You've come to the right place to understand health care services in France. Here is how we can help you:
Detailed research report on health care services in France with marketshare and growth rates for 18 sectors (HBI Intelligence)
Database of the top 317+ private health care operators, including profile and major external investors across 18 sub-sectors from diagnostic labs to domiciliary homecare and from telehealth to hospitals (HBI Intelligence)
Merger and acquisition (M&A) intelligence showing likelihood of sale (HBI Intelligence)
News stories and interviews with operators and investors in France (HBI Deals and Insights)
Events that cover health care services globally including France (HBI 2024)
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Country ReportFrance Country
Updated: September 2022
Executive Summary
Executive Summary
Impact of Covid-19
We are in the process of analyzing the impact of Covid all countries in HBI Intelligence and should have updates on market sizes by the end of May for the 5 largest economies and by the end of June for others. Meanwhile we are covering the impact of Covid in news stories. Recent examples include a detailed examination of the impact on French and German hospitals, an article on labs and imaging and a look at the broad elective sector.
Background
For a country where the state spends 57% of GDP, the second highest in the OECD, France has a surprisingly large for-profit sector. The state controls it through rationing capacity (every elderly care bed or MRI machine installed needs a licence) and through control of tariffs which are centrally controlled and voted through every year by the National Assembly. Tariffs are generally falling for for-profit operators. And in elderly care and hospitals, for-profit operators accuse the government of freezing them out, excluding them from additional budgets or regional plans. So far little has changed under Macron.
Expenditure
France spent almost €198.5bn on healthcare in 2016, 8.9% of GDP and 2,970 euros per inhabitant. The real expenditure on healthcare is around 11%of GDP, after all costs are taken into account. This is 77% funded by social security payments that are pooled into statutory health insurance funds which are very tightly controlled by the state, while voluntary supplementary health insurance (VHI or PMI) contributed 13.3% to this amount with the remaining 8.3% paid by households. The latter two which make up private expenditure are likely higher but the private sector’s expenditure is generally not very well recorded in France.
Almost all French have some form of supplementary insurance which effectively extends the already good basic coverage to areas such as complex dentistry and ophthalmology.
Below are two example extracts from the sector breakdowns. See the report for full details on each sector. See the table of contents for information on which sectors are represented in the report.
Dentistry
The French market is large and 90% provided by dentists in private practice, which at first glance makes it look like a tempting target for consolidation. 90% of all private practices in the country are solo clinics and just 10% are dental centres.
Only a small percentage of dentists work in practices owned by municipalities or insurance companies.
While the market is hugely fragmented with many small acquisition targets, regulations are hugely off-putting. Dental centres (around 15 dentists) will be a more attractive target since non-dentists cannot own small group practices. Well-run dental centres have EBITDA margins of 10-15% and can be acquired for a 4-8x EBITDA multiple. Dialysis
Like all healthcare services in France, dialysis facilities are commissioned according to the assessed local need. Private dialysis units can be set up and serve the surrounding area or compete in the cities for patients. Some so-called “limited care units” that work with a specific hospital to take care of its dialysis services can also be found in Paris.
The private for-profit sector has a one-third share of France’s roughly 40,000 dialysis patients but varies depending on the several different modalities by which modalities are classified.
Public data shows that Diaverum has 18 clinics treating 1,900 patients (as of 2017), implying sales of at least €60m, Fresenius Medical Care has 41 clinics treating 2,700 (€85m), while B. Braun has 16 clinics treating around 1,000 (€35m). The latter two have overall sales of €116m and €350m in 2017 but this includes the supply of drugs and equipment.
See the report for full details on each sector, including further details on the two above. See the table of contents for information on which sectors are represented in the report.
What we offer
- Instant overview of the French market This report gives you visibility of this fast-growing market detailed profiles of the Top 280 players.
- Ever green! Updated throughout your subscription As part of our HBI intelligence platform this report is updated throughout the period of your subscription. You will also receive additional news stories and interviews on France throughout the period.
- Insights on business models The report looks at the main models – private hospitals and lab and dialysis outsourcing.
- Identify national opportunities We assess opportunities at national level. - Size markets This report enables you to swiftly see market sizes and market shares at a sub-sector level
- Save time and money This report will save you time researching this opaque market and enable you to swiftly identify investment opportunities, new partners and markets.
Table of Contents
Table of Contents
France – National overview
Expenditure
Dentistry
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Dialysis
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Fertility
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Hospital
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Imaging Services
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Laboratory Services
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Medicalised Homecare
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Nursing Homes
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Occupational Healthcare
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Oncology
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Post-acute Rehabilitation
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Psychiatry and Mental Health
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Telehealth primary
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Teleradiology
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
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France News & Interviews
Our indepth stories dig deep and cover profit multiples, revenue, EBITDA and CEO thinking.
Pan-European French nursing home group emeis (formerly Orpea) has emphasised non-financial metrics such as reduced accident rates and increased satisfaction rates in its 2023 results. The company also reported 11% revenue growth for the year, although EBITDA d...
Pan-European listed French nursing home group Clariane is exploring disposal options for its Hospitalisation à Domicile and Services de Soins Infirmiers à Domicile (HAD/SSIAD) business in France with the members of the Comité Social et Economique Central d'En...
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....
French care home operator Orpea has rebranded itself as emeis, in the wake of a tumultuous period marked by allegations of mistreatment in its facilities. The company's decision to change its name comes as it attempts to distance itself from the scandals that...
Pan-European listed French nursing home group Clariane has successfully exited the UK with the sale of its Berkley Care subsidiary. The group has also made progress on the sale of its Belgian and Dutch branches, but has not yet secured a buyer for these....
Doctors are becoming increasingly interested in setting up clinics and running them as proper businesses. We spoke to Romesh Angunawela, who has recently completed an MBA especially for physicians in the US, and is the co-founder of OCL Vision, a three-clinic ...
Medicharme, a medium sized French nursing home group owned by UK PE investor G Squared, has entered liquidation. The company became insolvent due to rising costs and low occupancy. The company's 43 facilities will continue to operate as normal for the time bein...
Australia-based multinational hospital group Ramsay’s half year results have gained a positive response from shareholders. But the work is not yet done on the firm’s flagging European segment....
Embattled French nursing home group Orpea has announced it will pursue a reverse share split on all outstanding company shares. This means current shares which are valued at around €0.01 each will be exchanged for new shares valued at €10 each, at an excha...
Database of 317 France service providers
HBI has built a unique database of the Top 4,000 operators globally in health care services. As part of this we have identified the top 317 operators in France.
Profiles include revenue/sales data as well as EBITDA and other profit margins where known. They also cover private equity ownership with dates and mergers and acquisitions.
Mergers & Acquisition (M&A) Intelligence
Our deal pipeline shows how likely all private equity and some privately companies are to sell based on algorithms and journalistic know-how.
HBI 2024 – the only CEO-level conference to cover healthcare services globally
HBI 2020 – the only CEO-level conference to cover healthcare services globally
In 2019 this event brought together 700 delegates from over 40 countries. Over 60% are CEO level and they included 150 specialist investors in health care services. The French market is present in many of HBI 2020s sessions, including Digital Health, Elderly Care, Psychiatry and Mental Health. Some of the French market speakers include speakers from Domus Vi, KRY (a Swedish company with operations in France), Rad-X and Inicea.
Other sessions look at trends in hospitals and labs as well as investment and merger and acquisition, plus digital health and telehealth.
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