Medicalised Homecare sector across EMEA

You've come to the right place to understand Medicalised Homecare services in Europe and Emerging Markets. Here is how we can help you:
  • Detailed research report on Medicalised Homecare services with marketshare and growth rates for 10 countries and information on a further 134 (HBI Intelligence)
  • Database of 134 Medicalised Homecare service providers, including profile and major external investors (HBI Intelligence)
  • Merger and acquisition (M&A) intelligence showing likelihood of sale (HBI Intelligence)
  • News stories and interviews with Medicalised Homecare operators (HBI Deals and Insights)
  • Events that cover healthcare services globally including Medicalised Homecare (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

Sector Report
Medicalised Homecare Sector

Updated: May 2020

Executive Summary

EXECUTIVE SUMMARY
 
Impact of Covid-19 
We are in the process of analyzing the impact of Covid on the care sector and we should have updates for every country’s growth forecasts for 2020 and 2021 by end of May. There has been a strong short-term impact with costs rising and demand falling which we have already reported in news. A serious recession may further hit demand and tariffs and leave many investors breaking their bank covenants.
Methodology & definitions
Our definition of medicalised homecare is any service typically delivered in the home which includes an element of skilled medical care from a qualified nurse, technician or doctor. This contrasts with domiciliary care which is generally delivered by unskilled staff. 

You’ll see services divide themselves in the following way:
  • Nursing homecare: medically trained nurses (and sometimes doctors or other specialists) paying visits to a patient’s home to administer treatment and medication.
  • Intensive care: For patients requiring intensive rehabilitative treatment for wounds, those who are chronically ill and dependent on treatment.
  • Oxygen/apnoea homecare: To treat COPD and sleep apnoea through oxygen therapy. The gases are administered through specialised equipment delivered to a patients’ home and coupled with care from medical professionals who supervise the treatment.
  • Drug delivery at home: In the UK and, to a much lesser extent elsewhere, operators can deliver drugs to the home.
The scope of each national market is determined by the regulations and health structures within it, which varies hugely.
Payment and tender methods also vary, although there has been a general tendency towards larger contracts which has often led to lower prices. 

See the full report for a breakdown of the different suppliers, including oxygen groups, companies from a distributor background, players delivering nursing care, integrated medtech and nursing homes providing medicalised homecare.
Drivers
Operators tell us these are the key drivers:
  • Medical drivers - the growth of incurable, long-term chronic conditions which require patients to have regular medicalised homecare.
  • Demographic drivers – with an ageing population comes more disease to manage.
  • The move from inpatient to outpatient - as healthcare systems try to adapt to squeezed budgets and demographic challenges, the step-down from hospitals to outpatient and homecare frees up much-needed capacity and allows for more people to be treated alongside effective cost reduction
  • There is demand from patients and some payors for suppliers who can offer a very wide range of intensive care services to patients. 
  • For-profit operators seem to be better at diagnosing respiratory conditions - as this improves it will contribute to growth in the sector.
Scope for growth & consolidation
For full details on growth & consolidation, see the report.
The three largest consolidators on the oxygen market are Linde/Praxair, Air Liquide and Vivisol, a subsidiary of SOL Group. All three of these pan-European providers have their core businesses in industrial gas provision and have gone into the supply of home oxygen services as a way to diversify activities.
Then there are national providers, many of which supply additional medicalised homecare services such as artificial home nutrition and infusion-based treatments.
The intensive and nursing care sector is also being consolidated by the large oxygen groups.
When it comes to intensive care for the chronically ill in particular, for-profit providers are sometimes waiting for payors to catch on to the value of prevention. 
Opportunities
In some markets, there are particular opportunities to disrupt conventional ‘analog’ provision (without a digital component to service delivery) with patient-facing digital disruptors. For example, Korian has set up Oriane, a digital platform linking patients, their families and carers. 
Opportunities for acquisitions across the sector abound as all medicalised homecare segments remain highly fragmented. In France and Spain we see promising, well-staffed start-ups appearing such as Qida, which provides nurses as well as some auxiliary services.
On the oxygen market, margins were very good historically, budgets are in the billions and margins remain around 20% EBITDA. But large countries have learned to monitor the profitability of providers.

Trends & prices
Prices for oxygen treatment vary substantially across Europe, reflecting differences in quality of care.
A general trend in this segment is the reduction of reimbursement rates across geographies. A new business model has emerged on the heels of this change, where care is provided in community day-care settings.
Another trend is for large international providers to create a one-stop-shop for payors and patients. Operators once specialising in pure oxygen therapy have diversified into sleep apnoea, infusions, wound care, ostomy care and enteral or parenteral nutrition, for instance. Some even provide domiciliary care.
Challenges
Some of the key challenges in the medicalised homecare sector.
See the report for full details:
  • Siloed budgets
  • For-profit sector penetration
  • Growth limited by staff crisis
  • Payors
Sample report pages and data
What we offer
 
-       Instant overview of the EMEA dialysis market and players This report gives you visibility of this important, fast-growing market across 9 countries with market data on all, as well as detailed profiles of the Top 50 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 medicalised homecare throughout the period.
 
