Occupational Healthcare sector across EMEA

You've come to the right place to understand Occupational Healthcare services in Europe and Emerging Markets. Here is how we can help you:
  • Detailed research report on Occupational Healthcare services with marketshare and growth rates for 22 countries and information on a further 70 (HBI Intelligence)
  • Database of 70 Occupational Healthcare 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 Occupational Healthcare operators (HBI Deals and Insights)
  • Events that cover healthcare services globally including Occupational Healthcare (HBI 2020)
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    Wolfgang Hofmann, Senior Vice president, Fresenius Medical Care
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    Dr Mark Wadley, Fund Manager, Visio Capital Management
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    Irina Stamate-Rocha, Principal, Patron Capital Advisors
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    Laurent Ganem, CEO, G Square Capital
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Sector Report
Occupational Healthcare 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 sector and we should have updates for every country’s growth forecasts for 2020 and 2021 by end of May. This is a partially elective sector and there has been a strong short-term impact which we have already reported in news. A serious recession will further hit demand and leave many investors breaking their bank covenants.
 
Occupational healthcare is the most varied sub-sector in healthcare services today on a country-by-country basis. In Finland, Poland and Romania it is the foundation for some of Europe’s largest for-profit operators and is the main way that people access the private sector. Elsewhere it is often small, little used and sometimes loss making - defined only by health and safety legislation. It succeeds where there is strong labour legislation and incentives to layer other services on top - and here we also find ripe lab conditions for testing innovation before products are brought to a consumer market. Even in countries where it is relatively small right now it is growing fast.
It’s a unique sector as it’s defined by its payor as much as its activity. Because of that complexity we’ve collected two different market sizes. The first is based on the core occupational healthcare services which are mandatory for employers to give employees in the country - the ‘activity market’. The second is the first plus all other voluntary spending by all employers and self-employed for health care services - the ‘payor’ market.  
The majority of countries only experience an ‘activity market’ because - and for a variety of reasons - there is little voluntary spending on top of the core mandatory activities forced on the employer. Differing legislation across each country also changes the activity but the most common services are preliminary medical assessments and periodical check-ups. 
Finland, Poland and Romania have large payor markets. Here employers often layer extra services for their employees on top of the mandatory “tray” that they have to provide.  
While the ‘payor market’ is written into the report, we cannot display it as part of the market size data in the top of each country entry because it will create significant overlap with market sizes that we have collected for other activity market reports here in the HBI Intelligence centre.
See the report for comparative market data on the occupational healthcare market, including ranking the corporate pay of large general healthcare payors.
Does occupational healthcare actually work?
The growth of the market depends quite significantly on providers being able to prove that it’s worth the costs. In such fragmented markets, large-scale quantitative data around the financial benefits of occupational healthcare is limited.  
Case studies provided by Stamina Health show that its contract with Norweigan municipality Tromsø kommune reduced sickness absence from 10.3% to 8.8% in 18 months and that an investment of €150k per year gave estimated savings of €1m. Terveystalo, which provides occupational healthcare for about 12% of the Finnish working population, has an even wider data set from its annual Cost of Inactivity report. It claims that in 2018, inactivity in Finland cost companies on average 6.13% of payroll, or €2,500 per person, and that employers spent 0.7% of their payroll on occupational healthcare, or about €450 per person. Over the past decade, as the sector has developed in Finland, that cost of occupational healthcare services has fallen by an average of 1.39% and €400 per person. 
System of Health Accounts 2011 methodology 
Our ‘activity market’ occupational healthcare definition aligns with that of the WHO’s System of Health Accounts (SHA 2011) - the unified methodology under which many official statistics offices define healthcare expenditure and activity - under HC.6.5. It says: “Occupational health care includes the surveillance of employee health (routine medical check-ups) and therapeutic care (including emergency health care services) on or off business premises.”
The ‘payor market’ falls within Enterprise financing schemes (HF.2.3) which is “arrangements where enterprises directly provide or finance health services for their employees without the involvement of an insurance-type scheme” plus HF2.1.1.1 Employer-based insurance, which is always voluntary.   
Market size and provider types
To this end, HBI estimates that the activity market is worth around €8.5bn across the markets covered. 
We have found that there are four main business models for occupational healthcare, which we can use to categorise national markets. These are: a) pureplay/specialist, b) general healthcare, c) reactive travelling/expat staff, and d) health and safety.  
General healthcare providers
This is where we have seen the emergence of the big names like Medicover, Terveystalo and Mehilainen over the past decade. We say they are general healthcare providers because they also have individual pay segments and deliver healthcare services above and beyond that which is mandatory. However, these groups position themselves as occupational healthcare providers because over half their revenue comes from employers. Where these groups exist, the main way that people access the for-profit sector is through their employer. 
Growth is strong. Medicover’s privately funded healthcare services grew 22% (total growth 15.8%) in 2018 as it says that “a favourable employment market with continued good economic development are driving member and revenue growth.” Terveystalo’s corporate growth was 8.2% (total growth 8%) and Mehilainen as a whole grew 21.2% but doesn’t break down its streams. Its 2018 annual report does say that the number of employer customers grew for the fourth consecutive year. 
Innovation is also key to retaining customers in highly competitive markets: Medicover claims an astounding 98% retention rate. 
See the report for full details on this category and others, including data.
Opportunities
The wider payor market - rather than just the activity market - is where the biggest opportunities are. 
The healthcare services that employers most often seek in the payor market, according to operators, are basic primary care, access to specialist outpatient sectors and diagnostics. In Western markets, there is a small payor market focused around psychiatry/psychoanalysis and digital health. While telehealth is still a small market, occupational healthcare is one of its largest and most promising payors (see our HBI Intelligence telehealth report). Dentistry is of surprisingly little importance with one pan-Nordic operator calling it a fringe benefit and it not being reimbursable under the Finnish social security model. 
See the report for full details on opportunities in the occupational healthcare sector.
Challenges
By its very nature occupational healthcare is pegged to the economy, falling employment levels naturally leads to a smaller market. Analysts are predicting an economic slowdown across CEE but particularly in Poland as the country reaches historically low unemployment levels. More competition for staff leads to bigger healthcare packages to attract and retain. Its economic growth is forecast to decelerate to 3.6% in 2020 and 3.3% in 2021, according to the World Bank. Germany has also narrowly avoided a recession and of course Brexit looms. Employee-benefits are one of the first things to go when a company gets into trouble and that doesn’t fare well for the payor market.  
See the report for full details on challenges in the occupational healthcare sector.
 
