For-profit health care services in Spain

You've come to the right place to understand health care services in Spain. Here is how we can help you:
  • Detailed research report on health care services in Spain with marketshare and growth rates for 15 sectors (HBI Intelligence)
  • Database of the top 253+ 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 Spain (HBI Deals and Insights)
  • Events that cover health care services globally including Spain (HBI 2020)
  • “A key research tool for Fresenius. Nothing else is gives such a broad, yet structured picture of all the players.”
    Wolfgang Hofmann, Senior Vice president, Fresenius Medical Care
  • “Aetna finds the service really useful. Often insightful on business model innovation and help us in our thinking, particularly about Emerging Markets.”
    Dr Sneh Khemka, Managing Director, Population Health, Aetna International
  • “Awesome, always on the money, full of good information, much used internally.”
    CEO of one of the top five international hospital groups
  • “The best source of information for deals and trends in the global healthcare market.”
    Mr. Stefano Ciampolini, CEO & Co-Founder, Renal Services
  • “A really useful tool for investors. Continually digs out interesting stories and casts light on healthcare services internationally.”
    Dr Mark Wadley, Fund Manager, Visio Capital Management
  • “A fascinating ecosystem of data, information, and perspectives on the private healthcare market. My favourite source of information.”
    Andreas Völkl, Global Marketing Manager - Outcome Studies and Collaboration, Siemens Healthineers
  • “I like the team at HBI, their highly focused, analytical work and their ability to bring senior people from different countries in health care together.”
    Dr. Sanjeev Kanoria, Chairman, Advinia Healthcare
  • “May I congratulate you, very interesting and relevant content.”
    Joe Ryan, CFO, Medicover
  • “Unique focus on private healthcare globally. Always learn something useful about sectors, companies and countries where we invest.”
    Kemp Dolliver, Chief Investment Officer, Cherrystone Hill Capital Management LLC
  • “Really useful in keeping track of transactions across Europe and trends in healthcare services.”
    Irina Stamate-Rocha, Principal, Patron Capital Advisors
  • “Extremely useful view of what is happening in European healthcare”
    Laurent Ganem, CEO, G Square Capital
  • “A great site for keeping up with the healthcare sector. Its excellent search facility also means that it is easy to find older but relevant information about a given company or sector.”
    Rune Aresvik, Co-owner, Vardetun
  • “A really valuable initiative that tracks developments across Europe. If it didn't exist, we'd have had to invent it ourselves.”
    Jeremy Tasker, Head of Healthcare, Colliers International
  • “Gives an excellent overview of the European healthcare industry, very perceptive, written with real insight!”
    Nancy Hollendoner, Industry Consultant, Senior Adviser to Hawkpoint Partners

Country Report
Spain Country

Updated: May 2020

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
Spain has an impressive for-profit sector thanks to high levels of private medical insurance. It is slowing destroying the greatest experiment in outsourcing health care to the private sector - the Alzira model. Its for-profit lab and fertility sectors are perhaps the most efficient in Europe and there are major consolidation plays in elderly care and dentistry. Major international operators - Helios Fresenius, Orpea and NMC - have entered the market over the last two years. 

Market size
Spain provides universal public healthcare funded by taxation and about 70% of the total healthcare spending is accounted for by the public payor, according to Eurosta. But there is a strong private insurance market and many middle-class people have retained these policies despite the recession. Spain has an NHS system, although much is decided according to regional elections. Socialist areas such as Andalusia have little to do with the private sector, whilst regions like Madrid and Valencia, traditionally controlled by the rightist-PP have favoured the private sector.

A swing to the left in Valencia means that this is now being destroyed. Hospitals in Spain take up most of government healthcare budget, although the financial distribution in the acute care sector varies across the 17 autonomous communities or regions in the country. 
 
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.
 
Nursing Homes
The sector is estimated at €5bn with the private providers accounting for a quarter of the market, while the remaining are public or not-for-profit operators. At a growth rate of 2.5% we estimate the sector to be worth €1.3bn in 2018.