-       Insights on business models The report is based on in-depth interviews with many operators. The report also looks at how medicalise homecare players can best build customer loyalty.
 
-       Identify national opportunities We assess opportunities at national level based on the regulatory environment and proposed reforms.
 
-       Size markets This report enables you to swiftly see market sizes and market shares
 
-       Save time and money This report will save you weeks researching these opaque markets and enable you to swiftly identify investment opportunities, new partners and markets.
 
 

Table of Contents

Table of Contents
EMEA overview
 
Datasets  
Size of EMEA market 2018
Marketshare of major EMEA players 2018
Comparison of market sizes 2018
Comparison of market growth rates 2016-2020
 
Introduction
 
Methodology & definitions
 
Drivers
 
Scope for growth & consolidation
 
Opportunities
 
Trends & prices
 
Challenges
 
France
 
Data sets
For-profit /private market size and growth rates 2016-2020
Marketshare of major players 2018
 
Market description and trends.
 
Germany
 
Data sets
For-profit /private market size and growth rates 2016-2020
Marketshare of major players 2018
 
Market description and trends.
 
Ireland
 
Data sets
Marketshare of major players 2018
 
Market description and trends.
 
Italy
 
Data sets
For-profit /private market size and growth rates 2016-2020
Marketshare of major players 2018
 
Market description and trends.
 
Netherlands
 
Data sets
For-profit /private market size and growth rates 2016-2020
Marketshare of major players 2018
 
Market description and trends.
 
Spain
 
Data sets
For-profit /private market size and growth rates 2016-2020
Marketshare of major players 2018
 
Market description and trends.
 
Sweden
 
Data sets
Marketshare of major players 2018
 
Market description and trends.
 
United Arab Emirates
 
Data sets
For-profit /private market size and growth rates 2016-2020
Marketshare of major players 2018
 
Market description and trends.
 
United Kingdom
 
Data sets
For-profit /private market size and growth rates 2016-2020
Marketshare of major players 2018
 
Market description and trends.

Medicalised Homecare News & Interviews

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

250 news stories on Medicalised Homecare.

Interview: Mario Paterlini, CEO, Sapio Group 4w ago

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. ...

M&A frenzy in French medicalised homecare sector 1mo ago

Italian industrial and medical gas group Sapio has entered France's medicalised homecare sector with the acquisition of one of the ten largest for-profit providers. It is the latest in a string of transactions in the space including by some left-field buyers. ...

COVID-19 and Emerging Market healthcare 2mo ago

We talk to two of the world's largest investors in emerging market health care about Covid's likely impact. Despite so far much lower death rates, the initial effect on health care operators has been worse than in Europe. Covid is set to destroy several motors f...

Exclusive prediction: Pandemic reaching turning point in Europe? 3mo ago

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....

COVID-19: Care sector confronts crisis, hospitals hit hard 4mo ago

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 ri...

Germany to reform financing of long-term care 4mo ago

Germany is on the brink of reforming the financing of long-term care insurance (LTC) which funds elderly care. The industrious Federal Minister of Health Jens Spahn could produce a draft law by the summer, and private insurers are proposing revolutionary ways ...

Vivisol wins UK regional contracts and acquires in Switzerland 5mo ago

Oxygen therapy provider Vivisol, part of the Italian gas company SOL group, has won three regional NHS tenders through its UK subsidiary Dolby Vivisol....

Private equity grabs France's third-largest homecare group 5mo ago

French private equity firm Ardian has acquired a majority stake in Santé Cie, the parent company of medicalised homecare specialists Elivie and Asdia. We discuss Santé Cie's plans and the wider market with an expert in the respiratory sector from advisors Can...

The long-held homecare companies most likely to sell this year 6mo ago

This week we look at homecare companies which have been held longer than the usual private equity cycle (some by a large margin) and ask: which are most likely to sell?...

Database of 134 Medicalised Homecare service providers

HBI has built a unique database of the Top 3,700 operators globally in health care services. As part of this, we have identified the top 134 Medicalised Homecare operators in Europe and will soon add the major players in Emerging Markets.

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 includes a session on medicalised homecare models, with a facilitated discussion with three international CEOs.
 
Other sessions look at trends in the investment and merger and acquisition, digital health and telehealth.  
Contact us in the UK on 0207 183 3779 for more information.