It is striking how overlooked Northern Europe is by the big French care home consolidators. The UK is much more attractive and a lot cheaper than Spain. And investors and operators should also be looking hard at the Nordic region.
Despite the travails of Four Seasons and Bupa's well publicised comments about not being able to make money from UK care homes, EBITDAR margins are surprisingly high for operators and US REITs love the sector.
As Western companies are starting to doubt the promises of China's elderly care market, we hear Fosun Property, the real estate division of conglomerate Fosun, is looking to invest into European nursing homes.
Single specialty chains offer the fastest growth in Indian healthcare says the CEO of MyDentist, Vikram Vora. Diabetes care, orthopaedics and rehab offer opportunities that remain untapped by private equity and are servicing the country’s growing elderly population.
The Asia Pacific region is home to four of the ten largest acute care operators in the world, trading at an average EV/EBITDA multiple of 22x. APAC now has 58 listed healthcare services groups for an aggregate market cap of $158bn. But has it passed its peak? At the Healthcare Business International conference in London, private equity firms spoke of 2016 as a ‘crash year’, marked by political uncertainty and financial instability.
The bidding process for Spain's fifth largest group Amma continues. Three operators (Orpea, Maisons de Famille and Domus Vi) and three private equity houses (PAI Partners, Permira and Bridgepoint) have progressed to the second round after offering more than 11.5x EBITDA.
We are hearing grunts of disillusionment with the Chinese elderly care market from European operators who have examined it seriously. They say there is no goldrush.
Cultural issues are at the forefront of the difficulties in running and investing into long-term care in emerging markets. At the Healthcare Business International 2016 conference, the CEOs of Senior Assist, Belgium’s third largest care home operator and a player in Latin America and Turkey, and TVM Capital, a private equity firm investing in rehabilitation in the Middle East, shared their views on the sector.
Esperi Care, the third largest elderly care player in Finland, says it expects a boom in services-heavy assisted living for new division Saga Care. A new voucher system also introduces more choice, says Marja Aarnio-Isohanni, CEO of Esperi Care. This will expand homecare and also allow the elderly to choose between various care services.
Sources claim Paris-listed care group Orpea has closed a preliminary agreement to buy Spanish nursing home group Sanyres for nearly 13x EBITDA. Spain's market leader SARquavitae only pulled out at the last minute, we hear. But Orpea had the upper hand thanks to its strong financial muscle and Sanyres' asset-heavy operation fitted well with its approach.
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