the company is in good financial shape, and has been spending to grow. [+]
Two years of deals squeezed into one?
As had been long expected, M&A activity which was deferred at the height of Covid has ramped up to almost record proportions. [+]
European imaging ramps up: Two big deals, and an ongoing process
M&A is picking up in the European imaging sector this week with Affidea and Naxicap buying big in Italy and Switzerland, respectively, and a top-five German imaging group reportedly in the middle of a sales process. [+]
Ophtha M&A: the latest European deals and rumours
The ophthalmic services M&A market is heating up across Europe as investors envisage a largely COVID-free 2022. HBI has been speaking to operators to find out the latest on known deals and rumours circulating at the moment. [+]
Quironsalud further expands in Spain
Pre-Covid, Spain's largest hospital group Quironsalud appeared far more interested in its international market than the domestic one, with Latin America appearing to be its main focus. Does a new multidisciplinary clinic in Santa Cruz de Tenerife, which will double its care and diagnostic capacity there, and it's recent announcement it will open a new 250-bed hospital in Zaragoza suggest a swing away from LATAM and back home? [+]
Watered down version of Finland's SOTE passes at last
Finland’s parliament has passed a version of the long-awaited healthcare reform, known as SOTE. HBI hears that it’s nowhere near as interesting as the original version. [+]
Why the low margin Danish nursing home sector is attracting attention
Denmark is a relatively small market, with a population of less than six million, and like the rest of the Nordics its politics can often be very hostile to for-profit operators. Despite this, the for-profit care home sector is growing despite relatively low returns. HBI talks to two market experts about the appeal and development of the Danish nursing home sector. [+]
Emergency department visits not quite back to normal - Infographic
Hospital admissions for A&E patients have not yet returned to their pre-Covid levels in Western Europe, despite significant increases in attendance since January this year. [+]
Antin considers sale of €1bn Almaviva
HBI hears that Antin Infrastructure Partners is considering the sale of Almaviva Sante, the fourth largest French hospital group by revenue. HBI speaks to a France-based consultant to find out more and to talk about potential suitors. [+]
Looking to build an ophtha pipeline? Sell glasses first
What is the key to a regular throughput of profitable ophthalmology clients, and how does an operator fill its clinics? According to Ulla Näpänkangas, ophthalmologist and CEO of Finland-based Silmäasema Silmäsairaala, the answer lies in selling them glasses first. [+]
UK children's home operators under fire for "indefensible fees"
The for-profit children's home market in the UK has been criticised for "indefensible" fees by the chair of the Independent Review of Children's Social Care. [+]
Gas rivals agree to supply poorer countries
Global industrial gas providers Air Liquide and Linde have signed two agreements with development agencies Unitaid and Clinton Health Access Initiative(CHAI), to combat a critical oxygen shortage in low and middle-income countries (LMICs) amid the second COVID wave, supplying gas for a "fair price". [+]
Interview: Ray Berglund and Dominic Orchard, Alvarez and Marsal
The pandemic is causing many businesses and their investors to reassess their plans - and their portfolios. HBI speaks to Ray Berglund, Head of European Healthcare and Life Sciences at management consultants Alvarez & Marsal, and his colleague and Managing Director Dominic Orchard, about why they have never been busier, and the clear trend they are seeing towards carve-outs. [+]
Europe's telehealth consolidators explain their M&A
Acquisitions in the European telehealth space are ramping up this year thanks to some mid-sized consolidation plays. HBI speaks to the CEOs of the buying parties: Ranjan Singh from HealthHero and Murray Ellender from eConsult. [+]
No jab, no job: Essential patient protection, or staffing disaster?
The UK government's consultation on mandatory vaccination for social care staff has finally reported that a “no jab, no job” policy will soon be in place. Is this a necessary step to restore confidence in a sector badly damaged by Covid or a major risk to staffing in a sector that has always struggled with recruitment and retention? [+]
Lack of infrastructure hampers integrated digital care
Progress made on the digital and data front continues to raise hopes of truly integrated healthcare, but that promise relies on infrastructure which can support it. At digital healthcare conference HIMSS21, a panel of European experts warned that in countries like Spain and the UK, infrastructure issues are the biggest impediment to progress. [+]
Primary care networks and the need for eHubs
An eHub platform pioneered by GP-led NHS Partnership the Hurley Group has been replicated elsewhere across the UK. HBI speaks to a pioneer of the concept to find out how eHubs work, and how they could transform primary care. [+]
Malaysian private hospitals struggling to procure vaccines
For-profit hospitals in Malaysia looking to provide a private Covid vaccination service are struggling to source vaccines. HBI talks to Dr Datuk Kuljit Singh, medical director at Prince Court Medical Centre and president of the Association of Private Hospitals of Malaysia (APHM), to find out more. [+]
EU healthcare is a bribery hotspot - Infographic
Healthcare in Europe is a corruption hotspot: six percent of people have paid bribes to get medical care and a third relied on personal connections. That's according to a new report by Transparency International. [+]
Greek nursing home sector: An untapped opportunity?
The Greek care home sector gets scant support from a periodically hostile government and has yet to attract major interest from large European nursing home groups and investors. Despite this, the population is ageing rapidly and demand for nursing care is growing. HBI talks to two market experts about the pandemic in Greece and the future of the market. [+]
Hospital mergers could lead to nationalisations
A UK NHS Trust's acquisition of a hospital from the UK's largest for-profit hospital group Circle-BMI Healthcare may not be the last of its kind, local sources tell HBI, while calls for state takeovers of private hospitals have been heard across Europe. [+]
Spire shareholder rebellion grows as Toscafund voices opposition
Global hospital group Ramsay Health Care's 240p-per-share bid for UK chain Spire Healthcare looks increasingly unlikely to make it over the line, with two of its four largest institutional investors now voicing opposition. We talk to an analyst about Spire's outlook and look at its shareholder structure. [+]
UK private hospital nationalised
Bath NHS Foundation Trust has acquired the local hospital of for-profit operator Circle Health, completing a disposal process ordered by competition authorities following Circle's acquisition of competitor BMI Healthcare. Could this be a sign of things to come? [+]
Private players swoop on national hotlines
Outpatient group Gajda-Med has won Poland's multi-million euro contract to deliver first-contact telehealth services for the Polish NHS. It follows a recent trend of private sector companies moving to work on national hotlines, including in Sweden and Switzerland, and it is very controversial where operators already own physical clinics. [+]
Shareholder rejects Ramsay's £1bn Spire offer
One of Spire's biggest shareholders has rejected the takeover by Ramsay Health Care saying its 240p per share offer was 'nowhere near enough'. [+]
Is a 2021 recovery for the care home sector realistic?
Across Europe care home operators are optimistic about recovery, with many saying they expect a return to something like normality by the end of 2021. Is this too optimistic? HBI looks at France-based Orpea and Korian, and talks to a market expert to find out more. [+]
HIMSS-21: Covid means there is no such thing as telecare now, just care
Attendees at the HIMSS-21 virtual conference this week heard how Covid has created a world where there is 'no such thing as telecare, just care", and how Israel's substantial successes in battling COVID were, in no small part, down to it's digital preparedness. [+]
Market welcomes strong Q4 for Max, despite Covid-related revenue drop in FY21
The market welcomed a strong Q4 performance from India's second-largest for-profit hospital chain by revenue, Max Healthcare, last week. Record-breaking Q4 EBITDA appears to have offset any potential market concerns that could have arisen from reporting a drop in revenue, and a resurgence of COVID, especially around the capital. [+]
Share prices of top listed healthcare groups up 25% since October - Infographic
The share prices of 14 of the top listed healthcare services groups have increased by 25% on average since the start of October, following a fall of 13% in the first three quarters of 2020. The best-performing shares are hospital and outpatient groups, whilst elderly care companies have done less well. [+]
The maths behind the sector
Getting a clear picture of profitability and perhaps more importantly what level of profits is really attainable is a fascinating exercise in health care services. [+]
Social care job applications drop as economies open
Job applications for social care have dropped off a cliff in the UK as the economy starts to open up, according to an operator. Groups in Germany, France, the Netherlands and Austria say they are still seeing a surge. [+]
Italy leads Europe on 'no jab, no job' rule
Under new measures introduced by Mario Draghi’s government at the end of April 2021 healthcare workers who refuse the vaccine will be transferred, demoted, or suspended without pay. [+]
Ramsay makes £1bn Spire offer - but investors want more
Global hospital operator Ramsay Health Care has made a £1bn offer to acquire listed UK group Spire Healthcare, but some investors may reject the offer and share price movements show another bid may be expected. The 29.9% shareholder, Mediclinic, has agreed to sell to Ramsay despite making a similar takeover offer three years ago. It comes during a UK market pivot towards NHS activity to help clear massive backlogs after Covid. [+]
The deals you can expect to see in the next two months
M&A slowed to a trickle during COVID but the next six weeks will see a flood of deals. HBI examines the deals that are about to happen, the companies looking to IPO, and reviews a handful of deals that remain resolutely on hold for the moment. [+]
A PE buyers' strike?
The last year has seen something like a buyers strike from private equity with a whole range of stalled sales processes. [+]
Whistleblower and low occupancy hit Attendo
Pan-Nordic care group Attendo, which runs 350 nursing homes in Scandinavia, is struggling to recover occupancy in Sweden. The picture is better in Finland, but a scandal over the treatment of a whistle-blower in the Swedish press has damaged the groups image. [+]
Fresenius raising $1.5bn bonds as Covid hits Q1 results
Global dialysis provider Fresenius Medical Care has issued bonds with an aggregate principal amount of US$1.5bn across two tranches. The proceeds will be used for general corporate purposes, including the refinancing of outstanding indebtedness. [+]
Denmark tenders €250m of homecare contracts
The Danish regions have collectively tendered more than €250m worth of homecare services since the beginning of the year. Municipalities are finally shrugging off a hostile approach to for-profit healthcare, which HBI understands is driven by a desire to avoid further bankruptcies in the sector. [+]
French hospital groups race to consolidate the sector
Large French hospital groups continue to buy up smaller players. Vivalto Santé and Almaviva Santé, the country's third and fourth-largest players, respectively, have both struck deals in the past week. [+]
Mitsui mulls buyout of $13bn IHH Healthcare
Japanese conglomerate Mitsui is considering a buyout and de-listing of IHH Healthcare, the $13.4bn-valued pan-Asian hospital operator in which it holds a 32% stake, according to reports. Its share price has declined in the last five years amidst perennial problems in Turkey and India. [+]
COVID testing doubles Synlab's Q1 revenue
Europe's largest lab group Synlab continues to see huge COVID-19 driven growth with organic revenue doubling and EBITDA quadrupling in the first quarter. 92% of that growth came from COVID-19 testing. [+]
Interview: Marc Saillon, CEO, Almage Alzheimer Centers
The French nursing home sector has produced some of the largest consolidators in Europe, such as Orpea and Korian. But even small groups are looking at international expansion. Almage, a group with just six homes and 530 beds dedicated to Alzheimer care, plans to hit Spain in the next few months and is looking at other European markets. Marc Saillon, the CEO of Almage Alzheimer Centers, also tells us that the group has expanded into consultancy in China. [+]
medneo targets other markets after UK expansion
Nicolas Weber, CEO of German imaging group medneo, says that the company has had "a great market entry" to the UK. He expects more national openings as demand for imaging soars post-COVID. [+]
No private healthcare bounce back yet
Admissions to private hospitals in the UK are still well below pre-pandemic levels with activity in January and February down on last year. The expected demand boost for private healthcare due to NHS waiting list pressures is yet to materialise. [+]
Ambea Q1 points to slow recovery for Nordic social care
Recovery in the Nordic social care market is happening slower than expected as provider Ambea expects a hit on revenues and profits in Q1 to continue in the second quarter. Sweden has been particularly badly hit with EBITA down in both its elderly care and disabled care segments. [+]
HC-One gets new majority owner with £540m refinancing
Private equity firm Safanad now owns a majority stake in HC-One after the UK nursing home group went through a £540m (€620m) refinancing. [+]
German hospitals cut staff as volumes fail to recover
Germany's third-largest hospital group Sana Kliniken has announced the layoff of over 1,000 employees, while number one Fresenius Helios is also cutting staff, as patient numbers fail to recover from Covid. Volumes are still lower than in 2019, Dr. Boris Augurzky tells HBI. [+]
Gimv ups stake in German buy-and-build dental group GPNZ
PE firm Gimv has upped its stake in German buy-and-build dental platform Gesellschaft für Praxisnachfolge in der Zahnmedizin (GPNZ). The market is the most fragmented in Europe. [+]
Synlab still trading at low end of IPO range
Synlab's shares have continued to trade in the lower end of the IPO price range since it took to the Frankfurt Stock Exchange last Friday, April 30, opening flat and now around 3% up. [+]
EU countries to pump €50bn into health and social reform recovery plans
EU countries have already earmarked over €47bn euros to spend on health care from the €672bn Recovery and Resilience Facility (RRF), the continent's centrepiece of COVID-19 recovery. Digital innovation, primary care and long-term care are clear spending priorities across the board. We should know the full allocations next week. [+]
Diversification saves Life Healthcare
Life Healthcare's international division continued to make up for its sluggish core South African (SA) market in the last two quarters meaning it expects better results than SA-only competitor Netcare. German group Asklepios, the largest single-country hospital operator in Europe, saw a big loss in 2020 despite generous state support. [+]
Growth picks up in Spanish homecare post-COVID
Spanish homecare is returning to pre-pandemic double-digit growth after a flat 2020, HBI hears from Asisted, a Spanish homecare operator. [+]
French groups drive to consolidate Irish nursing home sector
Orpea, the pan-European care home operator, has continued its drive to become the number one player in the Irish nursing home sector. Local operator Virtue, which is majority-owned by French operator Emera, is also expanding its market share. [+]
Mid Europa pushes back Regina Maria exit after bumper 2020
PE firm Mid Europa has pushed back its exit horizon for Romanian healthcare group Regina Maria to 2024 at the earliest, three years later than it planned to pre-Covid. Regina Maria grew revenues 27% in 2020. [+]
India's Covid crisis to peak 'for another two weeks'
Indian hospitals are struggling and failing to cope with the ruinous COVID-19 wave running rife through the country. As resources dwindle and the international community steps up efforts to assist, HBI talks to an exhausted Delhi-based for-profit hospital operator source who is on the frontlines. He says their modelling predicts another two weeks of intense pressure. [+]
Synlab IPO priced low
Lab group Synlab has announced pricing at the bottom of its range, a price that values the group at just 8.8 times 2020 EBITDA. Sources say that investors are worried about the resilience and performance of its huge COVID earnings. The IPO is now proceeding at a valuation far lower than that generated by the sale of Cerba to EQT. [+]
Interview: Raj Shah, Partner and Head of Healthcare, Nordic Capital
Few investors have been as active in healthcare services as Nordic Capital. Or as ambitious in building pan-European platforms in outpatient sectors such as dentistry, veterinary and ophthalmology. Raj Shah is also looking for new deals - Nordic has just raised a massive €6.1bn for its tenth fund of which 30-40% is destined for healthcare. [+]
If for-profit health care services in Europe was a country, which country would it be?
