Updates
Dec18

Update 18 December 2017

I am back from a fantastic time in Sri Lanka. Definitely a place that is worth visiting.

Welcome to the newest update on private healthcare in the Netherlands. This will be the last update for 2018, but I will be back again in January. In this update we cover:

  • NPM Capital lets chain specializing in complex pain treatment go bankrupt after fraudulent declarations to insurance companies. Is fraud an overlooked risk in investing in the healthcare sector?
  • OECD report shows interesting comparisons between Dutch healthcare and healthcare in other countries. Is long-term care the most interesting sector in the Netherlands?
  • In our snapshot we give an overview of SAOW (Samen Aangenaam Ouder Worden), an organization that has ambitious growth targets in the elderly care sector

Top Care, specializing in complex pain treatment is bankrupt after claims by insurance companies that it has overcharged

Top Care was established in 2000 by two physiotherapists who believed that pain treatment could best be provided through a combination of physical and psychological treatments. By 2009 the company had six locations. In 2012 Medux, a holding company owned by NPM Capital, bought a 65% share in Top-Care and affiliated companies. In 2015 Top-Care had revenues of €18 million and made a profit of €3.4 million.

Problems for Top Care started with a television program that claimed that the company structurally overdeclared the treatments it carried out. This lead to a separate study by VGZ (the insurance company with the largest payments to Top Care) that showed many irregular declarations. Based on this, payments to Top Care were stopped, and the company was forced into bankruptcy.

According to the bankruptcy trustee NPM Capital and Medux were not interested in providing any further financing, and a spokesman for NPM Capital has only said that NPM Capital and Medux were not involved in the process.

OECD comparison of key healthcare indicators in member countries highlights interesting aspects of Dutch healthcare

The OECD has recently published its comparison of key healthcare indicators across member countries (Healthcare at a Glance 2017). This report highlights several interesting comparisons between the Netherlands and other member countries:

  • The Netherlands has a relatively high spend on healthcare. Annual spend per head of population in the Netherlands is $5.395. This is low compared to the US ($9.800) but higher than the OECD average ($4.000) and comparable to the spend in countries such as Sweden ($5.488) and Belgium ($4.840)
  • As a share of BNP, the Netherlands is in eight place with a share of 10.5%. This is compared to an average of 9% across all member countries
  • The most interesting difference between the Netherlands and other countries is that Dutch healthcare is very heavily skewed towards long-term care. 25% of healthcare expenditure in the Netherlands goes to long-term care compared to an average of 14% across all OECD countries

Snapshot of a Dutch private sector healthcare operator: SAOW

SAOW (Samen Aangenaam Ouder Worden – Getting Old Together with Pleasure) is a young organization with ambitious growth plans. SAOW currently has four locations with a total of 197 apartments. The current locations are a mixture of own developments, locations acquired from other providers of elderly care, and joint ventures for redeveloping older elderly care locations previously owned by a traditional and local provider. The location that has been developed internally offers a mixture of apartments that can be purchased and rental apartments. Healthcare and other services are provided by a 100% daughter Ontzorgd Wonen.

On the company website SAOW claims to have five other locations in development. However, the situation around these locations appears to be very unclear. In some cases, the municipalities are not in agreement with the increase in housing for the elderly, in other cases the number of apartments suggested by the municipalities is much lower than the numbers quoted by SAOW.