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 23 countries and information on a further 100 (HBI Intelligence)
Database of 100 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 2024)
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Sector ReportOccupational 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.
The three founders of Asia-Pacific occupational health care provider Fullerton Healthcare have been charged for paying bribes to the (now former) CEO of insurance and professional services firm Aon Singapore. A regional source tells us this is an example of th...
HBI attended the Global Health Exhibition in Riyadh, Saudi Arabia, and saw first-hand how the country is changing ahead of its 2030 transformation plan. Here are our three key takeaways from the event....
Portugal’s competition authority has given the greenlight to CUF, the country’s largest hospital group, to acquire occupational health provider AtlantiCare....
Insurers are making fundamental changes to health care delivery. A lively discussion at HBI 2023 explored the changing relationship between private medical insurance, the providers who are delivering new models, and the rise of employee paid insurance....
Regulatory changes are one of the major concerns among players in healthcare services. A busy panel of lawyers, operators and investors considered this thorny issue at HBI 2023, with a general feeling that even the strictest of regulations can provide some kin...
On first glance the Q1 reports for Finnish groups Pihlajalinna and Terveystalo present a mixed look at the state of the for-profit market in Finland – but this couldn’t be further from the truth....
Medigold, one of the UK’s largest occupational health care providers, is acquiring Health Management, a major competitor, in a deal that will make it the UK's largest provider of occupational health in terms of number of employees covered....
Elderly care group Attendo and outpatient group Terveystalo, two pan-Nordic giants with over a billion in revenue, struggled to turn a profit in 2022. This was despite strong (organic) revenue growth, set against a backdrop of rising inflation. HBI looks at th...
Database of 100 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 100 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 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. 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.
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