The sheer size of the for-profit health care services sector isn't really appreciated. So if it were a country, which country would it be? [+]
Eurofins wins €48m contract for EU-wide genome sequencing
The European Centre for Disease Prevention and Control has awarded Eurofins a €48m whole-genome sequencing (WGS) contract for COVID-19 variant testing. The move demonstrates confidence that countries will be running high volumes of COVID-19 testing in the mid to long term. [+]
Mediclinic bullish for 2022 despite drop in revenue
Group revenue fell 3% at South Africa-based EMEA hospital group Mediclinic International for the year ending March 31, 2021. But there were positive signs in H2 as the London-listed group came to terms with how to work during a pandemic, and the group is bullish about next year despite a particularly challenging start to the last. [+]
San Donato bids for Catholic-owned hospital
Italy's largest hospital group San Donato is bidding to make its first move out of northern Italy through a binding offer for Rome's Fatebenefratelli hospital. Another Vatican-owned hospital is trying to shut down sale rumours at a time when many are struggling with the financial fallout from the pandemic. [+]
"No jab, no job" policy splits UK nursing home operators
The UK government has launched a five-week consultation to look at whether vaccines should be mandatory for care home staff. Care operators are split on the issue, with some fearing it could cause staff retention and recruitment problems. [+]
German ophtha chain "selling to pan-European PE firm"
An ophthalmology chain that operates across Germany and Austria, and has a small presence in Russia, is about to be purchased by Trilantic Europe, HBI can reveal. [+]
Unicare founder furious after ousting
London-based private equity fund G Square Capital has taken full control of private health and care group Unicare. Founder and minority shareholder Tom Tidemann tells HBI he is dismayed by its action - but G Square's CEO tells HBI it was necessary to stop Unicare going bankrupt. [+]
Covid continues to boost Unilabs in 2021
Executive chairman Jos Lamers has told HBI that Covid sales continue to rise in Q1 and Q2 2021. They certainly boosted 2020 results at the international lab and imaging group owned by Apax Partners. Like rivals Synlab and Sonic, the business continues to roar away. [+]
UK government accused of overlooking care sector in visa snub
The UK government has been accused of overlooking care workers after announcing a free one-year UK visa extension for frontline health workers, but not care home staff. [+]
NMC tells its $6.4bn creditors to take it over, or lose money
Creditors of in administration GCC-based NMC Health face a stark decision between now and May 28. Buy us, or face a 'distressed sale' - and possible liquidation. Accepting the deal will see creditors losing out on billions of dollars in the short term. But not accepting the deal could be worse. [+]
Covid - a rare bonanza for Europe's private medical insurers
Covid has seen high demand and low claims for European PMIs which suggests soaring demand for private health care over the next few years. [+]
Cera Care strives to hit recruitment target
In March last last year, the UK homecare group Cera Care said it would create 10,000 new jobs for carers across the country in response to COVID. More than one year on, HBI understands that less than 40% of these prospective vacancies have been filled so far, but the project continues. [+]
Partners Group acquiring stake in wound care company
Partners Group is acquiring a stake in Healogics, a US-based ambulatory care company with wound care centres in the UK, HBI can reveal. [+]
BioNTech owners in talks to buy stake in MLL
Europe's largest specialised lab Munich Leukaemia Laboratory (MLL) could be taken over by the family-office owners of COVID-19 vaccine maker BioNTech. [+]
Aedifica makes its biggest buy into German care homes
Aedifica has made its largest single acquisition of care homes in Germany. The Belgian REIT has taken ownership of 19 care homes in Germany, in a deal worth approximately €245 million. [+]
Axa launches support service for Long Covid sufferers
Axa Health customers in the UK suffering from Long Covid are to be offered rehabilitation and consultations on referral from their GP or occupational health officer. [+]
Synlab to IPO in Frankfurt
Europe's largest lab group Synlab will list on the Frankfurt Stock Exchange in Q2 after releasing an intention to float document on Wednesday morning. The group says revenue will grow 17% this year to €3bn+ revenue and that COVID-19 revenue will only continue to grow. [+]
Domiciliary care flatlines in Sweden
The Swedish domiciliary care sector did not enjoy the same growth as its European neighbours through the pandemic, with older residents rejecting all but the most essential services. HBI speaks to two Swedish domiciliary care operators to find out more. [+]
EQT Real Estate invests in Italian care home sector
EQT Real Estate has announced a €300m joint venture with Italian construction company Arco Lavori, to build high quality care homes in Northern Italy. [+]
NHS will 'not have the capital' for 100 new imaging centres
NHS England will not have the capital to fund the 100-plus new outpatient imaging centres needed to meet demand in the coming years, says the CEO of Imaging Holdings, a top-five for-profit imaging operator. The group is launching four new mobile imaging units after securing a growth funding facility from its PE backer Apposite Capital. [+]
French general home service group shifting to healthcare
Domiciliary care is set to go from 30% to 50% of revenues for France's largest home services group Oui Care, as demand for child care declines and people opt against going into care homes, CEO Guillaume Richard tells HBI. [+]
EQT buys Partners' stake in Cerba
EQT has agreed to buy Partners Group's stake in French lab group Cerba for a ball-park enterprise value of €4.5bn, making it a 12x multiple on the group's 2020 EBITDA. [+]
How Covid changed four sectors' growth trajectory - Infographic
How has the global pandemic changed the 2020-23 growth trajectory for the EMEA for-profit hospital, imaging, lab and teleradiology sectors, compared to what would have happened with no Covid? HBI Intelligence data reveals all. [+]
Is the UK nursing home sector in “crisis”?
Elderly care has had a challenging year in the UK, but is it too strong to call it a crisis, and how will things look as it recovers? HBI chats to a consultant and operator to find out more. [+]
Lifebrain for sale as EBITDA for lab groups near doubles
Italian lab group Lifebrain is the latest to take advantage of swollen revenues and profits in the lab sector with owner Investindustrial appointing Goldman Sachs and JP Morgan to explore a sale. Meanwhile, COVID-19 testing across Europe led to a near doubling of EBITDA for the largest players in the third quarter of 2020. [+]
City & County acquires UK rivals
UK-based community homecare and domiciliary care specialist City & County Healthcare Group has acquired rivals MiHomecare Limited and Complete Care Amegreen, further extending its UK portfolio as M&A activity in the sector resumes after a Covid hiatus. [+]
COVID-19 testing costs billions, and that will only reinforce the long price war on labs
Even pre-COVID the lab sector was battling against decreasing tariffs as policymakers grew wary of automation and its higher margins. With EBITDA all but doubling for the largest players on the continent, that old feud is going to resurface soon. In some cases it already has. [+]
2021: A boom year for health care M&A
The M&A market has roared out of Covid in the first quarter according to the HBI Panel Discussion. Are multiples likely to drop and what is investor appetite? [+]
Garofalo continues M&A as Covid hits 2020 organic growth
Listed Italian hospital, post-acute and outpatient group Garofalo Healthcare (GHC) has continued its M&A drive with the acquisition of a hospital in Verona for 8.5x 2019 EBITDA. Deal-making drove 7.3% revenue growth in 2020 to €196.5m, although on a like-for-like basis, revenues fell 5.2%. That is still much better than many large Italian hospital groups. [+]
Interview: Mark Chapman, International CEO, Life Healthcare
What are South African hospital group Life Healthcare's plans for its international division, mainly comprised of pan-European imaging operator Alliance Medical? In a long and wide-ranging discussion, Chapman talks about expansion in South Africa and one to two new countries, 'winners and losers' in the imaging AI market, tariff pressure across Europe and what the first new potential drug therapy for Alzheimer's in 18 years means for its PET-CT business. [+]
NMC Health's Aspen disposal could end with propco takeover
In-administration GCC group NMC Health's attempt to offload UK hospital chain Aspen Healthcare looks to have stalled. An advisor says the opco could be taken over by propco owner NorthWest Healthcare Properties, echoing what happened to the largest operator BMI Healthcare just two years ago. [+]
Who would invest in UK nursing homes in the face of a "care crisis"?
It has been a horrible year for nursing home sector in the UK. Who would want to be an operator? The answer may surprise you. [+]
EMEA imaging sector down 6% in 2020
The EMEA for-profit imaging and teleradiology sectors shrank 6% in 2020, figures from HBI Intelligence show. [+]
Orpea and Korian's FY2020 results show resilience in the face of Covid
Shares in listed European care groups Korian and Orpea dropped slightly on publication of their FY2020 results – but despite a difficult year there are reasons for both companies to be hopeful of better times ahead. [+]
Interview: Martin Jones, CEO, Home Instead UK
This week we interview Martin Jones, the CEO of UK-based home care operator Home Instead, about the effect of COVID on the market, drivers, and the growth of the franchise model. [+]
GHP continues organic growth in 2020 despite pandemic
GHP, a listed provider of specialist clinics in Scandinavia and hospitals in the Middle East, increased revenue and EBITDA in 2020 despite the difficulties caused by the pandemic. HBI talks to CEO Daniel Ohman to find out how. [+]
Which UK private hospitals earned the most from £2bn NHS block-booking?
NHS England will have spent around £2bn on buying capacity and services from the private hospital sector for COVID-19 related services in the last 12 months, according to recently-released public documents. We break out the figures to reveal which operators earned the most and how the picture changed in Q4. [+]
For-profit homecare may struggle to compete after French reform
Legislation in France is set to hike minimum homecare carer wages by 20% in the not-for-profit sector, with financial support from the government to do this. HBI hears low margin for-profit operators fear they will struggle to match this and retain staff. [+]
EMEA for-profit hospital sector shrinks 3-5% in 2020
Revenues in the EMEA for-profit hospital market fell by 3-5% in 2020 due to COVID-19 but could bounce back strongly in 2021, figures from HBI Intelligence show. NMC Health CEO Michael Davis tells HBI he anticipates a ‘return to normalcy’ to continue through the year. [+]
Triton "invests" in Bergman - Aleris merger to follow?
PE firm Triton has agreed to "invest" in Dutch, Nordic and German ambulatory clinic operator Bergman Clinics, possibly implying it is not buying control from NPM Capital and the Malensteins who are retaining stakes. Triton would not comment on the size of the stake nor on our speculation it plans to merge Bergman with Nordic operator Aleris. [+]
Vaccines causing minimal headwinds in COVID-19 testing volumes
HBI analysis of COVID-19 testing volumes and pricing reveals how vaccine programmes and the rise of antigen tests might impact future growth for the lab groups. PCR volumes and have dropped 16% in the UK since it started vaccinating its population and one lab group is expecting a 35% to 50% drop in COVID revenue this year. [+]
Fertility: Where politics and ethics trump science
Most civilised nations able to afford it offer some assistance to couples struggling with fertility problems, but there are usually a list of stringent criteria based on age, health, previous treatments and more. That is far from the end of the story, however. Just because you can do something doesn't mean you should. Nowhere is this more keenly felt than with fertility. [+]
Interview: Nimrod Altman, CEO, Natali Healthcare Solutions
HBI talks to domiciliary care specialist Natali Healthcare Solutions’ CEO, Nimrod Altman, about COVID, and the market challenges and opportunities it has created. [+]
Domiciliary care losing staff to nursing homes in France
Care workers in France are quitting domiciliary care in droves, and heading into the more lucrative nursing homes sector, Amir Reza, CEO of France-based domiciliary specialist Vitalliance tells HBI. [+]
When will vaccine rollouts hit PCR test volumes?
As vaccine rollouts pick up the pace across the world, we ask when lab groups' volumes will start to be affected. [+]
Attendo strengthens its position in Finland
The large pan-Nordic care group, Attendo, has reached an agreement to purchase Uudenmaan Seniorikodit Oy, a local Finish nursing home operator. [+]
UK domiciliary market M&A picking up - but government support still needed
That the UK's COVID-hit domiciliary market has recently been hugely challenging both operationally and financially for providers is no surprise, but there is ‘light at the end of the tunnel’ with M&A increasingly back on the table, one UK-based operator tells HBI. [+]
Affidea enters UK with double-deal
Pan-European imaging and outpatient operator Affidea has entered the UK market with the acquisition of Fortius Clinic, a group of musculoskeletal (MSK) and orthopaedics centres in central London, and an outpatient centre in Northern Ireland. [+]
Interview: Dr Juan Abarca Cidon, president, HM Hospitales
We talk to Dr Abarca Cidon, part of the controlling family and current president of Spain's third-largest for-profit hospital group HM Hospitales with nearly €500m in sales. He talks strategy, Covid, and rumours of selling a stake in the company. [+]
Italy's recovery plan has €18bn for healthcare, the UK's none
Italy's COVID-19 recovery plan contains €18bn for homecare, integrated health facilities and telemedicine that can be run by the private sector in a whole-scale reform of the country's healthcare system. Meanwhile, a new budget in the UK failed to allot any new funds for its overstretched health and social service. [+]
$20bn merger could transform Brazilian healthcare market
A $20bn merger between two giants of Brazilian healthcare, listed HMOs Hapvida Participacoes e Investimentos SA and Notre Dame Intermedica Participacoes SA (GNDI), will create one of the world’s biggest companies providing verticalized health-care solutions. HBI looks at the deal in detail, and talks to a Brazil-based operator to find out more. [+]
HC-One selling 52 care homes
One of the UK’s largest five largest care home operators by revenue, HC-One, is putting 52 care homes up for sale and closing four more. We talk to UK advisor Candesic. [+]
EMEA hospital sector finishes 2020 strongly
Private hospital operators across Europe, the Middle East and South Africa had a good last few months of trading in what was a turbulent 2020, but the start of 2021 looks tougher. We talk to operators across the region. [+]
Amedes for sale as Synlab forecasts future organic growth to settle about 3%
Europe's largest lab group Synlab forecasts that it will see 3+% of annual organic growth over the mid-term, saying that testing will remain a core part of pandemic control. Other lab groups clearly agree with that punt, with news that smaller rival Amedes reportedly is preparing for sale. [+]
Regional Czech governments look to PPPs to meet care home demands
In a notable shift in policy, regional Czech governments have started entering into PPPs with local operators to build additional nursing home capacity. Substantial contracts to for-profit operators could follow, according to a CEE-based expert. [+]
Medica in Aussie JV to grow night-time capacity; eyes Middle East
UK teleradiology provider Medica Group has launched a JV with an Australian radiology group to increase reporting capacity for its out-of-hours Nighthawk services and explore new markets including the Middle East, CEO Stuart Quin tells HBI. [+]
Governments are already tired of how much telehealth costs
Telehealth had reached a critical mass in Sweden with providers able to generate decent sales from an established reimbursement model. However, spiralling costs have now tipped its payors over the edge with many refusing to pay the tariff. It's not the first time that authorities have taken a stand against telehealth's costs and it could have far-reaching policy implications. [+]
NHS payments provide fivefold revenue boost to Romanian outsourcer
Romanian healthcare provider Santa Maria, part of listed group Medlife, has grown its revenue by fivefold since 2016 mostly from patients outsourced to it by the Romanian NHS. HBI speaks to the group's CEO to find out more. [+]
N. Macedonia's second-largest private hospital in talks to sell stake
The owner of North Macedonia's second-largest private hospital, the Zan Mitrev Clinic, tells HBI he is in discussions with outside investors and a deal could happen 'in the future'. [+]
Aedifica takes first step into Ireland
Aedifica has acquired its first asset in Ireland. The Belgian REIT has taken ownership of an operational purpose-built care home in Mallow, County Cork in a deal worth approximately €25m. [+]
Teleradiology veteran joins AI outfit as sectors' outlooks diverge
The former CEO of lab group Unilabs' teleradiology arm TMC, Alexander Böhmcker, has joined the eighth most-funded imaging AI company in the world, Aidoc, as VP Europe. We talk to Böhmcker. What does the move say about the two sectors which had very different 2020s? [+]
McDermott Will & Emery talks Europe's complex regulatory landscape
Encroaching protectionism from governments across Europe is leading to some initiatives that might limit foreign investment in key strategic services like healthcare. Sharon Lamb, a partner with law firm MWE, talks to HBI about those new laws and a host of others introduced over the last year. It’s a complex regulatory and reimbursement landscape but MWE has a new report to help. [+]
Atrys CFO on recent M&A and pan-European radiotherapy plans
Spain-listed diagnostics and radiotherapy group Atrys Health's CFO talks HBI through the strategic rationale of its spate of recent acquisitions including a €550m merger with another listed group, after we questioned the diversity of deal-making it is pursuing. He says it is looking at acquiring radiotherapy centres in Europe outside Iberia. [+]
Synlab and Cerba looking for exits, while Unilabs in 'no rush'
The COVID-19 pandemic has uniquely warped revenue for the big lab groups. Difficulty forecasting means Apax is in “no rush” to explore an exit while Cerba Healthcare may join Synlab in an IPO process, HBI can reveal. Synlab is reportedly on an IPO roadshow this week and Biogroup’s recent record-breaking raise on the bond market shows there’s an investor appetite. [+]
Atrys continues M&A splurge as shares soar
Spanish listed precision medicine, diagnostics and radiotherapy group Atrys Health continued its relentless M&A drive through 2020 and has started 2021 with its biggest deal yet. But how much is too much? [+]
Penta to sell stake in hospital business; IMs out by March
CEE private equity firm Penta Investments is seeking a new investor for its hospital division, Penta Hospitals International (PHI), and aims to launch a process with investment memorandums (IMs) out by the end of February, investment director Václav Jirků tells HBI. He discusses the reason for the sale, including international expansion, and the current political turmoil surrounding Penta and its healthcare business. [+]
Dentalpro acquires Vitaldent Italia and plans further expansion
BC-Partners backed for-profit Italian dentistry group DentalPro has signed an agreement to acquire Vitaldent Italia from JB Capital. The agreement will see DentalPro take control of Vitaldent’s 80 dental practices and integrate them into DentalPro’s network and brand. [+]
Elsan to "refrain from sizeable acqusitions for 12-18 months" after C2S deal
Credit rating agency Moody's understands that France's largest for-profit acute hospital group Elsan will "refrain from sizeable debt-funded acquisitions such as Groupe C2S over the next 12 to 18 months and focus on bolt-on acquisitions," after downgrading its debt rating outlook to 'negative' following an increase in leverage from its the deal. We talk to Elsan and L.E.K. France. [+]
UK commits to releasing social care reform this year
The UK government has said it will introduce long-awaited reforms on social care this year, as part of a new package of measures to reorganise the structure of NHS England. [+]
Efficiency innovations becoming added-value for oxygen suppliers
Many oxygen suppliers have been continuously hostile to innovation that could make delivery more efficient, HBI hears. The pandemic has renewed attention on supply, pricing and patient outcomes leading to some to reassess the approach. HBI speaks to one medical device company that claims to save up to 80% of oxygen for an inpatient. [+]
UnitedHealth Group appoints new CEO
UnitedHealth Group, the largest health insurance firm in the United States, has appointed a new CEO. Andrew Witty will take the helm from outgoing CEO David Wichmann, following his three-year tenure. [+]
Reason to be cheerful?