There are 375,000 nursing home beds in Spain and, according to Jorge Guarner, former CEO of SarQuavitae and founder of Activos investment, occupancy rates stand at 95%.
According to Orpea, average daily revenue per bed is €60, and Guarner tells us this is covered by a copayment of around 70% resident pension and 30% public. The amount varies depending on the pensioners’ economic condition.
It is estimated that up to 65% (€3.25bn) of the nursing home market is publicly funded while out-of-pocket payment account for the remaining 35% (€1.75bn).
Spaniards have the highest life expectancy in Europe of 83 years, and about 40% of public hospital beds are occupied by chronically ill patients, many of them old. There is a government strategy to move the care of this group of people from hospitals to nursing homes, so specialist facilities will need to be built.
Telehealth Primary

Private healthcare insurers are the only for-profit bodies providing doctor-to-patient telemedicine in Spain. We estimate that the 2018 market is worth €5m but could be worth €30m by 2020, as the country reaches around 1.2m consultations. The largest growth will come from the PMI market until the government starts to reimburse telemedicine. 

Bupa’s Sanitas offers digital consultations to around 115,000 people through its Blua and Sanitas Pymes Digital products and charges a €10-20 supplement for those on other plans. With just 19% of the population signed up to private insurance, penetration is limited. We estimate that the total primary telehealth market is worth around €5m. 

Spain’s strong public health system is unlikely to outsource telemedicine contracts (many primary care doctors are civil servants), so the only other market opportunities are in the integration of services into private primary care facilities or a product that expects the customer to pay out-of-pocket. Llorbachs says it would be easy to turn his rating platform into a telemedicine service, but he’s worried that doctors and patients won’t take the service seriously in a country so dedicated to the local family doctor. But in ten years 30% of them will be retired, so a solution must be found from somewhere.
 
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 Spanish market This report gives you visibility of this fast-growing market detailed profiles of the Top 221 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 Spain 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
 
Spain – National overview
 
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.
 
Domiciliary Care
 
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.

Spain News & Interviews

Our indepth stories dig deep and cover profit multiples, revenue, EBITDA and CEO thinking.

457 news stories on Spain.

Goodgrower buys back 20% Vithas stake, with HM merger "impossible" 15m ago

Spain's second-largest for-profit hospital chain Vithas will be 100% owned by the founding Gallardo family after their family office Goodgrower agreed to buy the 20% stake held by Criteria Caixa, a bank investment arm. What does it mean for Vithas' M&A plans and...

Advent buys from bankrupt Dentix 7d ago

The largest shareholder in Spain’s dentistry group Vitaldent, Advent International, is acquiring 80 dental clinics from struggling Dentix, and the Dentix brand....

Korian enters long-term real estate partnership 7d ago

France-based pan-European Care group Korian has entered into a 15-year-partnership with BNP Paribas Cardif and EDF Invest, creating a real estate vehicle with Korian at the helm....

Fresenius Helios buys Eugin, Elsan buys C2S 4w ago

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 a...

HBI 2020: Zur Rose turns online pharmacy into a healthcare ecosystem 4w ago

The largest e-commerce pharmacy group in Europe, Zur Rose, set out its vision at HBI 2020 for turning its core business into a healthcare ecosystem that will remotely treat the chronically ill with advice, medications and apps....

HBI 2020: Regulatory and Political Risks post-COVID 4w ago

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...

HBI 2020: Care homes may never return to pre-COVID occupancy 1mo ago

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 occup...

Report: 20% of hospital care could be offered remotely by 2030 1mo ago

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....

Diaverum to IPO in Stockholm as Saudi JV buyout boosts EBITA 2mo ago

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. ...

Database of 253 Spain 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 253 operators in Spain.

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 2020 – 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.
 
HBI 2020 include sessions which look at trends in hospitals and labs as well as investment and merger and acquisition, plus digital health and telehealth.
 
In the wake of Covid, HBI has launched HBI 365, an exciting series of digital events. 
Contact us in the UK on 0207 183 3779 for more information.