NPM Capital

Jointly largest provider of insured healthcare via focus clinics

NPM Capital as an investment company is clearly committed to Healthcare, with current investments in various focus clinics of NL Healthcare, the Arts en Zorg health centres (combining GPs, physiotherapists, pharmacists and psychological healthcare providers) and psychological and psychiatric care providers (Mentaal Beter).

On 26 September 2017, NPM Capital announced jointly with the Malenstein family that their respective interests in NL Healthcare (which include the clinics Oogziekenhuis Zonnestraal, Orthopedium, Medinova, Dermicis and Nedspine) and Bergman Clinics would be merged. Via their focus clinics, they will jointly be the largest provider of medical specialist care in the Netherlands following the merger.

By joining forces, both parties are responding to the need for upscaling and specialisation in the medical specialist healthcare sector. Their aim is to deliver high-quality, patient-focused treatments at competitive prices throughout the Netherlands. The merged chains of clinics will jointly become the country’s largest provider of treatments included in healthcare insurances in the fields of hip, knee, shoulder, foot/ankle, back and eye disorders and plastic surgery. They also provide specialist treatments in the field of skin, gastro-intestinal and pelvic floor disorders (for women). The new group comprises more than forty specialised clinics throughout the Netherlands. Joint revenue amounts to some EUR 220 million, and the organisation will have around 1,500 employees following the merger. The group expects to be able to create new employment opportunities in the years ahead by expanding existing clinics and opening new ones.

Investment and greater focus
The increase in scale will enable medical teams within the merged clinics to focus their attention even more closely on their specialisation. The combination also provides greater scope for investing in technological innovation, digitalisation and training. Planning efficiency for treatments will also be increased due to the nation-wide coverage, leading to better utilisation of the available treatment facilities in the clinics. This offers opportunities to deliver customised high-quality medical care at lower costs.
The merger is taking place against a background in which people in the Netherlands are making increasingly informed choices in all areas of their lives, including the medical field. For both patients and healthcare insurers, the demonstrable quality of treatments, costs and the service they are offered are increasingly important. Focus clinics are able to offer high quality at competitive prices, which they successfully combine with a customer-focused approach in which service and patient experience are among the key factors.

“Specialisation and focus are important principles for improving treatment outcomes and service,” says Bart Malenstein, CEO of Bergman Clinics. “To achieve those aims effectively requires an organisation to have a certain size and the volume of disorders presented to increase significantly. That creates greater potential for giving medical specialists room to specialise even further and for stepping up investments to improve the medical services they deliver”.

Photo: Bart Malenstein

Close cooperation with hospitals
After the merger, the new organisation will continue to seek partnerships with traditional hospitals in order to work jointly on improved indication setting and uniformity for treatments.
The merger will lead to a more mature offering by focus clinics that complements the transition that these traditional hospitals are undertaking to define clear treatment profiles in order to maintain the high quality of their medical care at affordable costs. Malenstein: “For that reason, we expect that they will be open to complementary alliances with specialised healthcare providers such as our clinics. This will enable hospitals to maximise their focus on patients’ disorders, leading to better diagnosis and treatment of patients as well as lower healthcare costs for society in general.”

Frank Arnoldy, CEO of NL Healthcare Clinics, points to another consequence of the merger: “The focus clinics of Bergman Clinics and NL Healthcare Clinics are able to provide high quality at competitive prices. That is important in a sector in which people are increasingly taking control of their own affairs, including insured healthcare. We successfully combine this high price/quality ratio with a customer-focused approach, in which service and patient experience are key factors. Entering into this merger enables us to continually improve the way in which we deliver that combination and means we have even more to offer our patients and staff.”

Photo: Frank Arnoldy

Better diagnoses
The new organisation will devote special attention to innovations that utilise data analysis to ensure that better and more transparent diagnoses are provided. This leads to better and more objective indication setting, contributing to more effective treatments. The upscaling also offers opportunities to treat disorders in a uniform manner, according to clearly described methods and guidelines throughout the Netherlands. “Overall, this creates better outcomes for patients,” concludes Arnoldy.

New management
Following a transition period, the new organisation will be led by a new CEO. The current CEOs of Bergman Clinics and NL Healthcare Clinics will step down when the new CEO is appointed. The CEO of Bergman Clinics, Bart Malenstein, will continue for some time as a director after the transition phase. The Malenstein family, which at present is a major shareholder of Bergman Clinics, will remain a shareholder in the new company after the merger, as will NL Healthcare Clinics shareholder NPM Capital, part of family-owned multinational SHV.

Rutger Ruigrok, managing director of NPM comments: “We know that it takes time to achieve change in the healthcare sector. Our flexible investment horizon and conservative financing of our portfolio companies provides a good match not just for the healthcare sector but also for the Malenstein family’s investment philosophy. These are important foundations for achieving further sustainable growth for our clinics.”

After completion of the transaction, teams from both organisations will work on developing in further detail the merger plans drawn up in outline as part of the negotiations. In doing so, they will also identify potential synergies, particularly at the central support departments.

Required approvals and timeline
The merger will take place subject to approval by the relevant authorities. The works councils of both businesses will also have to consider the requests for advice that will be submitted by the management of the companies concerned. The parties expect to be able to complete the merger before the end of this year.

About Bergman Clinics
Bergman Clinics has been one of the leading independent chains of focus clinics for more than 25 years, with more than 25 locations throughout the Netherlands.

The focus clinics engage in delivering high-quality plannable medical care, centred on the customer and the disorder. Owing to their focus on frequently occurring treatments, a great deal of knowledge and expertise has been built up. Today, Bergman Clinics is one of the most highly experienced institutions in the Netherlands for a range of frequently occurring treatments.

The five categories in which Bergman Clinics offers insured or uninsured care are: Movement care, Eye care, Women’s care, Internal care and Appearance and Skin care.

Bergman Clinics has contracts with all healthcare insurers. The majority of treatments qualify as insured healthcare (70%), which is reimbursed from the basic insurance package. Bergman Clinics receives more than 80,000 customers a year. The average customer rating for Bergman Clinics on zorgkaartnederland.nl is 8.7.

About NL Healthcare Clinics
NL Healthcare Clinics provides high-quality secondary healthcare which it delivers through a focused approach for each specialisation.

The organisation has around 500 employees and 18 clinics throughout the Netherlands with various labels for orthopaedic care (Medinova, Orthopedium and NedSpine), ophthalmology (Ooghospital Zonnestraal) and dermatology (Dermicis). The average customer rating on zorgkaartnederland.nl is 8.8.

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