For those of us in the northern hemisphere, Spring may still be a good six weeks away – but something is in the air. Our newsdesk inboxes and telephones are buzzing with news of prospective M&A deals, and we hear collectively that prospects for consolidation look to be blooming. [+]
Multi-million oxygen tender in Italy to increase market by fifth
Piedmont, a region in northwest Italy, has tendered for €213m worth of home oxygen services split over two years, which could boost the market up to 20%. [+]
Bergman process inches forward as Dutch clinics await elective boom
Preliminary bids for Dutch, Nordic and German ambulatory and ophthalmology clinic group Bergman Clinics were due last week, HBI is told, with big-hitting PE firms expected to make offers. [+]
NMC CEO: Any sale will be a competitive, traditional process
Will the creditors of NMC Healthcare, the GCC's largest for-profit healthcare operator which has been in administration since April 2020, choose a sale of its core UAE business in the next 3-6 months or a longer-term, creditor-led restructuring? We talk exclusively to NMC CEO Michael Davis and UAE sources. A 'fire sale' of parts of its core UAE business now seems entirely off the table. [+]
Private sector "should have large role in vaccine distribution in SSA"
The private healthcare sector should have a large role in distributing the COVID-19 vaccine in sub-Saharan Africa alongside traditional NGO vaccine distributors. Why? Because it already has a much closer relationship to those who are most at risk, chronically ill men, HBI hears. [+]
Ameos "prepares for sale or refinancing"
Multiple sources tell HBI that DACH psychiatry and acute hospital group Ameos is preparing for sale or refinancing. The group vehemently denies it is preparing for sale. [+]
How healthcare spending has changed at France's statutory insurer - Infographic
This week HBI breaks down data from France's statutory insurer to see how it has changed since 2017. It makes clear just how much the ongoing COVID-19 pandemic has upset ongoing trends. [+]
NHS uses COVID surge capacity amidst private pay resurgence
NHS England trusts have triggered clauses granting full access to private hospital capacity in some areas as COVID-19 hospitalisations soar, amidst controversy over the ramp-up of private pay activity - although private operators tell HBI they are focusing on time-critical surgery and cancer care. [+]
Hungary's consolidators grow through COVID as 'grey' market formalises
Hungary's largest private acute care operators continued double-digit revenue growth of previous years in 2020 despite COVID-19, HBI can reveal. Recent analysis by analysts shows much of the sector's pre-pandemic growth may have been enhanced by capturing the 'grey' market of previously under-the-table private pay. [+]
Quironsalud buys hospital in northwest Spain
Spain's largest for-profit hospital group Quironsalud, part of Fresenius Helios, has acquired its fourth hospital in the northwest region of Galicia. [+]
Half of postponed PMI hospital treatments may never come back
Not all of the PMI-funded treatments deferred by the COVID-19 crisis will be treated once it's over. One private insurer is modelling for just 50-60% of those claims to ever come back. [+]
$3bn Imaging AI sector will re-shape industry after watershed 2019/20
Imaging AI solutions which can read images just as well as radiologists are now demonstrably effective medical products that will revolutionise the medical imaging industry forever. $1.5bn in VC funding has been ploughed into companies developing solutions whose tech promises to transform diagnosis and improve operational efficiency. We talk to seven of them who've commercialised products in 2019/20, operators using them, and look at the sector in detail in this long-read feature. [+]
'Interest' in Everlight despite COVID hit to teleradiology
Private equity has reportedly rekindled interest in UK-Australia teleradiology group Everlight Radiology, over a year after owner ICG kickstarted a sales process before COVID hit. But with UK competitor Medica revealing a 20% drop in revenue for the year because of the pandemic, how likely is a sale? [+]
Ramsay Sime Darby targeting $300m spin-off IPO
HBI understands that Malaysian/Indonesian hospital group Ramsay Sime Darby has appointed banks for a $300m IPO. One side of the JV says that expansion in healthcare is a key strategic focus, the other appears notably quiet about its investment in Asia. FY2020 saw profits drop for "the first time in many years" as COVID struck. [+]
Richer countries are buying their way to COVID immunity ahead of the rest
According to the WHO, there is a clear problem: rich countries have the majority of the supply of COVID-19 vaccines. [+]
Lockdown and Zoom create cosmetic boom
Demand for aesthetic surgical procedures and cosmetic dentistry is on the rise, fuelled by both a Zoom meeting culture where everyone is aware of their appearance on camera, and the lockdown enabling otherwise undisguisable procedures to remain hidden during recovery. [+]
Vaccine tours to claw back medical tourism losses
A handful of medical tourism hubs are starting to organise 'vaccine tours' in a bid to replace lost revenue, HBI hears. The idea is to fly the wealthy to somewhere they can get a COVID-19 jab. [+]
How the world’s largest consumer PE house views healthcare
At HBI 2020 we interviewed Chinta Bhagat, a managing partner at private equity house L Catterton, the world’s biggest private equity investor in consumer products and retail, about the destruction of the general hospital and the new digital models that will replace it. “If you don’t have digital embedded in everything you do in such a way as to give the customer a choice of how to interact with you, your business will eventually be destroyed,” he says. Bhagat should know, he led McKinsey’s healthcare practice in Asia for many years and at Khazanah Nasional was intimately involved in the creation of Pan-Asian hospital chain IHH. He is now scouting the world for digital healthcare investment opportunities. [+]
Aetna Global Benefits for sale
The sales process has started on the sale of one of the top four global ex-pat healthcare insurers, HBI hears. We name names and potential buyers in what is likely to be a billion dollar plus deal. [+]
HMOs are the key to Israel's vaccine success
Israel's HMOs have already transformed health risk predictions in Israel through big data analysis. Now, the systems' abilities to integrate messaging and data is pushing the country to the top of the COVID-19 vaccine league table. [+]
Denmark tenders €200m lab services for COVID-19
The Danish regions want to spend just over €201m on collection and analysis services for COVID-19 PCR and antigen tests. This is more than 13x what the market's largest players - Unilabs and Synlab - earnt in the market in 2019. [+]
Final bids for IDH/mydentist "due in two weeks"
Bids in the sale of UK-based dental specialist IDH have been postponed to later this month, HBI hears from an operator source watching the deal. [+]
Vaccinations in UK care homes rolled out this week
Vaccine teams started working en masse in UK care homes this week, providers tell HBI. The new move is expected to greatly accelerate the vaccination programme - one of the first of its kind in the world - as residents until now have had to leave facilities to be jabbed. [+]
The main themes of HBI 2020
Massive uncertainty, new relationships with governments, a huge acceleration in digital and roll-up opportunities were the themes that out of HBI 2020. [+]
Fresenius Helios buys Eugin, Elsan buys C2S
German and Spanish for-profit hospital operator Fresenius Helios has acquired global IVF operator Eugin from in-administration NMC Health, while French number two hospital group Elsan has bought smaller competitor C2S. What does the deal pricing for both say about relative valuations in the two sectors and any COVID impact? [+]
HBI 2020: Hospital CEOs focus on digital, the care continuum and culture
To a remarkable extent, hospitals CEOs whether in Europe, China or Emerging Markets share the same goals around extending their patient offering forwards into primary and back into chronic and rehabilitation using digital health to achieve this. And the one thing they all know they need to get right is culture. [+]
HBI 2020: Non-COVID lab volumes recover in Q3 but M&A model may be redundant
Non-COVID lab volumes reached their pre-pandemic levels in Q3. But does the pandemic signal the end of the sector's reliance on M&A, and what are the implications of new B2C markets? Operators Unilabs, amedes, Medicover and Dr Lal Pathlabs, B2C platform Daslab and supplier Abbott discussed all this and more at HBI 2020's 'Diagnostics: Opportunities and Challenges' & 'A new global consumer market?' sessions. [+]
HBI 2020: TPG-backed Asia Healthcare Holdings EBITDA grew 60% through pandemic
The EBITDA of one of Asia's largest hospital consolidators grew 60% through the COVID-19 pandemic, its executive chairman Vishal Bali said at HBI 2020, as the group "skinned" out a lot of operating costs. [+]
HBI 2020: Data drives Ping An and Teladoc's global expansion
Ping An and Teladoc revealed their plans for global expansion at HBI 2020. The former says it's hard to leave such a big domestic market as China but has sights set on SE Asia and 'the developing world'. Teladoc is focused on Europe, Brazil and also on Ping An's home turf, China! Both are now capable of delivering full acuity care and have driven their insights using some of healthcare's largest datasets. [+]
HBI 2020: The future of domiciliary homecare - meeting an insatiable demand
In many markets there is a growing, perhaps even an insatiable demand for unskilled homecare. Is it a sector where it is possible to make money, and how? Is reimbursement sufficient? How do you attract and retain staff? And what effect is COVID having on the market? An expert panel at HBI 2020 considered all this, together with the biggest risks, and best opportunities, as we all dare to look forward to a more normal life in 2021. [+]
HBI 2020: Investor interest in hospitals increases while outpatient valuations drop
Investors from varied backgrounds - infrastructure, private equity, and REIT, are all bullish about the prospects for healthcare investment in 2021, according to a panel of experts speaking at the HBI 2020 European Investment Panel discussion. But the pandemic may have 'readjusted the relative value discussion across sectors' according to one private equity investor. [+]
HBI 2020: Dentistry - will we see a truly pan-European group and the COVID bounce back?
At the start of this year, there was a lot of optimism around dentistry. The dental sector was seen as one of the biggest and most exciting opportunities for private operators and investors. Largely unconsolidated across Europe and beyond, many asked ‘when will we see a truly pan-European operator'? COVID derailed all expectations of the year but with a vaccine now in play, what are the prospects for consolidation and expansion? HBI 2020 gathered a panel of experts to find out more. [+]
HBI 2020: Medtech and services - new partnerships and opportunities
The relationship between medtech and its customers is changing. No longer is medtech wheeled out for a one-off purchase. Long-term partnerships are being built, and patients and providers are benefitting. An expert panel at HBI 2020 explored the burgeoning relationship between medtech and services, and some of the challenges this presented. [+]
HBI 2020: Regulatory and Political Risks post-COVID
With increasingly strained public health systems firmly in the spotlight during COVID, and a reliance on for-profit providers to step into the breach and help, relations between for-profit groups and governments have been cordial recently - or at least thawing. Regulatory and political risks remain, however, and scrutiny of foreign investment appears to be on the rise. An expert panel convened at HBI 2020 to explore these themes. [+]
HBI 2020: Elsan and Mehilainen on in-house digitalisation of patient pathway
Elsan and Mehilainen, top-two private hospital operators in France and Finland respectively, and both CVC portfolio companies, say their in-house investments in digitalising the patient pathway have increased customer loyalty, cross-selling revenues and insurer-funded work. They were joined by GE Healthcare for the 'Hospitals: The journey towards digital and outpatient transformation' session at HBI 2020. [+]
HBI 2020: UBS says that COVID has demonstrated systemic relevance of diagnostic groups
Martin Henrichs, managing director and Head of Healthcare at investment bank UBS, shared his thoughts on long-term trends in healthcare consolidation as well as his big takeaway from this year's pandemic, at HBI 2020. [+]
HBI 2020: UK private and NHS elective backlogs explode
There is a crisis in access to treatment in the UK as private and NHS waiting lists soar, said panellists at the 'State of the Region: The UK' at HBI 2020. [+]
HBI 2020: Infra, family office and continuation funds to muscle in on M&A in 2021
Infra, family office and continuation funds will play a bigger role in healthcare service M&A in 2021, with a strong pipeline of assets in a 'bumpy market', Rothschild's managing director of healthcare M&A Hedley Goldberg told delegates at HBI 2020. [+]
HBI 2020: Healthcare spend is an enabler of economic growth, not a burden
Healthcare costs should be seen as an enabler of economic growth and not a burden, says a new McKinsey report following a two-year study by the firm, presented by senior partner Penny Dash at HBI 2020's 'Where are we now?' session. Dash was joined by the Austrian health minister and a Siemens Healthineers executive for the big picture discussion. [+]
HBI 2020: Korian aims to make homecare 20% of revenue
Pan-European care group Korian aims to double homecare revenues from 10% of its business today, train 6,000 nurses a year and use 60% of capex to transform its care homes, CEO Sophie Boissard tells us in an interview at HBI 2020. [+]
HBI 2020: Care homes may never return to pre-COVID occupancy
The COVID-19 pandemic is driving regulatory changes in the care home sector across western Europe, said speakers on the 'Elderly Care: How big is the opportunity?' panel at HBI 2020. One said: "Do not assume you will ever see a return to pre-COVID levels of occupancy." [+]
HBI 2020: Lessons to learn, changes to make, opportunities to find, friendships to forge
There is light at the end of the tunnel. After a difficult year for everyone, personally and professionally, the prospect of a level of normality returning in 2021 as the first batch of vaccinations are applied to those with the greatest need, is an enticing one. [+]
Movement at the top of German imaging
Curagita-backed Deutsche Radiologienetz AG (DeRaG), one of the first movers in consolidating the German imaging market, will soon bring in a new investor, HBI can reveal. Meanwhile, ongoing investigations into the founder of Med 360°, the largest player in the market, may raise questions over the future of one of its minority shareholders. [+]
Poland issues €40m tender for telehealth services
Poland's national health payor NFZ is looking to expand its telehealth services in a national hotline tender worth up to €40m. [+]
Report: 20% of hospital care could be offered remotely by 2030
The COVID-19 pandemic has accelerated the adoption of remote hospital care across Europe and could contribute to up to 20% of hospital care being offered remotely by 2030, according to a new report. [+]
Calls to cull NHS England's triple-figure million imaging outsourcing spend
NHS England should cut its spending on imaging outsourcing and set up community blood-collection points, recommends a review of diagnostic services for the health service. It says the estimated cost of outsourcing is £160m but results from the largest players suggest it's a lot more. [+]
Private insurance premium inflation down, public up
Private medical insurers will likely drop premium increases over the next 18 months on the back of near-record profitability in 2020. In contrast, public insurers warn that its costs will rise to cancel out growing deficits. [+]
European mid-market deals return but top end still quiet
Middle-market M&A is picking up again across healthcare sub-sectors in Europe, but investors are still reluctant to take the leap on larger assets. We round up where deals are - and aren't happening, and why. There is close to €1.2bn revenue up for grabs in the dentistry sector, nearly €1bn in the psychiatry sector, and around €750m in other outpatient services like ophthalmology and IVF. [+]
Interview: Dr Peter Byloos, Optegra
As HBI reported last week, UK, Czechia and Poland-based ophthalmology platform Optegra Eye Health Care is being acquired by H2 Equity Partners. HBI caught up with Optegra CEO Dr Peter Byloos to hear his views on the market (and inevitably these days, the impact of COVID), and to find out about Optegra’s plans under new ownership. [+]
2020: It was all about the C words
There was a lot of optimism around at the start of 2020. Operators and investors we spoke to had a 'C' word on their lips. That word was consolidation. Whether it was the enticing prospect of consolidating the €26bn dental market, or IPOing the world's most internationally diversified for-profit service operators, HBI's digital pages were brimming with plans. Another 'C' word, sadly, had a different idea. [+]
Interview: Klaus Boehncke, Partner, L.E.K. Consulting
What can you do with AI and big data today and what will be possible within three years? Why has adoption been slower than you might have expected? And what sort of role should health care providers look to play? HBI gets an expert view from digital, technology and business strategy expert Klaus Boehncke, partner at L.E.K. Consulting, who is chairing the Best Practice Workshop: Delivering Digital Excellence: A Framework for Success at HBI 2020 in two weeks. [+]
Questions raised over state support to private hospitals in Germany and England
Financial support to for-profit hospitals in Germany and England during COVID-19 has come under scrutiny in both countries, with suggestions it did not represent value for money for the public payor. [+]
CEE - a land of opportunity?
With 125 million people - 80 million of whom live in the big four (Poland, Romania, Czechia and Hungary) - CEE is a large and diverse market. But is it a tempting one? HBI-365 members heard an expert panel in our CEE State of the Regions broadcast suggest that while COVID is creating huge problems across the world, it is also creating opportunities in Central and Eastern Europe. [+]
Sub-Saharan Africa invests and insources during pandemic
The direct health impact of COVID-19 on sub-Saharan Africa has so far been significantly less than expected. But economic activity has fallen sharply and a vaccine impact is not expected until late next year. Panellists from Anadach, the IFC, Columbia Africa, AfyA Care and Nyaho Medical Centre talk about consolidation, supply chains and teledensity. [+]
Nordics: Finding positives in a difficult year
HBI 365's State of the Regions: Nordics panel found a lot of positives had come out of a difficult year. But better relationships with payors and public providers, and a vastly increased understanding and recognition of the benefits of digital clinics were tempered with the knowledge that, as the pandemic recedes, the new normal is likely to see some of these advances pull back - albeit not to pre COVID levels. [+]
China's new 5-year plan: tech ambition and a robust domestic market
The world's second-largest economy will start its 14th 5-year plan next year. Panellists at HBI's State of the Region event discussed China's plan to onshore both physical and online healthcare services. [+]
Why lockdown to protect the elderly, then deny them treatment?