Sample report pages and data
 
What we offer
 
-       Instant overview of the EMEA occupational healthcare market and players This report gives you visibility of this important, fast-growing market across 21 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 occupational healthcare services throughout the period.
 
-       Insights on business models The report is based on in-depth interviews with many operators. The report also looks at how occupational healthcare services 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
                                    - Occupational health payor market data table
                                    - Ranking the corporate pay of large general healthcare providers data table
                                     
Does occupational healthcare actually work?
 
Systems of health Accounts 2011 methodology
 
Market size and provider types
 
                                    - Pure-play/specialist
            - General healthcare providers
            - Reactive travelling/expat staff
            - Health & Safety specialists
 
Opportunities
 
Challenges
 
Austria
 
Data sets
For-profit /private market size and growth rates 2016-2020
Marketshare of major players 2018
 
Market description and trends.
 
Belgium
 
Data sets
For-profit /private market size and growth rates 2016-2020
Marketshare of major players 2018
 
Market description and trends.
 
Bulgaria
 
Data sets
For-profit /private market size and growth rates 2016-2020
Marketshare of major players 2018
 
Market description and trends.
 
Croatia
 
Data sets
For-profit /private market size and growth rates 2016-2020
 
Market description and trends.
 
Czech Republic
 
Data sets
For-profit /private market size and growth rates 2016-2020
Marketshare of major players 2018
 
Market description and trends.
 
Denmark
 
Market description and trends.
 
Finland
 
Data sets
For-profit /private market size and growth rates 2016-2020
Marketshare of major players 2018
 
Market description and trends.
 
France
 
Data sets
For-profit /private market size and growth rates 2016-2020
 
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.
 
Hungary
 
Data sets
For-profit /private market size and growth rates 2016-2020
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.
 
Norway
 
Data sets
For-profit /private market size and growth rates 2016-2020
Marketshare of major players 2018
 
Market description and trends.
 
Poland
 
Data sets
For-profit /private market size and growth rates 2016-2020
Marketshare of major players 2018
 
Market description and trends.
 
Portugal
 
Data sets
For-profit /private market size and growth rates 2016-2020
 
Market description and trends.
 
Romania
 
Data sets
For-profit /private market size and growth rates 2016-2020
 
Market description and trends.
 
Russia
 
Data sets
For-profit /private market size and growth rates 2016-2020
 
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
For-profit /private market size and growth rates 2016-2020
Marketshare of major players 2018
 
Market description and trends.
 
Ukraine
 
Data sets
For-profit /private market size and growth rates 2016-2020
 
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.
 

Occupational Healthcare News & Interviews

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

120 news stories on Occupational Healthcare.

COVID widens fault line between outsourcing and private pay in Hungary 2mo ago

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 ...

Interview: Daniel Soukup, head of EUC Virtual Clinic 3mo ago

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 be...

Terveystalo creates COVID-19 plans for employers but corporate pay flat 5mo ago

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: The double whammy – who will be left standing? 6mo ago

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, ...

Exclusive prediction: Pandemic reaching turning point in Europe? 6mo 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....

Competition watchdog takes deeper look into Mehilainen-Pihlajalinna merger 6mo ago

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....

Employer-pay growth loses to individual at big occupational healthcare groups 7mo ago

Occupational healthcare groups Medicover and Terveystalo are growing revenue at upwards of 25%, much faster than the 6-9% seen in other publicly listed groups so far this year. Historically employer-funded, individual pay is now growing three times faster than...

Canadian telehealth player buys German occupational healthcare group 8mo ago

The Canadian partner to Fresenius Helios' telemedicine joint venture has acquired an occupational healthcare company in Germany....

Mid Europa pulls Regina Maria sale 9mo ago

PE firm Mid Europa has pulled the sale of its Romanian healthcare provider Regina Maria, but may re-launch it in the second half of 2021....

Database of 70 Occupational Healthcare 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 70 Occupational Healthcare 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 occupational healthcare, with presentations and a facilitated discussion with three CEOs. They will discuss wider opportunities beyond core countries and the impact of digital health on the sector.
 
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.