Page 42 - THE ROMANIAN HEALTH CARE
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The     largest private hospitals in 2017 are:

                   1.     Regina Maria, turnover: 120.6m



                   2.     MedLife, turnover: 81.5m


                   3.     Sanador, turnover: 62.2m


                   4.     OncoFort / Gral Medical, turnover: 23.0m



















               In     Annex G are listed the 10 largest private hospitals. The combined turnover of these 10 was
               337m     euro in 2017. The private hospitals vary a lot in size. The four listed above are by far the





















               largest,         a lot of private hospitals have a modest turnover between 5 and 2 million euro. The





















               large     hospitals are all active in 3 to 12 cities, the small ones only in one city. Apart from the


               private     hospitals, there are other commercial service providers such as clinics/medical centres















               or     laboratories. It is estimated that the total private healthcare services market is 1.7bn euro




                                              23


                     in size and grew by 12% in 2017 .





               Profitability         in the private hospital sector is at best meagre, many report losses in 2017. It is



















               not     uncommon that a hospital runs with losses for several years in a row. For example from











               the     top 5 largest hospitals: Regina Maria had for all legal entities combined a loss of 10m euro














                     in 2017, Polisano lost 7.6m, MedLife reported a small loss of 0.5m euro. Sanador presented a





















               profit     margin of 4% and OncoFort / Gral Medical 3.5%. Working conditions for nurses for
               example,     are less good in private hospitals compared to public hospitals, salaries are lower
















               and     shifts are longer. A study by ING 24     showed that salaries in public healthcare are 30%














               above     the national average (public and private sector included).












               At     the moment, the private hospital sector undergoes a restructuring and consolidation.










               Probably     due to the bad financial results of some hospitals. By the end of 2017 Regina Maria













               was     the largest private hospital. In 2015, investment firm Mid Europa Partners acquired 100%




               of     Regina Maria’s shares. In 2016 Regina Maria acquired the Ponderas Hospital 25         in Bucharest.













               Generally     Regina Maria is expanding rapidly by acquisitions and organic growth, it secured a









               European     Investment Bank loan of 15m euro. A new hospital will be opened in Cluj Napoca in















                                    26
               2018     worth 15m euro . Competitor MedLife is listed at the Bucharest Stock Exchange and
















               controlled           Romanian family. Also MedLife is growing organically and acquisition of
                          by a






                                                                                            27

               healthcare     companies, its most recent acquisition is Polisano hospital and clinics .











               5.7     Private medical clinics














               Private     clinics offer only ambulatory services and have no beds. The services included are
               usually     general practitioner consults, laboratory analysis various scans. They offer also










               23
                 https://www.romania-insider.com/private-healthcare-services-market-2017
               24
                 https://think.ing.com/snaps/romania-wage-growth-remains-strong-again
               25     http://www.mideuropa.com/media/news/2016/regina-maria-acquires-leading-hospital-in-bucharest
               26     https://seenews.com/news/romanias-regina-maria-to-open-15-mln-euro-hospital-in-cluj-583382
               27     https://www.romania-insider.com/medlife-buys-polisano-hospital-clinics
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