This week, an exclusive HBI report has uncovered a troubling statistic: people over the age of 80 were up to three times more likely to die of a COVID-19 infection in countries using rigid rationing guidelines that excluded the elderly from intensive care. [+]
Special report: How rationing care in the pandemic is killing the elderly
People over the age of 80 are up to three times more likely to die of a COVID-19 infection in countries using rigid rationing guidelines that can exclude the elderly from intensive care - and sometimes even from hospital. HBI's extensive analysis of death, hospital and ICU data reveals that Sweden has lost eight times more, England seven and the Netherlands six of its elderly population compared to Germany. In a special report, we explore how rationing killed the elderly. [+]
DACH operators should feel positive about 2021
Despite one of the panellists at HBI's DACH-State of the Regions broadcast last week labelling 2020 "the wildest year in recent history in the healthcare sector", there are lots of reasons to feel positive about Europe's German-speaking countries as we look towards the new year. [+]
Operators in Russia and ex-CIS hit hard by COVID
State financing has seen little growth in expenditure in Russia over the last couple of years, while former CIS countries are struggling to fund robust healthcare systems. Despite this, panellists at HBI's Russia and Former CIS - State of the Regions discussion last week found some reasons to be positive. [+]
At $2.4bn, Rede D'Or IPO would be emerging market hospital record
Brazil's largest private hospital chain Rede D'Or's December 10 IPO could raise US$2.4bn, which would make it the largest emerging market hospital listing ever and second overall. That is despite the fact 2020 revenue is flat and net profit is down 80% due to COVID-19. [+]
LATAM: "2021 cannot be worse than 2020"
Operators from Latin America shared their experience of the COVID-19 pandemic and longer-term trends in the continent at HBI's State of the Region event. [+]
Indian inbound medical travel 'a trickle' as operators consider costs
Medical travel to India is still 'a trickle' compared to pre-COVID figures although restrictions have also increased the supply of specialists locally, said panellists at HBI's State of the Region's South Asia session. Like elsewhere, the pandemic has forced a re-think of how operators manage costs. [+]
Payor reforms loom in GCC as COVID/expat exodus bites
Payors are maturing and providers are suffering from the double whammy of COVID and a declining expat population, said panellists at HBI's State of the Regions webinar on Middle East & North Africa (MENA). Other topics including hedging risk, public sector reform and how global trends are manifesting in the region. [+]
Interview: John Gladstone, Head of Healthcare Investment, International Capital Markets, EMEA, JLL
Health care looks like the promised land to property investors hit hard by the collapse of retail and office and deal flow is picking up, says John Gladstone at global real estate advisors. [+]
Optegra sells to H2 Equity Partners, and looks to expand
H2 Equity Partners (H2) has agreed to acquire UK, Czechia and Poland-based ophthalmology platform Optegra. [+]
Emerging market lab roundup
HBI rounds up the latest news from the world's largest emerging market laboratories, including Grupo Fleury in Brazil striking a deal with a rival, and lab activity normalising in India. [+]
Swedbank Robur takes stake in Min Doktor, IPO could be on cards for rivals
Swedbank Robur, an asset manager within Swedbank, has bought a majority stake in Swedish health tech company Min Doktor. A source reckons that the revenue boost from COVID-19 could push the country's competitors on to the public market pretty soon. [+]
Second wave of state financial support for private hospitals
Governments across Western Europe are re-instating financial support for private hospitals involved in the second wave pandemic response. Some are treating COVID patients for the first time as hospitalisations soar above first wave numbers, but support packages are heavily-adjusted from those in spring. We talk to operators in Italy, Portugal, Germany and Switzerland and provide an update on the UK and France. [+]
NMC beats 9-month forecast, lenders submit claims, and EY faces "£1bn+" lawsuit
In-administration global operator NMC Health's revenues are nearly 10% ahead of its business plan for 2020, while the deadline for creditors to submit claims has passed. Meanwhile, administrators Alvarez & Marsal (A&M) are reportedly preparing to sue accounting firm EY over its auditing of NMC for a reported £1bn or more. [+]
Occupational healthcare "cuts cost of absenteeism by half"
The COVID-19 pandemic shifted the working patterns and environments of every type of workforce, resulting in big hits to free-for-service (FFS) business models and new opportunities in remote care. Panellists from Medicover, Medigold and Qualitas discussed this and how good occupational healthcare can reduce the costs of absenteeism by half, at last week's HBI Big Picture Seminar. [+]
Carlyle buys UK developer specialising in for-sale senior housing
Multinational PE firm The Carlyle Group has acquired Beechcroft, which runs a portfolio of UK retirement homes, from British PE firm Alchemy Partners. [+]
FDA approves first home COVID-19 test
The US Food and Drug Administration (FDA) has approved its first COVID-19 test where patients can both take the sample and receive results at home. [+]
Diaverum to IPO in Stockholm as Saudi JV buyout boosts EBITA
Global renal care group Diaverum's upcoming Stockholm IPO has 'strong international and Swedish investor interest', CEO Dimitris Moulavasilis tells HBI, as the market reaches historic highs. We talk expansion and diversification plans and 2020 performance. [+]
COVID vaccine: Shot in the arm the markets needed?
Pfizer shares rocketed 15% on Monday with news of a vaccine that's more than 90% effective. But lab and telehealth shares plummeted upon the announcement while hospitals, care homes and outpatient groups recouped some of their YTD losses. HBI explores what a vaccine might mean across the five sub-sectors. [+]
The State of the Regions: An opportunity to listen, learn and share
Healthcare business opportunities are global. Sadly, as COVID has made all too apparent, risks can be global too. Next week, HBI has arranged an all-star virtual line-up to discuss the state of the regions, a three day event covering everywhere from CEE to China. [+]
CVC "frontrunner to buy Eugin"
HBI hears that CVC is frontrunner to buy international IVF chain Eugin as parent company NMC Health's administrators Alvarez and Marsal looks to complete a lender-led sale of the group by Spring 2021. [+]
The Fertility Partnership looks for PE injection
The Fertility Partnership (TFP) is looking to sell a minority stake, HBI exclusively hears. We speak to an operator and a banking source to find out more. [+]
Curaeos restructures its debt - but are there wider lessons to learn?
As predicted by HBI in the summer, Dutch dental chain Curaeos has now struck a deal with its creditors. We speak to a banking source to find out more, and hear why this could be a salutary warning for other operators. [+]
Interview: Javier Román, CEO, Clece
Clece is one of Spain's largest homecare providers and is also present in the UK, with total domiciliary care sales of over €400m in 2019. HBI gets a snapshot of the business and its views on sector challenges from CEO Javier Román. [+]
Exemplar snatched by Ares in pre-emptive bid
Mid-market UK adult specialist care provider Exemplar Health Care has sold to the private equity arm of US investment fund manager Ares Management for "double-figure EBITDA multiple" in a pre-emptive bid. [+]
Ramsay Sante sees double-digit revenue fall in first six months of 2020
Pan-European hospital operator Ramsay Sante's full-year accounts to June 30, 2020, reveal that like-for-like revenue fell by 6.2% over the year and double that in the first six months of 2020. We dissect the numbers. [+]
Four Seasons carves off adult specialist care for £35m
Four Seasons is selling off part of its adult specialist care business, The Huntercombe Group, in a continued portfolio carve-off by administrators Alvarez & Marsal. [+]
Slovakia spent €60m testing whole population for COVID-19, the UK plans to spend £43bn
Last weekend the Slovakian government tested its whole population for COVID-19 using rapid antigen tests, spending €60m in the process. That looks cheap compared the £43bn worth of contracts awarded or up-for-grabs in the UK. HBI looks at the winners and the losers. [+]
Synlab refocuses on core diagnostics business with analytics sell-off
Synlab has followed through on rumours it was divesting its non-core business by selling its Analytics & Services business for €500m. It says the proceeds will stay in the group for future use. [+]
Quarterly sales performance across Europe's subsectors - Infographic
As we head into the fourth quarter of the financial year, the impact of the COVID-19 pandemic on organic and inorganic growth is becoming clearer. Most groups have tipped back into positive growth but the lockdowns that hit finances so hard in the first half of the year are either looming or in full swing already. [+]
Artemis "enters sales process"
Artemis, Germany's second largest ophthalmology chain by revenue, has entered a sales process, HBI hears from multiple sources. [+]
Europe's largest specialist leukaemia lab on sale for €480m
Munich Leukaemia Laboratory (MLL), a specialist founder-owned lab in Germany, is for sale with a potential €480m price tag. A source says it's one of the "most modern genetics labs" in the world and is likely to sell to one of the large lab groups. [+]
Manipal buys Columbia Asia in India
As predicted by HBI, India-based multi-speciality healthcare provider Manipal Hospitals has agreed to acquire 100% of Columbia Asia's Indian hospitals from Columbia Pacific Management. The deal is valued at Rs 2,100 crore ($282m) including debt. [+]
Dentex gets cash injection from shareholder
In what has been a tough year for dentists across Europe, UK dental partnership group Dentex has raised a further £20m from its major shareholder "to continue success in the corporate dental world". HBI speaks to CEO Barry Lanesman to find out more. [+]
Why your communications director could be your next CEO
The biggest for-profit hospital operators in Australia, Hungary and Norway have all appointed new CEOs internally from communications roles or backgrounds in 2020. Is this indicative of a wider trend in the healthcare sector? The three women appointed tell HBI why it makes sense. [+]
Asklepios: €730m loan 'nothing to do with' COVID in Q4, as occupancies fall
Germany for-profit hospital group Asklepios's €730m Schuldschein, a debt instrument raised last week, has nothing to do with the potential negative financial impact of COVID-19 in Q4, CFO Hafid Rifi tells HBI, though he adds that occupancy in the hospital sector is falling. 95% of the amount will be used to refinance the Rhoen acquisition financing.
[+]
Medica buys Irish diagnostics/teleradiology group for 8-10x EBITDA
The UK's largest teleradiology provider Medica has acquired Global Diagnostics Ireland (GDI), which does eye screening, diagnostic managed services and teleradiology. With only a minority of revenue from the latter, we ask CEO Stuart Quin what this expansion outside of Medica's core business means for its strategy. [+]
Integrated model 'alive and kicking' despite Banmedica closures
Greater scrutiny is being brought to bear on the use of integrated models in Chile - a practice where any impropriety is sidestepped through the use of holding companies. Where does this leave the likes of UnitedHealth Group-owned Banmedica, which has just closed four health centres in its Vidaintegra network - and why is public concern mounting about private insurers profits? [+]
Grim pandemic outlook sees homecare business booming
This is an auspicious time for the medicalised homecare sector, albeit for a tragic reason. Providers of drugs, medical equipment such as oxygen, and healthcare services to the patient's home see a COVID-fuelled boost in demand over the next few years. [+]
Private equity targeting €1.2bn Mediq
Netherlands-based medicalised homecare provider and pharmaceutical distributor Mediq is for sale, with a potential €1.2bn price tag. With non-binding bids for the pan-European group due in the first week of November, HBI hears that a private equity buyer is almost certain with little interest from strategic parties. [+]
Another Chinese hospital IPO in Hong Kong but market looks flat
Chinese private hospital operator Guodan Healthcare has refiled plans to IPO on the Hong Kong exchange and, if successful, will become the twelfth Chinese hospital in the country to list. But it's a crowded space and most of the 11 other stocks have underperformed in the last four years as our infographic shows. [+]
Patients starting to avoid care again in Poland
The Polish national payor has recommended that electives be delayed to reduce the risk of COVID-19 infections. HBI hears that after a good summer of business people are again starting to avoid physical care. That could plunge the market back into the dark months of lockdown, which saw one operator considering firing 70% of its staff. [+]
Under-fire Dentix may have a new suitor
Spanish dental chain Dentix has a new suitor, according to the Spanish press. The company has had a troubled history of late, heading into voluntary administration in April following a reported series of failed sales processes, including to Advent and KKR. [+]
German hospital bankruptcies "to resume in 2022"
An expected wave of German hospital bankruptcies this year has been averted thanks to state support during the pandemic, but operators should expect a difficult 2022 with more going to the wall than in recent years, Professor Boris Augurzky, the acknowledged expert on the sector, tells HBI. [+]
Capio and Ada show potential of digitalising patient pathway
Telehealth provider Doctrin and symptom-checker Ada Health provided fascinating insights as they revealed the results of their work with operators in the Nordics and the US, in the HBI-365 panel session 'Digital Health: Case Studies in Acceleration', while Siemens Healthineers' global head of digitalising healthcare gave an overview of the global landscape. [+]
Interview: Massimiliano Colella, CEO, Evercare Group
We talk to the CEO of Evercare Group, the diverse conglomerate of South Asia and African hospitals that make up the $1bn Evercare Health Fund originally raised by Abraaj before TPG's takeover in 2019. Colella talks strategic priorities including 'turning Evercare from a fund into a real company', recent management departures, the platform today and why his own lack of emerging market healthcare service experience doesn't matter for this job. [+]
Analysis: which listed care providers are recovering best?
Why are listed Nordic care providers' share prices seeing a faster recovery than other European counter parts? And how has each operator weathered the storm? HBI takes a deep dive into the financials to deliver an exclusive analysis as providers prepare their Q3 results. [+]
€1.8bn in write-downs and impairments for big hospital/care stocks - Infographic
Did you know the last two years has seen a combined €1.8bn in goodwill write-downs and impairment charges at seven of the largest listed hospital and elderly care stocks in the sector? And that NMC Health had nearly that amount of goodwill before it de-listed? [+]
The challenges of valuing private and listed companies during COVID
How do you value stock-listed and private healthcare service companies during COVID-19? [+]
IDH sale could lead to group breakup
UK-based NHS dental specialist IDH, which operates over 600 UK-based clinics as {my}dentist and supplies thousands of dentists with products and equipment through dental supplier DD, is for sale. Could the group could be broken up if the buyer for the whole is not found? [+]
Evercare Lagos hospital to open in December
Evercare Group, the operating platform held by the (ex-Abraaj) $1bn Evercare Health Fund, aims to open its Lagos hospital in December this year, Evercare Group CEO Massimiliano Colella tells HBI. [+]
NephroPlus buys in Philippines as its home haemodialysis triples
India's largest dialysis provider NephroPlus has acquired the fourth-largest private operator in the Philippines, while its home haemodialysis volumes have tripled during the pandemic in India, CEO Vikram Vuppala tells HBI. [+]
ICG indirectly acquiring stake in €3bn nuclear medicine group
Intermediate Capital Group (ICG) is indirectly acquiring over 25% of the shares of Europe's largest radiopharmaceuticals provider Curium Pharma, HBI can reveal, after owner Capvest earlier pulled a majority sales process because of COVID-19. [+]
You cannot have strong healthcare and a bad economy
The solution to Africa's healthcare problems - cruelly highlighted by the COVID-19 pandemic - lie not just in improving its healthcare infrastructure, but on improving the continent's financial independence, and weaning it off its outside relationship. You can't easily have strong healthcare and a bad economy. [+]
Veritas Intercontinental raises €5m as it off-shoots from ailing US business
Veritas Intercontinental, the spin-off of US genome sequencing group, Veritas Genetics, has raised €5m from existing investors to help finish building a new lab in Spain. CEO Javier de Echevarría tells HBI that the money will help to establish its independence from its former parent company which temporarily ceased US trading last year. [+]
KRY 'steals' patients as it moves into capitated model
Swedish B2C telehealth player Kry has registered 14,000 patients in its first health care centre in Sweden, which comes as it's been forced into the capitated funding system. The start-up has been criticised for not making it clear enough to patients that they would be de-registered from their physical healthcare practice. [+]
UBS, EQT, TPG and Icade discuss COVID investment climate
Valuations in the healthcare services sector will roughly stay the same post-COVID, according to a panel of investors from UBS, EQT, Icade Sante and TPG at a HBI-365 panel. That's despite the fact that HBI-365 delegates do not think that deal flow will return to pre-pandemic levels until the second half of next year. [+]
Cinven hires banks for Synlab 2021 IPO
HBI hears Synlab's private equity owner Cinven has mandated banks for an initial public offering, expected to take place next year. It will value Synlab at €5bn-6bn. [+]
Four Seasons selling its Northern Ireland care homes
Administrators for UK-based nursing home provider Four Seasons have put its Northern Irish care homes up for sale. [+]
Bioiatriki open to sale talks now and international expansion from 2022
HBI speaks exclusively to George Spanos, chairman and CEO of Greece's largest primary care and diagnostic chain, about the company's plans for the future and whether rumours the company might be for sale are true. [+]
Korian: Inicea a 'unique opportunity' with international bolt-ons to follow
Buying France's third-largest private psychiatry group Inicea was a 'unique opportunity' for which a capital raise had to be used, Korian CFO Philippe Garin tells HBI, and international bolt-on acquisitions could follow. He discusses the deal's finances, COVID-19's impact on its regulatory environment, and one reason why Germany might have weathered the pandemic so much better than other countries. [+]
NMC could sell by April 2021; Aspen/Eugin by January
NMC Health's administrators Alvarez & Marsal expect to complete a lender-led restructuring or sale of the group by April 2021, and sales of non-core assets - UK hospital chain Aspen Healthcare and international IVF group Eugin - much sooner. It's also revealed the COVID-19 impact on the group's healthcare services revenue. [+]
Ramsay Sante's Capio integration and finances paint a puzzling picture
It's been nearly two years since Australian-owned French hospital group Ramsay Sante completed the acquisition of Nordic-French acute care operator Capio. Contacts give HBI their assessment of how the integration is going and we take a look at Capio's performance since it was acquired. [+]
COVID-19: The view from Africa
Africa needs to come together to find a solution to the COVID crisis, which has proved to be as much an economic one as a healthcare one - and cannot and should not rely on help from outside. This was the view of an expert panel which convened online to discuss COVID-19, healthcare more generally, and African economics. [+]
Liberia during COVID: A case study for Africa?
