Planned acquisition of TSN by health care group Espria: further investigation needed into district nursing services


Health care group Espria wishes to acquire health care provider TSN Thuiszorg. In July, they notified the Netherlands Authority for Consumers and Markets (ACM) of their acquisition plans. Both health care providers offer vulnerable individuals health care services, such as district nursing services, nursing home care, and primary-care hospital stays (for example, after hospital treatments). Espria is active in the northern and central regions of the Netherlands. TSN is mostly active in the northern province of Groningen. After assessing their application, ACM has concluded that further investigation is needed into the acquisition’s consequences for district nursing services. ACM does not see any problems for nursing home care and primary-care hospital stays.

After the initial investigation, ACM has come to the provisional conclusion that both Espria and TSN are large competitors in district nursing services, especially in the south-eastern part of Groningen. Other, smaller health care providers are active, but they do not always seem to be able to offer an alternative. Market entry by new health care providers in the area also does not seem easy. This means that the acquisition may have consequences for the price and quality of the services in this region, as well as for the room for service innovation. Therefore, ACM wishes to conduct a more thorough investigation, and it imposes a license requirement on this acquisition. 

What are the next steps in the investigation?

If these health care providers decide to apply for a license, ACM will further investigate the consequences of this acquisition. One of the things ACM will do in the follow-up investigation is to ask further questions to representatives of patients, health insurers, and other health care providers about the possible consequences of this acquisition.