A health crisis leading to an economic downturn and a political crisis. Here is a case study of how COVID has hit Liberia based on the view of Gyude Moore, senior policy fellow at the Centre for Global Development, and former Minister of Public Work speaking on Saturday (October 10). [+]
Interview: Sofia Palmquist, CEO, Aleris
Pan-Nordic healthcare group Aleris lost its previous owner Investor AB nearly 1bn SEK (€90m) in its last nine months of ownership before PE group Triton acquired it in late 2019. New CEO Sofia Palmquist, pinched from competitor Capio, has been tasked with the turnaround and digitalisation of the company and gives HBI her first public interview since taking the job. [+]
Interview: Sanjeev Kanoria, Advinia Healthcare
HBI talks to Sanjeev Kanoria, founder and chairman of UK-based care home specialist Advinia Healthcare, about how COVID has affected his business, funding support, and the affect of Brexit on issues like recruitment. [+]
JP Morgan appointed to sell former Priory clinics
HBI hears that JP Morgan has today been appointed to handle the sale of Elysium Healthcare by owners BC Partners. [+]
Covid grows the lab market in 2020
HBI Intelligence is now forecasting that most European lab markets will be larger in 2020, than our pre-Covid forecasts. That is despite deep dips in March and April, with some groups thinking about firing two-thirds of their staff and defaulting on rent. [+]
HBI updates dental market forecasts as operators face second wave
Dental markets have reopened following the pandemic peak but the impact may be felt for many months to come, not least because of a second wave winter. HBI has added new post-COVID market size data on the Intelligence platform based on conversations with operators. Most think new national lockdowns are unlikely but regional lockdowns, prolonged economic uncertainty for patients, and scared patients are all causing concern. [+]
Concerns COVID is turning dentistry into a reactive service
Delays in treatment caused directly by COVID-19 and a reluctance to attend routine appointments are turning preventative dental markets into reactive ones. The financial pressures resulting from the pandemic means there might not be a big enough supply of dentists to cope with the pent up demand. [+]
Healthcare Activos internationalises with Portuguese acquisition and French listing
REIT Healthcare Activos Yield has listed on the Euronext Access Paris, while its sister company Healthcare Activos has made its first acquisition outside of Spain, CEO of the management company for both tells HBI. He talks us through the listing and the long-term impact of COVID-19 on the development of the Spanish care home sector. [+]
Unilabs new innovation chief targets consumer market
Unilabs has a new chief innovation officer who comes from recently acquired Dutch lab Saltro. Dr Esther Talboom-Kamp tells HBI about the consumer-facing and B2C platforms that she built there, but the pan-European lab group is coy about what it's now building in the space. [+]
Regulator: 'Politics played no role' in Mehilainen-Pihlajalinna decision
The Finnish Competition and Consumer Authority's (FCCA) surprise decision to oppose the merger of Mehilainen and Pihlajalinna has nothing to do with the changing political climate around the privatisation of healthcare, its merger control director tells HBI. She also explains why you can't compare it to the merger of Terveystalo and Attendo in 2018. [+]
European operators brace for second wave
COVID's second wave looks either imminent, or is already starting to hit in many jurisdictions. Wave one saw lockdowns and closures - and not all closures were temporary. Will wave two be any different? HBI has been talking to operators across EMEA to see if forewarned is forearmed, how they predict the next few months will go, and what lessons have been learned. [+]
The San Donato hospital empire: a financial analysis
HBI's analysis of Italy's largest for-profit hospital operator San Donato Group's accounts answers many questions about the group's financial health before COVID. Like: which hospital accounts for 40% of revenues yet drags down profits by 20%? How concentrated is the business in its Milan stronghold and does this differ for profitability? Which subsidiaries are growing and which aren't? [+]
Interview: Justin Ash, CEO, Spire Healthcare
COVID-19 transformed how private hospitals in the UK operate perhaps more than anywhere else, with groups like Spire becoming majority-funded by the NHS for the first time ever. But where does that leave its private business going forward and what has the experience been like? CEO Justin Ash discusses this as well as the lessons learned from recent investigations into transgressions at Spire hospitals. [+]
Pihlajalinna shares tumble as regulator recommends blocking Mehilainen takeover
Shares in Finnish outsourcing specialist Pihlajalinna have crashed 25% on the news that the Finnish Competition and Consumer Authority (FCCA) has recommended that the country's Market Court block its takeover by CVC-backed competitor Mehilainen. [+]
Russian hospitals continue push into oncology
MD Medical has seen oncology revenues soar by 351% in H1 and this month will open its new cancer hospital for patients. It's not alone in diversifying away from self-pay activity. [+]
Eugin process enters second-round - but will COVID impact valuation?
Sell-side advisors Perella Weinburg have shortlisted a dozen second-rounder bidders for Eugin, the global IVF arm of NMC Health, according to reports in Spain. A source tells HBI Eugin's recent figures have been significantly impacted by COVID - will it impact the valuation? [+]
French and Italian hospital groups' diverging recovery reflects COVID experience
August activity levels for France's second-largest hospital group Elsan were ahead of 2019, while Italy's largest player San Donato is still 30% down due to a more gradual restart of electives and stricter contagion control in Lombardy, HBI can reveal. The cautiousness reflects just how hard-hit the region was. [+]
Austria goes nuts for Covid tests
Life may be tough in emerging markets, we hear, but rich West European countries are showering lab groups in gold. [+]
Spire's payor mix turned on its head in Q2
UK hospital group Spire Healthcare became a majority NHS-funded provider for the first time ever during the first half of 2020 as it became an extension of the public health system, its H1 2020 results reveal. What are the implications and how do you value a company in such unprecedented circumstances? We talk to an analyst. [+]
PWC on M&A drivers in Spanish healthcare sector
The Spanish private healthcare market has been one of Europe's most attractive for institutional investors of late with strong organic and inorganic growth opportunities. PWC Spain's deals leader for Healthcare & Pharma Jose Zarzalejos talks us through the drivers, movers and shakers in the six main sub-sectors: hospitals, imaging, oncology, care homes, IVF and dentistry. [+]
Italian pharmacy chain Hippocrates 'open' to new shareholders
Italian pharmacy group Hippocrates Holding has attracted interest from several potential buyers according to a source close to the company, who adds that the group needs significant investment for its expansion plans. [+]
Digital aftercare can save payors £11k per cancer patient
HBI examines a variety of digital aftercare programmes for cancer, some of which claim to save payors £11k per patient. [+]
Covid: The good news from Sweden
Is herd immunity a thing? The obvious place to look to answer that is Sweden where the weekly infection rate is more or less flat with 1-2 people dying a day. [+]
Diversification helps Grupo 5 grow despite COVID
Grupo 5 has carved out an unusual but successful niche for itself in Spain, balancing a mix of healthcare services (predominantly mental health and treatment for patients with brain injuries) with social emergency care for the homeless, children, and people with disability. CEO Guillermo Bell tells HBI it has proved to be a robust combination during the COVID crisis. [+]
How Covid opens up new B2B and B2C testing markets
The lab sector could be "uberised" by an app which currently enables individuals to see where, and when they can get a Covid test as part of government and corporate schemes. The aim is to create a consumer solution which will enable individuals to select from a very wide range of tests on price and proximity. [+]
Employee testing drives 30%+ organic growth for labs through summer
COVID-19 testing for businesses, the sports industry and governments has cancelled-out and countered most falls in routine testing for the pan-European lab groups. Synlab says it signed 3,000 back-to-work testing contracts and saw 32% y-o-y organic revenue growth in June while Eurofins has 1,200 signed or in discussion. HBI examines the impact of the pandemic so far and what's next. [+]
Mehilainen 'spinning off digital arm' as Pihlajalinna deadline looms
Finnish healthcare group Mehilainen is spinning off its digital consultancy business into a separate company which would make it easier to sell off in future, a senior banker tells HBI. An analyst adds that raising cash this way makes sense considering what has happened since it offered to buy competitor Pihlajalinna. [+]
HBI-365 is ready for liftoff
Each week, we bring you our take on what's happening in the world of healthcare services. This week, we're going to allow ourselves to be a little self-indulgent. We know a global healthcare services network is a compelling prospect - because we asked what you wanted and you told us. And now we've built it. [+]
Apollo Q1 results highlight scope of COVID impact in India
The effect of the COVID crisis was evident in Indian hospital chain Apollo's Q1 results, announced on Monday. It reported a consolidated net loss of Rs 226 crore ($31m) for the quarter ending June 30, but there was a silver lining in the growth of it's pharmacy business. [+]
Insurers record massive savings from deploying telehealth
Traditional hospital business models stand to be massively disrupted as payors adopt front-end telehealth. Early adopters insurers Cigna and Aetna are seeing high patient satisfaction and huge cost savings from the deployment of telehealth in EMEA and emerging markets. Cigna is starting to grade quality at operators outside of the USA, according to the latest HBI-365 panel discussion. Go to HBI-365.com to find out more. [+]
Interview: Stuart Quin, CEO, Medica Group
What is the outlook for the UK teleradiology sector, with the largest player Medica's elective volumes still less than half of pre-COVID levels? We talk to CEO Stuart Quin about the group's recent H1 results and its strategy around specialist reporting, AI solutions, diversification and internationalisation, the latter of which has shifted since we last spoke. [+]
Ramsay Sante sells remaining Capio Germany hospitals to Bergman
Pan-European hospital operator Ramsay Sante is selling six ex-Capio hospitals in Germany to Dutch and Nordic outpatient clinic operator Bergman Clinics, confirming HBI's earlier exclusive report. [+]
Multiples drop 10-15% in German outpatient sector
EBITDA multiples paid in the German outpatient sector have fallen 10-15% from pre-COVID levels because of market uncertainty due to the pandemic, an advisor tracking the space tells HBI. [+]
Entrepreneur opens new hospital in Mumbai
Healthcare entrepreneur Sanjeev Kanoria tells HBI his latest venture is a new major hospital in Mumbai. [+]
UK care homes show resilience, but in urgent need of preventative and crisis funding
According to a new report the UK care home sector is showing some resilience despite COVID-19, with occupancy steadily improving as confidence improves in the sector and care homes better prepared for an imminent risk of resurgence. Despite this, thousands remain at risk of closure and in need of stronger government support. [+]
Optegra sales process begins
Multiple sources tell HBI that UK, Czechia and Poland-based ophthalmology platform Optegra is for sale. We take a look at the detailed figures behind the prospective sale, speculate as to price and buyers, and speak to an operator source about his view of the business. [+]
Digital therapeutics - the new frontier for health care services
Insurers are seeing massively higher usage of primary care triage apps and telehealth. The next step is the development of digital therapeutic platforms which extend touch with the patient beyond diagnosis. How? And who are the players in this new game? [+]
NHS England trims operator list as PMI drives private pay recovery
We reveal which UK private hospital operators are still in NHS England's new national agreement and which left it on Tuesday, September 8. Private medical insurers (PMI) are 'busting' to get policyholders treated after delays but operators face a delicate balancing act in also helping the NHS clear waiting lists, an analyst tells HBI, as the market recovers to 70-80% of 2019 activity levels during July and August. [+]
EXCLUSIVE: Dutch mental health operator for sale
HBI hears that PE-backed Dutch mental health provider Mentaal Beter is for sale, with both private equity and international sector operators interested. A local consultant tells us why this is an attractive buy. [+]
Bupa CEO steps down
The CEO of international health insurer and services group Bupa is stepping down at the age of 55 and being succeeded by an internal appointment. We ask why and look at the group's H1 results. [+]
BIMA raises $30m as it hits 2m teleconsultations in emerging markets
BIMA, an insurance and telehealth platform working in nine emerging markets, has raised $30m to increase penetration in those markets. It already has 35m insurance policies and has run 2m teleconsultations. HBI speaks to CEO and founder Gustaf Agartson. [+]
IK Investments to sell Colisée to EQT Infrastructure
French nursing home operator Colisée is changing hands as IK Investments sells its majority stake to Sweden-based PE firm EQT's infrastructure arm. This is the first large transaction the sector has seen all year. [+]
Ada Health building diagnostic results into its app
In the peak of Germany's pandemic, symptom-checker app Ada Health rapidly built a solution to digitally return COVID-19 test results to a lab's customers. Founder Claire Novorol tells HBI that the new capability is part of a long term strategy that will allow the company to better incorporate diagnostic data into its app. [+]
Max India expands into new elderly care services
Max India, the conglomerate that recently sold a large stake in hospital chain Max Healthcare, has announced it will expand its elderly care business in India by moving into mid-market independent living, medicalised nursing homes and homecare. [+]
Strand exits Indian Quest labs bought two years ago
Indian lab and bioinformatics group Strand Life Sciences has sold off the clinical lab business it bought from US lab giant Quest Diagnostics just two years ago. HBI hears why. [+]
Interview: Nasser Al Hagbani, CEO, Dr. Sulaiman Al Habib Medical Services Group
Saudi/UAE hospital operator Dr. Sulaiman Al Habib Medical Services Group (HmG) is by far the largest player by revenue in the GCC at $1.3bn. Shares have all but doubled since its IPO in March, making it the sixth-largest hospital stock globally by market capitalisation at $8.5bn. Its lucrative tele-ICU centre is the largest in the world by beds monitored. In this exclusive interview, Hagbani discusses HmG's listing, business model, Saudisation efforts, declining expat market and of course COVID-19. [+]
HBI Deals+Insights briefing October 2020: Intelligence members
Our October edition sees the fight against COVID continuing, and employee testing driving 30% growth for labs through the summer. There was M&A news too, with Eugin, Coliseé and Optegra all making headlines as markets try to work out where pricing should be in a pandemic. Interviews this month include Stuart Quin, CEO of Medica Group and Jan Leister, executive director of digital health at Fresenius Helios. [+]
HBI Deals+Insights Briefing October 2020
Our October edition sees the fight against COVID continuing, and employee testing driving 30% growth for labs through the summer. There was M&A news too, with Eugin, Coliseé and Optegra all making headlines as markets try to work out where pricing should be in a pandemic. Interviews this month include Stuart Quin, CEO of Medica Group and Jan Leister, executive director of digital health at Fresenius Helios. [+]
GHP rolls out new deal with insurers
GHP, the Stockholm-listed Swedish and Middle East clinic chain, where shares have risen all but sevenfold in seven years, is rolling out a new outsourced model for health insurers. So far this covers 100,000 patients. We talk to CEO Daniel Ohman. [+]
Advent rekindles Dentix bid
Advent, the owner of Spain's largest dentistry group Vitaldent, has emerged as the leading bidder for the market's second player, Dentix, despite earlier reports that it had frozen a rescue package. [+]
What is happening with the big pre-COVID sales processes? - Infographic
This week HBI takes stock of the sales processes that were launched before international lockdowns hit in late Spring to see which have been postponed, cancelled, agreed, re-launched or are still pending. [+]
Helios eats pack of Maltesers
German and Spanish hospital group Fresenius Helios is buying three more hospitals in Germany from the Malteser non-profit foundation, adding €160m in annual sales and increasing size of the for-profit hospital sector by 1-1.5%. [+]
Rede d'Or hires banks for $2.7bn IPO
Rede d'Or, Brazil's largest hospital chain by revenue, has reportedly hired banks to prepare a long-awaited $2.7bn IPO for the autumn. The company reportedly expects a valuation of $17.8bn, which would make it the second-largest listed hospital group in the world by market capitalisation after HCA. [+]
The COVID bonus as patient waiting lists soar
Massive increases in waiting lists mean that private healthcare should be well placed for growth over the next few years. [+]
BGI profits rocket but blacklisting could threaten supply chain
Profits at lab group Bejing Genomics Institute (BGI) are up 734% in the first half of the year after the company rapidly built 58 labs in 18 countries and sold 35m testing kits to 92% of the countries in the world for COVID-19. Yet the company is now caught up in the ever-escalating US-China trade war as two subsidiaries have been blacklisted by the States. HBI examines what this means for its global reach. [+]
Interview: James Thorburn, CEO, City & County Healthcare
The CEO of City & County Healthcare, the second-largest domiciliary care provider in the UK with 2019 revenue of £ 236m, tells HBI how the company is navigating the COVID-19 crisis and what prospects are now like for a sale. [+]
Investors discuss opportunities in Nigeria's private healthcare sector
A panel of Nigeria's healthcare operators, private equity investors and finance institutions including the IFC discussed opportunities for financing the sector in a recent panel discussion. HBI asked one of them whether recent entries into the diagnostics space from foreign entities are a benefit or are just helping to cream off the top-tier of the market. [+]
France's regional hospital groups consolidate as multiples increase
France's regional for-profit hospital operators have spent the last 12 months aggressively consolidating the c.65% of the sector not held by Ramsay Sante and Elsan who have been notably quiet on home turf. Vivalto, C2S and Doctegestio have added a collective €500m in sales while the larger pair have done as much selling as buying. Why? HBI talks to a Paris-based M&A advisor, who says deal pricing has improved as shown by the recent Elsan deal. [+]
Coronaria CEO: no plan to sell optical retail unit after ophtha merger
Finland’s fourth-largest healthcare operator, Coronaria, has built the biggest ophthalmology business in Finland and is also the largest player in rehabilitation. We talk to CEO Teppo Lindén about his plans, why he is keeping the optician arm and the impact of Covid. [+]
Bergman to re-launch sale process
Dutch and Nordic ambulatory and ophthalmology clinic chain Bergman Clinics will soon be back on the market after COVID delayed a process which began earlier this year, multiple sources tell HBI. We look at the facts and figures behind the prospective sale, and speculate on multiple and price. We are told it targeted the rest of Capio Germany from Ramsay Sante before the pandemic. [+]
Operators enjoy good summer but second wave jitters obvious
Private healthcare operators across Europe and elsewhere are seeing better-than-usual summer months as they play catch-up on the second quarter. But none are confident this will continue into the autumn and winter months as Europe enters an early second wave of COVID-19. [+]
Medlife reveals sub-sector impact as summer activity normalises
Listed Romanian operator Medlife's H1 results partially reveal how the national lockdown affected its hospital, lab, dentistry, outpatient, pharmacy and corporate businesses. HBI analysis and investigation reveals the Q2 segment figures and the factors behind average price increases partially offseting sharp volume drops. [+]
Amazon's Indian e-pharmacy play triggers rapid consolidation
In the space of a week, Amazon has launched an online pharmacy pilot in India, the country's largest retailer has retaliated by buying a controlling stake in established rival Netmeds, and the market's other two largest players - PharmEasy and Medlife - have merged to create a $1.2bn+ valued company. This is despite ongoing legislation that might ban e-pharmacies from any activity at all. [+]
Interview: Stefan Nilsson, Colosseum Dental Group CEO
HBI talks to Stefan Nilsson, CEO of Colosseum Dental Group, the Swiss-based pan-European chain with a presence in Finland, Norway, Sweden, Switzerland, Italy, Denmark, Germany and the UK, about how it has weathered COVID, and its plans going forward as we all adapt to the new normal. [+]
UK homecare braced for "failures and consolidation"
Councils have begun removing emergency funding from the homecare sector as the COVID-19 crisis enters a new phase. HBI interviews the UK Homecare Association and CEO of provider City and County Healthcare about the sector's future. [+]
Diaverum IPO pushed to 2021 as lockdowns hit growth
The IPO of international dialysis provider Diaverum by owner Bridgepoint is likely to have been pushed back to 2021, we are told. While dialysis volumes have been largely unaffected by the pandemic, lockdowns and travel restrictions may have hit its ability to reach full-year growth targets. [+]
Post-mortem on elderly care - evaluating the true impact of COVID
As we begin to understand the true impact of COVID-19, large disparities of outcome are emerging between countries. HBI speaks to operators and consultants across Europe to investigate how markets have been hit. [+]
New NHS deal for England's private sector
NHS England's exhaustive block-buying deal with the country's private hospitals will soon be replaced by a more local arrangement to help clear COVID-related backlogs of elective procedures, while smaller players are jostling to attack growing waiting lists for diagnostics. An advisor says the private sector is cutting corners when it comes to controlling COVID-19. [+]
Could COVID's legacy be one of change?
Perspectives on the lasting effects of COVID-19 differ drastically depending on who you talk to. Policymakers and councils funding the most vulnerable providers warn of real ongoing damage to parts of the health and social care sectors. Investors and entrepreneurs, while counting the human and financial cost, can also see some opportunities. Who should you listen to? [+]
Swiss Medical Network 'open to new shareholders' as it seeks HMO model
Conglomerate Aevis Victoria is open to selling a stake in its hospital chain Swiss Medical Network to an insurer to help it move towards an integrated payor-provider model, co-founder and delegate of the board Antoine Hubert tells HBI. We catch up on pre- and post-COVID developments in the Swiss hospital sector. [+]
Italian healthcare given $2bn European Investment Bank boost
The European Investment Bank (EIB) is lending Italy €2bn to be spend on its healthcare system, as it rebuilds after the COVID pandemic. [+]
Interview: David Hadley, CEO, Mediclinic Middle East
EMEA hospital group Mediclinic International is undergoing its last substantial capital project in the UAE for the foreseeable future, Middle East CEO David Hadley tells HBI, as the group switches expansionary focus to neighbouring Saudi Arabia. We discuss the two markets and the reasons for the segment's recent $600m+ impairment charge. [+]
Operators reconsidering payor mix in a post-COVID world
HBI hears UK hospital and outpatient operators are taking a long hard look at their public/for-profit payor split as they continue to count the financial effect of COVID and look to the future. [+]
Boring healthcare services suddenly 'more sexy'
Funds formerly looking at retail are now looking at retail health as a more secure option. Are we about to see a flood of new investors looking for more security? [+]
DIY: The key to building a dental network in India
If you’re building a dental network and can’t find the infrastructure you need, build it yourself. That’s the view of Louis Shakinovsky, chairman and co-founder at Global Dental Services, which as Clove Dental runs India’s biggest dental group. HBI caught up with him last week to find out more. [+]
COVID widens fault line between outsourcing and private pay in Hungary
Hungary's private pay-focused operators should maintain double-digit growth in 2020 despite COVID-19 while those reliant on public outsourcing face an uncertain future, the chairman of the fourth-largest private acute care provider tells HBI. Affidea just lost a large outsourcing contract while a billionaire and venture capital funds have recently entered the market. [+]
World's largest virtual care company will target Europe after $18.5bn merger
Europe's digital health companies could be run out of the market following a $18.5bn merger between Teladoc Health and Livongo. The newly formed largest virtual care company in the world has its sights set on a global market, and Chinese operators are likely to follow suit into Europe. [+]
Helios Q2 shows grudging German ramp-up and Colombian crash
Second-quarter results for Europe's largest hospital operator Fresenius Helios's parent company confirm anecdotal evidence that Germany's hospitals are taking longer to return to 2019 levels of activity than other countries'. A closer look at the numbers also shows revenue crashing at its recently-acquired Colombian hospitals as the country is battered by COVID-19. [+]
Thailand starts to welcome back medical tourists
Thailand's government has re-opened the country for medical tourists by launching a new special visa that at least 1,700 people have already applied for. The news will be welcome for major medical tourism operators like Bumrungrad whose shares are down 33% on a like-for-like basis. [+]
Spanish hospital M&A resumes in July
Spain's private hospital groups have resumed their pre-COVID M&A binge in July, with three of the five largest striking deals to acquire smaller competitors. It comes as private hospital activity levels across Europe recover more quickly than previously forecast - although that hasn't prevented casualties amongst some individual sites. [+]
Video consultations in the UK fell during COVID-19 - Infographic
For all the talk of COVID-19 pushing ahead the digitalisation of healthcare, the use of video consultations in both actual numbers and as a percentage of consultations in primary care fell during the pandemic's peak. Recent headlines talk about 48% of primary care being delivered digitally, but most of these were telephone calls. [+]
Orpea kickstarts €1.5bn propco sell-off with Icade deal
Europe's largest elderly care operator Orpea is preparing to strike more sale-and-leaseback deals with big REITs after concluding a €145m deal with Icade in Germany. HBI expects a flurry of deals may follow as part of a £1.5bn propco sell-off which will fuel further acquisitions. We talk to property investment sources about where else it might sell, potential buyers and the yields they can expect. [+]
Ramsay offloads Capio's German hospitals
Ramsay Sante, the European arm of Australian Ramsay Health Care, is divesting some of the German hospitals it inherited when it acquired Capio in 2018. [+]
Market welcomes Attendo's H1 figures as it turns the COVID corner
Attendo's H1 results saw improvement as COVID's impact lessened. And while the effects of the pandemic clearly have had a negative impact on the listed Nordic care group, the market reacted positively. A share price which at the start of July was down over 35% on it's mid-February price rallied, and it is now just 10% down compared to its pre-COVID position. [+]
Interview: Pablo Pantaleoni, VP of global strategy, Headspace
Headspace started a decade ago as a meditation app founded by a Buddhist monk. It is now one of the world's most successful consumer B2C businesses with 65m downloads, 2m paying subscribers and north of $50m revenue. HBI speaks to Pablo Pantaleoni who is leading the early stages of clinical trials for digital therapeutics (DTx) through its medical subsidiary, Headspace Health. [+]
Jose de Mello Saude/CUF revises 2020 forecast as COVID recovery quickens
Portugal's largest hospital operator Jose de Mello Saude, now CUF, has revised earlier full-year revenue forecasts upwards as it sees a stronger post-COVID recovery than expected, CFO Guilherme Magalhães tells HBI. He discusses the pandemic's impact on AVLOS, digital penetration and the market's medium-term outlook, as well as it's recent name change and the future of PPPs in Portugal. [+]
What does a good post-COVID outpatient clinic look like?
Outpatient activity all but came to a standstill as the COVID crisis tightened its grip. A panel of experts comprising Richard Banks, Chief Strategy Officer at international fertility player Virtus Health, Martin Bundschu, Director at Germany-based optical specialist Smile Eyes, former Colosseum Dental CEO Tomas Aubell, and L.E.K. Consulting's global co-head of healthcare Ben Faircloth joined an HBI-365 audience last week to discuss what a good outpatient clinic post-COVID might look like, and how markets have been affected. [+]
COVID reshapes the sector
Here are three recent quotes which would have been unbelievable in January. "We realise now that we can manage with half the 140 consulting rooms we had planned" Henrik Schødts, deputy CEO, Nordsjællands Hospital. "We have seen telehealth rise 500%" Arjan Toor, CEO, Cigna Europe. "We are doing 80% of our emergency consultations by telehealth," Dr Peter Thomas, director of digital innovation and consultant paediatric ophthalmologist, Moorfields Eye Hospital, London. [+]
Is M&A back in business?
COVID has clearly had a chilling impact on healthcare services M&A over the last few months. Some deals have fallen through. Some M&A-focused teams have seen their numbers paired. Some deals are simply on hold. As we emerge from lockdown, however, HBI hears there are positive signs of returning to business as normal. [+]
People are going back to hospital - Infographic
After sharp drops in March and April, hospital emergency departments across Europe are returning to their pre-COVID levels. [+]
Adding value post-COVID - where are the easy wins?
How do you add value to a business in a post COVID world - and are there any easy wins for new acquisitions? On Wednesday last week, an online audience heard HBI365's lively Q&A panel with with Ameos CEO Dr Axel Paeger, McKinsey partner Sebastian Sieler, and L Catterton managing partner Chinta Bhagat. [+]
Jefferies cuts price targets for Mediclinic, Spire and Terveystalo
Investment bank Jefferies has cut its price target for three major EMEA acute healthcare stocks by 33-50%. One of them, Mediclinic International, has confirmed HBI's recent reports of a quick rebound in the Swiss and UAE markets in June. [+]
Interview: Arjan Toor, CEO, Cigna Europe
Cigna now describes itself as “a global health service company” rather than an insurer and has reorganised its European operations. Toor has recently been promoted to CEO Europe. He says that the insurer, which has 15% (US$840m) of its revenue in Europe, doesn't want to verticalise through owning primary care providers but wants instead to provide an end-to-end user experience. [+]
IFC loans $5.2m to Ghanaian hospital
The IFC has loaned $5.2m to Nyaho Medical Centre, which claims to be the first private medical centre in Ghana, to help it expand outside of the capital Accra. [+]
Romanian post-acute hospital in difficulty
Romania's only substantial specialised rehabilitation hospital looks to be in financial difficulty, after it reportedly laid off the majority of its staff. Should it close, it would spell the death of a nascent market. [+]
West Europe's for-profit hospitals ramp up as financial protections phased out
For-profit hospitals across West Europe are ramping up activity as governmental financial protections are slowly phased out, but it's taking much longer than in outpatient facilities and varies wildly from country to country. Why? HBI looks at the situation in Germany, France, Switzerland, the UK and Ireland. [+]
Looking for easy wins post acquisition
How you add value to a business – especially post acquisition – is a hotly debated topic and is even more to the fore in these hopefully soon-to-be post-COVID times. But are there easy wins? Panellists at HBI's latest Big Picture debate on Wednesday thought so. [+]
Five Arrows-backed German imaging group quietly grows into second-largest player
A German imaging and radiotherapy group has quietly expanded to become the market's second-biggest player with the backing of Rothschild's PE arm Five Arrows, and is seeking additional financing to continue its growth, HBI can reveal. [+]
Interview: André Schmidt, CEO, Median Kliniken
Dr Schmidt gives HBI the inside view of Germany's €9-10bn rehabilitation sector in the pandemic months, from how activity dropped to what financial support it got, to its medium-term outlook. Are digital therapeutics apps like Kaia Health, which recently raised $26m, a threat? [+]
FocusCura acquired by Swedish locksmith conglomerate
Netherlands-based elderly tech solutions developer FocusCura has been bought by listed Swedish conglomerate ASSA ABLOY around 18 months after spinning off its telemonitoring app Luscii into a separate subsidiary. The €20bn market-cap 'access solutions' firm is a curious buyer but it tells HBI that the acquisition creates opportunities to develop further products for elderly care. [+]
If integrated managed care systems are so great, why aren't they everywhere?
CVC might be about to create a major integrated managed care system in Greece. Its target is the insurer Ethniki, and should it succeed HBI understands it would become the dominant player in Greek healthcare services, with competitors potentially frantically scrambling to merge and acquire to make up lost ground. So why hasn't this happened more in Europe? [+]
Profits soared at Max Healthcare ahead of COVID lockdown
Indian hospital chain Max Healthcare saw its Q4 (January to March) consolidated profit leap 75%, despite the start of lockdown at the end of that period seeing occupancy plummet by two-thirds. [+]
UAE's private hospitals boosted by fewer outbound travellers
Private hospitals in the UAE are seeing higher-than-normal volumes for the summer months as fewer people leave the country because of COVID-19 travel restrictions or hesitation, local sources tell HBI. [+]
Post-COVID care providers see effect of GCC diabetes crisis
A GCC-based post-acute and long-term care provider tells HBI about the plethora of rehabilitation needs his clinic is seeing amongst COVID-19 survivors. The region has a high rate of type 2 diabetes, the key pre-existing condition that predisposes people to a bad COVID-19 infection. [+]
Median looking at France, UK and GCC as Waterland stays put
Private equity firm Waterland has no current plans to put German rehabilitation group Median Kliniken up for sale again, and is focusing on internationalising the business into the UK, France and the GCC, Median CEO Andre Schmidt tells HBI. [+]
Circle divests to get BMI deal through
UK private hospital operator Circle Health is to divest its Bath and Birmingham hospitals to get competition watchdog approval for its buyout of larger competitor BMI Healthcare. [+]
COVID impact less severe than expected for cosmetic group
HBI talks to Tony Veverka, CEO of Transform Hospital Group, about the groups experience of reopening its core cosmetic business after supporting the NHS though COVID since the start of April, the affect on its revenue, and his hope a new understanding might be reached with the NHS. [+]
German and Dutch dentists struggle to make up COVID losses
Dentists in Germany and the Netherlands are playing post-COVID closure catchup as businesses have reopened after the height of the pandemic. One DACH-based operator tells us it may be harder to make up lost ground in these countries than elsewhere. [+]
CVC acquisition 'would trigger rush of M&A in Greece'
CVC Capital Partners clearly has big plans in Greece. After a slew of acquisitions, it looks poised to up its bid for Ethniki Insurance now that the process has opened up again. HBI talks to a market expert to find out more about a deal which he thinks trigger a wave of activity. [+]
Elderly care at the crossroads
What has the Covid crisis taught us about elderly care and its prospects as an industry? [+]
Spanish for-profits demand COVID compensation
For-profit hospitals and clinics in Spain are facing bankruptcy and closure unless urgent payment is made for work done and financial difficulties faced during the coronavirus pandemic over the last three months, according to The Spanish Private Health Alliance (ASPE), which represents more than 80% of private hospitals in the country. HBI speaks to a Spanish consultant to find out more. [+]
LATAM operators told 'agree COVID fees or face nationalisation'
For-profits in Peru were told to agree fees for treating pandemic patients or face effective nationalisation - the taking over of their administration and caseload for the duration of the COVID crisis. [+]
Elderly care post-Covid: HBI Big Picture Seminar
How has Covid affected the elderly care sector across EMEA? To find out, HBI-365, the new global digital platform, brought together a panel of three: Fredrik Gren, CEO and president, Ambea, a sophisticated and large Pan-Scandinavian care group, Alexei Sidnev, CEO, Senior Group, the largest player in a big emerging market, Russia and Pierre-Emanuel Bercegeay, CEO, Ouihelp, a VC-backed, digital-savvy domiciliary homecare start-up in France. The seminar was followed by the first meeting of our HBI-365 elderly community with a useful roundtable on workforce. [+]
COVID takes shine of Apollo's Q4 results
The Q4 results of India's largest hospital group by revenue, Apollo Hospitals, show the effect of a falling footfall, deferred electives and the loss of medical tourism will make for a troubling start to FY21. [+]
COVID crisis will present rollup opportunities in Greece
Greece has never been the most buoyant of markets for healthcare services operators, with limited PMI penetration and problems in the Greek economy limiting out-of-pocket spending. We speak to a Greece-based consultant to find out more about how COVID is affecting this landscape. [+]
COVID pandemic share prices: Who has bounced back, who is still playing catch-up? - Infographic
Shares in the biggest listed healthcare services operators all plummeted in mid March as the COVID pandemic spread rapidly. As our infographic illustrates, only around half of these have substantially recovered their value. [+]
HBI Exclusive interview: NMC Health's acting CEO Michael Davis on the future of the business
NMC acting CEO Michael Davis speaks publicly for the first time about the future of under-fire NMC Health. In this exclusive interview, we ask about a possible sale of all or part of the business, and whether and how NMC might recover from its present position. [+]
Gren quits Ambea: "There are many Covid turnaround opportunities"
After 9 years at the helm, Fredrik Gren, 52, has stepped down as President and CEO of Scandinavian care group Ambea. We talk to him about next steps. [+]
Health care values look high
Analyst forecasts suggest that healthcare sector valuations have been largely unaffected by the crisis, with EMEA hospitals and medtech stocks now being more expensive than before the Covid outbreak, both on an EBITDA and PE multiples basis. [+]
Exclusive: Steward’s International CEO on its future in Malta
Now that Steward Health Care has been bought by its doctors, what future does it face in Malta where the deal it inherited to run almost half the country’s public hospitals had attracted scrutiny? HBI talks exclusively to Dr Armin Ernst, CEO and President of Steward Health Care International. [+]
Bergman set to enter German ophthalmology market
HBI hears that Dutch and Nordic ambulatory and ophthalmology clinic chain Bergman Clinic is looking to acquire two substantial outpatient ophthalmology chains in Germany. This would mark its entry into the country’s ophthalmology market – and a significant one at that. We talk to a source about the targets, the price, and what this means for the wider market. Longer-term Bergman itself is likely to sell. [+]
The worst crises bring out the best, but will they leave a lasting legacy?
Healthcare systems are often seen as ponderous behemoths, set on a particular course and slow to adapt and change direction. The sense of urgency engendered by the COVID pandemic has shown that, when they have to, they can adapt, adopt new technology, and innovate quickly to save lives. [+]
Belgian dentistry back in business, but COVID has taken a bite out of profits
Belgian dentistry is booming again, with attendance exceeding pre-COVID levels, but even this revving up won't make up for lost revenue after months of closure. HBI speaks to an operator source to find out more. [+]
Aster shows Covid impact on India and GCC
Thanks to Covid, Aster DM, the GCC to India clinic, hospital and pharmacy chain, saw a 25% drop in revenue across both geographies in April. May and June have seen improvements with a return to normal expected in the autumn, providing there is no second wave. We look in detail at the impact of Covid in March to June and report full year results to March 2020. [+]
From homecare to hotels
In Argentina a domiciliary homecare group has taken over three hotels to offer accommodation to Covid-symptomatic patients. What does this say about the wider links between hotels and care homes in Emerging Markets? [+]
Interview: Daniel Soukup, head of EUC Virtual Clinic
The Czech Republic's largest primary care and occupational healthcare provider by revenue, EUC, has been leading the charge in bringing digital health care to the country. Daniel Soukup, head of its Virtual Clinic, tells HBI that while the service has before been only for its private-pay patients, it is starting to work much closer with public insurers to bring telemedicine to more people. [+]
Digital therapy provider Kaia Health raises $26m
Digital therapy provider Kaia Health has raised $26m in a Series B that includes a celebrity endorsement from the world's highest-ranked golfer, Rory McIlroy. [+]
Too big to fail?
Can a business ever be too big to fail? It’s a phrase which we often hear on the newsdesk. Sometimes, an operator deals with so many patients and is fundamentally so interwoven into the fabric of a country’s healthcare system that it seems integral to it. [+]
Interview: Katharina Juenger, CEO, TeleClinic
For the first time in Germany publicly-insured patients can go straight to an app to have a teleconsultation without paying out of pocket. Small start-up TeleClinic is the first to launch a reimbursable service, which comes as the country's largest statutory insurer launches its own telehealth solution and KRY and Doctolib enter the market. TeleClinic CEO tells HBI it hopes to hit 100,000 consultations this year. [+]
Labs bounce back and eye opportunities
A v-shaped recovery, new markets, new customers, new entrants, new technology and the ear of big government: the HBI 2020 diagnostics panel discussion reveals new opportunities. [+]
Unilabs' TMC muscling in on UK teleradiology market
Unilabs' teleradiology arm European Telemedicine Clinic (TMC) has launched a specialised oncology offering in the UK where it now has a 20% market share, its country head tells HBI. He adds that COVID-19 has seen NHS radiology departments clear routine imaging reporting lists for the first time in 20 years, although outsourcing is picking up again. [+]
Does anyone know what this 'New Normal' looks like?
Many healthcare providers are still at the forefront of the battle against coronavirus, and for them the thought of 'business as usual' is unthinkable. But in some geographies, whether because the pandemic has already wrought its worst, or because careful and early preparation minimised its effect, some healthcare practices are beginning to get to grips with the 'new normal' and opening their doors to non-emergency patients for the first time in many weeks. [+]
€300m-plus IPO for Middle East's largest imaging platform planned
Africa-focused private equity firm Meditterania Capital Partners intends to triple the EBITDA of its recently-formed imaging platform Ray Lab which spans Egypt, Jordan and Saudi Arabia before exiting, preferably by IPO, in a few years' time, partner Daniel Viñas tells HBI. He discusses the specifics of the deal, merging Ray Lab's two businesses, and how its markets are evolving. [+]
EU proposes standalone health budget
The European Commission has proposed a five-year €9.4bn health budget that will be used to train workforces and support digital innovation. How might the private sector benefit? [+]
Coronavirus compounding expat exodus in GCC countries
The population of GCC countries is set to fall by up to 10%, according to a report by global forecasting and quantitative analysis group Oxford Economics, as coronavirus encourages the largely foreign workforce to leave. HBI speaks to a source in the Gulf to find out how this might effect the insurance / healthcare market there. [+]
Interview: Mario Paterlini, CEO, Sapio Group
We talk to the CEO of pan-European industrial and health gases and homecare operator Sapio Group. It aims to grow healthcare from 50% now, to 65% of its revenue by 2022, and has been buying homecare companies across the continent to that end. [+]
European dentistry reopens
European dental markets are reopening for business as R numbers drop below 1 across the continent. HBI reviews what the current position is in these key markets and talks to operators in these markets to assess demand. [+]
PATRIZIA deal suggests healthcare real estate remains resilient, despite COVID
Global real-estate investor PATRIZIA AG has acquired a portfolio of seven healthcare assets in Germany specialising in assisted living and specialist care in a sale & leaseback deal. Is this a good time to be investing in this sector in the light of the coronavirus pandemic? How is it affecting prices? HBI looks further at the deal and speaks to a consultant to find out more. [+]
How cancer care is changing across Europe
Oncology patients are among the most vulnerable in the current pandemic. Will that lead to more outmigration of therapies and increased use of hypofractionation? HBI speaks to operators in the France, Germany and the UK. [+]
Helios Germany buys non-profit hospital as sector's low margins squeezed
German and Spanish hospital operator Fresenius Helios has added €66m of sales in Germany with the acquisition of a hospital in Bonn from a non-profit organisation, its first domestic hospital deal in several years. We compare the finances of the for-profit and non-profit sectors with data exclusively provided to HBI by KPMG Germany. [+]
Cerberus exits Steward as sector gets skewered
The largest private equity-owned hospital group in the world has been sold to its doctors. Cerberus Capital Management has sold a majority stake in US for-profit hospital chain Steward Health Care back to managing doctors, including CEO Ralph de la Torre, ending a 10-year tenure. [+]
V shape recovery for diagnostic labs
Labs have seen revenue and volumes start to bounce back, particularly in Germany say participants in our digital panel discussion. [+]
Dutch insurers to pay for empty beds to keep nursing homes afloat
Dutch insurers say they will pay for empty beds in nursing homes to prevent them falling into bankruptcy, as COVID-19 has hit the sector hard. HBI talks to an Arnhem-based consultant to find out more. [+]
Unprecedented European NHS rationing post-COVID could spur self-pay
NHS systems across Europe are likely to ration care at unprecedented levels in the aftermath of COVID-19 because of infection control measures. This may funnel more work to private hospitals, but it is not clear whether they will be in better shape to pick up the slack. NHS waiting lists will have more than doubled, with big hikes in waiting lists for private pay as well. [+]
Teleradiology's elective volumes crash
Teleradiology providers across Europe have seen volumes crash for elective reads because of the shut down of non-essential work in public hospitals, while emergency reads have been less badly affected. But operators' low fixed costs should mean that profits will hold. [+]
Indian hospitals fear capacity crisis as lockdown lifts
Despite soaring coronavirus cases, India is lifting the lockdown it put in place at the end of March. HBI talks to one concerned operator who acknowledges that though cases are set to soar, the economic imperative is too compelling to ignore. [+]
Even prenatal admissions are down in Kenya
Small and medium healthcare facilities across Sub-Sarahan Africa are facing liquidation with Africa Healthcare Federation reporting an average 40% revenue drop in March. Even the maternity sector, which has held steady in Europe, has seen fewer admissions in Kenya. [+]
Spanish dentistry re-opens but 20% contraction expected
Spain's dental clinics are re-opening with infection control protocols after being largely closed for months, but the market is expected to shrink by 20% in 2020. On top of the dealing with the COVID-19 pandemic, the largest players have been busy re-shuffling their boards and striking agreements with creditors. [+]
Authorities order B2C retailers to halt antibody test sales
Regulatory body Public Health England (PHE) has ordered telehealth player Babylon to stop selling B2C antibody tests until it has established their accuracy. Supplier Abbott has already said that the test is not suitable for home sample collection but players are still scrambling to sell in what's likely to be a multi-billion market. [+]
Ping An invests in PlusDental as DACH dentistry demand returns
Ping An's early-stage investment arm Voyager Fund has invested in Berlin-based dental healthtech group PlusDental. We examine PlusDental's business model and talk to CEO Peter Baumgart who says demand has surged back in DACH. [+]
Quick return to normal M&A levels and valuations
In last week's HBI 2020 online panel discussion, Hedley Goldberg, the head of Rothschild's global health care services arm, predicted a fairly rapid return to normal M&A volumes and pricing. Why? [+]
Brazil HMOs running at 50% occupancy as Latam becomes new epicentre
Brazil's private hospitals sat half-empty in April, the month before it and the rest of Latin America became the new epicentre of the coronavirus. [+]
Pandemic could accelerate push to home dialysis
COVID-19 could accelerate the push towards home haemodialysis and increased operator costs are unlikely to be reflected in revised tariffs, Fresenius Medical Care's global head of M&A Dr Wolfgang Hofmann tells HBI. [+]
Using remote solutions to monitor COVID-19 patients
Remote care provider Dignio has used its solution normally reserved for elderly and chronic management to track COVID-19 patients outside hospital. HBI speaks to the company's CEO and UK manager about how it adapted there and in Norway. [+]
Many CEE markets to crash as remittances drop
Private healthcare markets in CEE/Southeast Europe are set to crash this year due to economic contractions at home and abroad, with many countries highly reliant on remittance money from abroad. [+]
Netcare reveals 45% revenue drop for April
Netcare, one of South Africa's 'Big Three' private hospital groups, says that April revenues dropped 45% due to the COVID-19 pandemic. It is one of the first financial disclosures by a listed hospital group for a full month of national lockdown. [+]
New players threaten to disrupt lab market
Will Covid-19 be a game changer for the lab sector? The prospect of big government contracts and a massive, unserved B2C market is drawing new players into the diagnostic lab sector. Could they have a permanent impact? [+]
COVID-19 to open up property markets
COVID-19 is likely to accelerate the trend of hospital and care home operators selling off real estate, investors tell HBI, and the pandemic may significantly alter how care homes are designed in future. [+]
Patients eager to resume private treatment post-lockdown
The vast majority of private healthcare consumers want to resume treatment once movement restrictions are lifted, but operators may need to adhere to strict safety measures to get patients through the door according to a new patient survey. But a major global private medical insurer told HBI that global demand might take over a year to fully return. [+]
EBITDAC: A somewhat dubious term
It first became common parlance in a viral Tweet but is now starting to creep into the balance sheets of companies across Europe. EBITDAC has been described as a "generously redefined version of ex-COVID EBITDA" and it's dangerous for debt calculations. [+]
West Europe's for-profit hospital market to shrink 10%+ in 2020
West Europe's for-profit hospital market is set to shrink by at least 10% in 2020 due to the COVID-19 pandemic, according to research done for the HBI Intelligence Centre. [+]
What does COVID-19 mean for US health groups' global activity?
As the COVID-19 pandemic reduces international travel to a trickle, what are the short and long-term implications for the international collaborative activities of large US Academic Medical Centres (AMCs) like Cleveland Clinic, Mayo, UPMC and Johns Hopkins? We talk to Dr Heitham Hassoun, now at Cedars-Sinai but previously at Johns Hopkins where he helped create its JV in Saudi Arabia, Johns Hopkins Aramco Healthcare. He shares his thoughts on the latter. [+]
Bioiatriki founder dies of COVID-19
Evangelos Spanos, the founder of Greece's largest private primary care and diagnostics chain, has died from COVID-19. What's next for Bioatriki? [+]
HBI survey shows COVID-19 impact on sector
COVID-19 has been a nightmare for most for-profit health care operators according to HBI's online survey of 100 operators internationally. That is reflected in the response which also shows the great switch to digital health. [+]
COVID-19 winners and losers
We now have much greater clarity on the impact of COVID-19. As our online survey shows certain sectors, notably elective, private-pay have been truly walloped. The recession should hit them again. Other sectors, particularly those dependent on public payors in rich countries will suffer far less damage. [+]
Who is raising money?
Making sense of the money markets isn't easy right now. But some big players - Ramsay, Zur Rose and TPG are still raising money and some sectors such as German outpatient are still seeing M&A consolidation. [+]
Swiss hospitals re-start electives quickly but 2020 revenue fall expected
Switzerland's private hospitals have returned to all elective activity much quicker than other European countries, but local sources tell HBI lost revenues from the last six weeks will not be made up in 2020. [+]
Terveystalo creates COVID-19 plans for employers but corporate pay flat
Finnish outpatient group Terveystalo is working with businesses to create COVID-19 action plans as economies start to open. Meanwhile, corporate and private pay is down 30% in April. [+]
COVID-19 will accelerate outmigration of hospital care
Italy's COVID-19 experience will place a huge new emphasis on reducing inpatient hospital stays, says Bruno Biagi, VP of the country's third-largest private hospital operator GVM Care & Research. He adds that regions will provide financial support to the private sector but the market is likely to shrink this year. [+]
AI algorithms for COVID-19 imaging could double radiologists' throughput
There is a race against time to build AI algorithms which can diagnose and quantify COVID-19 from CT scans, and a hospital radiologist tells HBI an effective solution could theoretically double his throughput. But it may come after the peak of the crisis has passed. [+]
Doctors queuing up to sell
After years of umming and ahhing, German doctors who own outpatient practices in areas like dentistry, imaging and ophthalmology are keen to sell. And deals continue to happen in spite of COVID. [+]
Join me and the CEO of Diaverum on Tuesday
COVID-19 is forcing all of us to explore new business models and as a content business we are no exception. I'd like to invite you to join us on Tuesday for our inaugural online event: an interview and Q&A with Dimitris Moulavasilis, CEO of global dialysis player Diaverum. This will just be the first in what is an ambitious schedule planned for summer and autumn 2020. [+]
Who is raising money?
Making sense of the money markets isn't easy right now. But some big players - Ramsay, Zur Rose and TPG are still raising money and some sectors such as German outpatient are still seeing M&A consolidation. [+]
Dialysis players beat COVID-19, mostly
Global dialysis operators' volumes have been largely maintained during the COVID-19 pandemic. But the long-term impact of the crisis is not so clear. [+]
Prices for PPE stabilise
After a severe shortage and sky-high prices, personal protective equipment (PPE) supply has improved and prices have stabilised, say operators and purchasing organisations. [+]
How to mitigate the Filipino nurse lockdown
Over the past month, the Phillippines has made moves to prevent its nurses from leaving to join foreign workforces. Healthcare workforce expert Kate Tulenko says this sets a precedent for future and perhaps permanent blockades. HBI reveals her advice on how to mitigate the risk. [+]
HBI Deals+Insights briefing June 2020: Intelligence members
This month saw COVID-19's epicentre move beyond Europe. As the dust settles, HBI can reveal the financial impact with a survey of 100+ operators and the pandemic's implications for workforce, propco deals and the continued outmigration and digitalisation of healthcare. Our infographics cover which countries have seen telehealth laws change, the most electives cancelled, and might be most impacted by a drop in remittances. Outside of COVID-19 we bring you news of NMC’s likely selloff, plus French medicalised homecare M&A frenzy and major management changes at PingAn Good Doctor. [+]
Statutory insurers protect their hospitals, private pay markets look bleak
The post-COVID-19 financial outlook for private hospitals in Western Europe is becoming clearer. Those in statutory insurance-funded markets are likely to be protected by the public payor while private insurers look unlikely to shoulder the burden. And reimbursement for any COVID-19 care will barely make up the difference. [+]
The impact of COVID on for-profit health care
Here at HBI we are in the middle of a detailed and ambitious project on its impact on the industry we track. How and where will COVID affect hospitals, labs, nursing homes and the twenty other sub-sectors that together make up for-profit healthcare? [+]
Russia's care homes and hospitals hit hard while labs offset impact with B2C
Russia's lab market is likely to be boosted by the country's equivalent to Google setting up a courier network for B2C COVID-19 tests but the virus is "running rampant" through hospitals and elderly care. [+]
Revenue halves for lab groups
HBI understands that lab groups across Europe are seeing revenue drops of 50% despite having extensive participation in COVID-19 testing. [+]
Mass testing in Belgian nursing homes
Belgium, where health ministry figures show 53% of the country's 7,594 COVID-19 deaths have occurred in care homes is mass-testing all residents and has already completed over 100,000 tests. We are told that there are some surprising results. The aim is to enable homes to build COVID-free operations so that they can start replenishing. [+]
Medsi's parent company develops new test for COVID-19
Sistema, the conglomerate which owns Russia's largest private healthcare group Medsi, has developed a test through its biotech arm which can be rolled out across Medsi's clinics. It may be one of the only major private healthcare providers anywhere which is under the same ownership umbrella as a biotech company developing new tests. [+]
San Donato raises €265m loan for new Milan hospital
Italy's largest private hospital operator Gruppo San Donato (GSD) has raised a €265m loan from five Italian banks to go towards the construction of its new 16-story hospital in Milan. [+]
UAE mass tests while private hospital revenues drop 50%
The UAE's decision to mass-test its population for COVID-19 and develop responses at the federal rather than emirate-level look to be paying dividends, notwithstanding its very young population. But how far is the private sector involved in the response, both in the UAE and neighbouring Saudi Arabia? HBI talks to local hospital, lab and advisory sources. [+]
Healthcare is positively glitzy compared to retail and leisure
Things feel bad in health care services with closed shutters across the sector. But it could be a lot worse. [+]
Massive underreporting of care home deaths
Anecdotally, care homes across Europe are 'the new epicentre' of the coronavirus but most states still don't have any grasp on how much of the sector is infected. HBI collates reports to assess what the real impact of the coronavirus is across Western Europe. It suggests that rates could be under-reported by 80%. [+]
Homebound boost online mental health platforms
Much of the world’s workforce is sat working from home and many others are out on the frontline, either in hospitals or retail. That is presenting new potential customers for a host of online mental health services across Europe as they seek to plug the gap where the public sector has pulled back. Employers, health care providers and individuals – including children stuck at home – are now bumping up demand. [+]
Special report: How to meet the workforce challenge
With a global workforce shortage estimated by the WHO to reach 18 million by 2030, workforce has never been more top of mind for health care service operators be they hospitals, nursing homes, outpatient networks, diagnostic labs/imaging or homecare players. And COVID-19 will have a further enormous impact. [+]
Mexico's private hospitals enlisted in fight after occupancy plummets
Occupancy in Mexico's private hospital sector has plummeted due to COVID-19, a local operator tells HBI. Much of that spare capacity will go towards treating public non-COVID patients after a deal was struck with the government in an effort to prepare for an incoming wave of infected patients. [+]
Lawyers expect spike in outsourcing disputes and negligence litigation
The COVID-19 epidemic may see commercial disputes regarding NHS UK outsourcing deals and increased litigation against care homes and hospitals from relatives of deceased loved ones, partners at law firm Addleshaw Goddard tell HBI. This is likely to be true across geographies. [+]
Brazil has capacity for COVID - but peak is yet to come
HBI speaks to a source in Brazil who tells us for-profit and public hospitals alike are gearing up for COVID, and while capacity is not yet stretched, there is worse to come. [+]
Portugal's private hospitals and state agree price for COVID-19 care
Portugal's private hospitals have agreed terms with the state to provide publicly-funded COVID-19 hospital treatment, including pathways and bundled tariffs for both minor and serious inpatient episodes. Will the market's recent high annual growth be maintained in the post-crisis period? [+]
Eight ways to be a leader during COVID-19
HBI takes a look at some of the best examples of leadership we've seen in the response to the coronavirus. Here are the key takeaways... [+]
Covid: The double whammy – who will be left standing?
In a recent paper on the medtech outlook for Europe, UBS, looked at how Singapore and Toronto bounced back from pandemics. Pent up demand simply led to double growth rates the year after. But Covid is two things: a pandemic coupled to a steep recession, almost certainly worse than 2008. We look at what this means for a sector where private equity has often geared up to the hilt. [+]
Your chance to build deep and strong relations with the public sector
For almost all for-profit health care businesses this crisis is both a huge threat and an opportunity. We'd be lying if we claimed the opportunity was as big as the threat but CEOs are in many places laying the foundations for the next decade by how they respond to the crisis. [+]
Interview: Tony Veverka, CEO, Transform
HBI talks to Tony Veverka, CEO of cosmetic surgery specialist Transform Hospital Group, about his business, and the market pre-and (speculatively) post-COVID. [+]
From for-profit to non-profit: Helping out and paying the bills during the COVID crisis
HBI talks to the CEO of a cosmetic surgery business in the UK which, in the space of a week, transformed itself from a for-profit group targeting discerning paying patients to a non-profit making NHS-funded support group, helping during the COVID crisis. [+]
Hospital mega-mergers progress amidst COVID-19
Large hospital mergers that will re-shape the UK, German and Finnish private hospital markets are progressing despite the ongoing COVID-19 crisis. [+]
Spain's labs given to the public sector
The Spanish government has ordered that all private labs be brought under public control as the country looks set to ramp up mass testing. [+]
UK private hospital sector expected to ‘bounce back’ post-COVID
The UK's private hospital sector is expected to bounce back after restrictions on hospital activity are lifted, senior advisors tell HBI, although there is disagreement on whether they will be better or worse off than before. [+]
COVID-19 may force re-think of German hospital 'rationalisation'
Germany's arguably excessive hospital capacity, much of it in small regional hospitals, has proven an invaluable asset during coronavirus. A senior hospital executive tells us this may change policy conversations of the last 2-3 years around the need to trim the sector down, though paradoxically the crisis may also send the sector further into deficit. [+]
How Buurtzorg Asia is coping with the challenges of COVID
HBI speaks to Stephan Dyckerhoff, CEO of elderly care specialist Buurtzorg Asia, about how the company is managing its business interests in India, China, Taiwan and Japan as coronavirus sweeps the continent. [+]
Brazil looking to learn from Europe's COVID care home crisis
Care homes in Brazil are looking to avoid the mistakes made in Europe, and are lobbying government to ensure there are medical facilities available for elderly patients showing signs of COVID-19. If isolation within care homes in Europe didn't work, and it clearly hasn't, it will be impossible in Brazil they say. [+]
European dental markets "could take years to recover from COVID"
As HBI Intelligence reviews the impact of COVID-19, HBI has been talking to operators and analysts. One EU-based operator says many markets across Europe will struggle to recover once the COVID-19 crisis has passed. Here is his view of where will be worst hit - and where we may see a surprising rebound. [+]
Why can't anybody find an antibody?
This week the British government has admitted that the three million antibody tests it bought from China don't work. Spain, Czechia and Slovakia are in a similar position. Touted as key to exiting the restrictive lockdown across the world, there was also hope that they would be a saving grace for lab groups stuck with falling volumes. [+]
After the peak: Chinese hospitals fear economic downturn
China's private hospital groups appear to have survived the lockdown with limited financial intervention from the government, but concern is growing, particularly at the premium end of the market, that a long-term economic downturn will push demand away from private care. HBI talks to a Shanghai-based consultant to find out more. [+]
COVID-19: Lockdowns and travel restrictions hit emerging market hospitals
Nationwide lockdowns and travel restrictions are hitting private hospital chains in India, Turkey and Southeast Asia, where the biggest groups garner 10-15% of revenues from international patients. HBI talks to an India-based source to find out more and looks at how operators are faring. [+]
NMC Health goes into administration
Listed NMC Health has been placed into administration by a London court today (Thursday, April 9), following an application by Abu Dhabi Commercial Bank (ADCB). HBI talks to a UAE market expert about what may need to be sold off quickly to keep it afloat. [+]
'There is no deal for private sector to take UK NHS cancer patients'
Cancer companies in the UK do not have a contract with the NHS to take 20,000 public patients, despite an earlier report to the contrary in a UK broadsheet newspaper. Providers tell HBI that they fear that a mass of 'second-wave deaths' and look at how pressure might transform clinical pathways in oncology. [+]
Spain's private hospitals ask insurers to cover costs
Spain's private hospitals have called for private insurers to cover their costs as the stop on elective activity threatens their financial viability. [+]
Dental deal on hold due to coronavirus
HBI hears a 'done deal' to buy a fast-growing UK dental chain by a European PE group may have collapsed. [+]
Mediclinic founder stepping down as Chair in July
The founder of EMEA hospital group Mediclinic, Dr Edwin Hertzog, will be replaced as chair of the company board in July, 37 years after he founded the company. What does the choice of replacement signify for the future of the company? [+]
Sweden's private healthcare sector 'facing disaster' - but could COVID-19 response lead to reform?
Sweden's liberal attitude towards containing COVID-19 has divided opinion amongst HBI sources. But both agree its heavily de-centralised healthcare system has been a major stumbling block to preparations, with an operator saying that without state aid, the private health sector is 'facing a real disaster'. [+]
'Years of negative growth post COVID' predicted by UK dental operator
HBI has revised its HBI Intelligence forecast for growth in the UK dental market in 2020 down to -2.5%. It had been growing at 3.5% - but that was before the COVID-19 outbreak. One UK-based operator forsees revenues plunging, multiples dropping, patients avoiding appointments and some owner-practitioners simply calling it a day and selling up. [+]
Labs stand to lose at least third of routine testing volumes
Labs across Europe are set to lose at best a third and at worst all of their routine testing volumes as healthcare systems narrow their focus on coronavirus and patients stay away. The picture is even bleaker for imaging groups. [+]
Why aren't for-profits more welcome in the fight against COVID-19?
With national health systems at or beyond breaking point dealing with a global pandemic, how is it that, in some countries at least, for-profit facilities remain resolutely un-drafted into the fight? Surely, as COVID-19 blazes its way across Europe, it should be all hands to the pump? [+]
COVID-19 surges in West Europe: private hospitals under-used, requisition option raised elsewhere
As COVID-19 surges in Europe beyond the (reported) levels in its source country and across emerging markets, government utilisation of private hospital capacity is a mixed picture. And there are discussions about the possibility of wholesale requisitions of private capacity in emerging markets with under-resourced public healthcare systems. [+]
Exclusive prediction: Pandemic reaching turning point in Europe?
An exclusive analysis by Chinese insurance giant Ping An suggests COVID-19 cases could reach a turning point in the next few days, hitting the peak of new confirmed cases by later this week / early April, with that figure set to fall thereafter. [+]
Ping An leverages AI to vastly increase number of COVID-19 screening calls
Chinese insurer Ping An says its AI-powered audio screening system has helped detect over 1,600 cases of COVID-19 in China. [+]
Malaysian hospital group offers on-demand COVID-19 testing
Pan-Asian hospital group IHH Healthcare Berhad is among the operators rolling out on-demand coronavirus testing in its Malaysian hospitals. [+]
Thai government comes to gentleman's agreement with for-profits over COVID-19
A ‘gentleman’s agreement’ has been reached with for-profit hospitals in Bangkok to take in COVID-19 patients. [+]
Apollo partners with hotel chains to bolster isolation and quarantine facilities
Apollo Hospitals in India is in partnership with hotel chains in major Indian cities to set up quarantine facilities. [+]
State takeover of Polish private hospitals 'unlikely'
A Polish healthcare investor tells HBI that a state takeover of Polish private hospitals, a possibility touted in some national outlets, is unlikely. [+]
Competition watchdog takes deeper look into Mehilainen-Pihlajalinna merger
The Finnish competition authority has entered a 'phase II' investigation into the merger of Mehilainen and Pihlajalinna, two of the country's three big occupational, health and social care providers. [+]
HBI Deals+Insights briefing May 2020: Intelligence members
This month we dig deeper into the impact of COVID-19, specifically looking at how emerging market and GCC operators have been impacted and how volumes have plummeted in labs and outpatient globally, the latter with exclusive data given to HBI by DocPlanner. Our infographics look at the pandemic's impact on PE-held firms' gearing, care home deaths, for-profit hospital involvement and whether private healthcare is really recession-proof. Alongside our wide geographic coverage, this edition includes a 3,000-word feature on meeting the health workforce challenge. [+]
GSD was treating 20% of Lombardy's COVID-19 patients: the Private Hospital Association of Lombardy
We hear from Dario Beretta, who heads up the private hospital association of Lombardy. The region in north Italy has been battling a ferocious COVID-19 outbreak and is by far the worst-hit part of Europe. Beretta is also the general director the San Siro Clinical Institute in Milan, part of the country's largest private hospital operator Gruppo San Donato (GSD). [+]
Digital health companies scramble to launch free solutions
Digital health companies across Europe have put out press releases left, right and centre about new free solutions designed to help with the coronavirus. What's the end goal? [+]
Spain passes law to requisition private sector
Spain has passed a law enabling regional governments to seize control of private facilities. Portugal has passed a similar law. Meanwhile, HM Hospitales, the second largest group faces a backlash after suggesting now would be a good time for its staff to go on holiday. [+]
India's private labs allowed to test for COVID-19
A select few for-profit labs in India have been allowed to start running COVID-19 tests, albeit with a price cap and a shortage of tests kits to run them with. [+]
COVID-19: Hospitals drop 2020 guidance as private pay-focused operators suffer
Listed hospital and outpatient service operators across the globe have adjusted 2020 guidance, issued profit warnings and cancelled dividends as elective and private activity plummets due to the COVID-19 outbreak. Operators more focused on publicly-funded work seem to be doing slightly better. [+]
COVID-19 forces operators to look to China for procurement
Hospital and lab procurement has been hit hard by the COVID-19 outbreak, with four-fold price and an uptick in ordering from China, industry sources tell HBI. [+]
COVID-19 and for-profit health care
The likely impact on the sector is becoming clearer. It won't be pretty. [+]
Exclusive Prediction: Pandemic Turning Point in European Countries and the U.S. is Expected to Arrive This Week / Early April
Press Release: Exclusive Prediction: Pandemic Turning Point in European Countries and the U.S. is Expected to Arrive This Week / Early April [+]
Deals + Insights: Connect members' edition April 2020
Please log in to see your April 2020 edition of Deals + Insights [+]
Private sector COVID-19 testing is limited - Infographic
European laboratories were hoping to be a key part of the solution to stop the ongoing spread of COVID-19 but as it stands the bulk of testing remains with the state. As many declare that they are equipped to handle large volumes, HBI looks at where the private sector has been able to deploy its testing capabilities across Europe. [+]
COVID: What is the price tag of this war?
The UK's National Institute of Clinical Excellence is hated by big pharma and has been copied by governments across the world. Given the latest paper from Imperial College on who is affected, how would NICE cost-justify the global Covid response? [+]
European labs re-think where they test as COVID-19 rampages on
COVID-19 is forcing European laboratories to re-think where they test patients. Some are working with authorities to set up new ‘drive-through’ testing points, while others have closed more than half of their drawing points. [+]
Surgeries cancelled as for-profits drafted into coronavirus fight
Public elective surgeries are being cancelled across Europe, replaced in part by additional for-profit outsourcing, and governments are buying private hospital capacity for an expected flood of COVID-19 cases. In some countries, the stop on electives is across both public and private sectors. HBI investigates. [+]
Will Bergman buy big before prospective sale?
Rumours persist that Bergman Clinic, the Dutch and Nordic ambulatory and ophthalmology clinic chain, is looking to sell and may have one large acquisition in its sights ahead of any process starting. HBI speaks briefly to two banking sources, and a Netherlands-based advisor to find out more. [+]
Bupa letting go of M&A and Integration Team members
HBI hears that global healthcare insurer and operator Bupa is letting go of a significant number of its dentistry-focussed M&A and integration team. The decision follows huge write-offs in 2019 in its UK dentistry business and Australian care homes. [+]
Each COVID-19 patient could mean one healthcare worker in isolation - Infographic
In the early stages of the coronavirus outbreak, a third of all patients treated at one Wuhan hospital were healthcare workers that had treated positive patients. This week's infographic brings together stats from the worst affected areas to look at how must of the workforce might be lost to sickness. [+]
COVID-19: Care sector confronts crisis, hospitals hit hard
In the second of our two-part deep dive into how COVID-19 is hitting healthcare markets across EMEA, we ask how hospitals are coping with spiralling staff sickness and a flood of patients, and whether the care and dialysis sectors can stay afloat given the risk the virus poses to their most vulnerable patients. [+]
Health care service write-offs drive losses at Bupa
Bupa, the global healthcare insurer and healthcare operator went from pre-tax profits of £502m in 2018 to a loss of £78m in 2019, thanks mainly to huge write-offs in its UK dentistry business and Australian care homes. But stripping out write-offs, underlying profitability still plunged 31%. Revenue rose just 4%. Why, and what does this tell us about Bupa and its future? [+]
Paying the price of the COVID-19 outbreak
HBI has been talking to a lot of operators and analysts this week about the COVID-19 outbreak. Whatever their assessment of the current effect on their sectors is, one thing is clear: it is already impacting businesses and things will get worse before they get better. [+]
COVID-19: Threats and opportunities
Covid-19 is going to have a huge impact on for-profit healthcare services. In the first of a two-part report, we look at what that will be at a sector and country level. Digital health looks like being a winner, Ping An claims online consultations are up tenfold, with the spectre of a crash in elective procedures hanging over for-profit hospitals and specialist outpatient chains. We also look at the likely impact on M&A. The second part of this report, focussing on the care sector, will be published next week. [+]
25 perverse incentives and stupid things in health care services
Here is our New Year list of stupid things in health care services. It comes with a stupidity index where 10 is very stupid and an Easy to Fix index where 1 is very easy and 10 is all but impossible. Please give us your comments (in confidence!) and let us know of any additions you may have. Just email max@healthcarebusinessinternational.com. [+]
Report: Will big medtech follow Medtronic into services?
Will big medtech follow the IBM path from product supplier to service provider? No other medtech company has expanded as fast as Medtronic into services. Here, we look at what the company offers, as well as its plans for the future. We also talk to one of its new customers, and look at how far the big imaging groups are willing and ready to move into the service arena. What impact will this have on existing service providers? [+]
