Privately run public hospitals in Spain face shifting fortunes after concessions
In Torrevieja, a privately managed public hospital reported revenue approaching 128 million euros and delivered around 6 million euros in profits in its final year before handing operations back to the regional Ministry of Health. The numbers show a downturn from the year prior, partly because the takeover closed two and a half months after the year ended, on October 15.
These figures reflect the 2021 results filed by Torrevieja Health SL on behalf of the broader UTE responsible for the concession. While Ribera Salud remains the primary operator, regional management has been organized as a temporary association of companies. Ownership has shifted: the parent group previously held majority control at 65%, now transferred to the chief holding company Primero Salud, with 35% held by the other member. That subsidiary maintains separate accounts, offering a snapshot of activity as an entity within the concession framework.
For the previous year, Torrevieja Salud SL posted revenue of 44.6 million euros, a decline of about 14.5% caused by the shorter billing period. On its own, profits fell roughly 40%, reaching around 2 million euros. Since this entity has no other business lines, these results can be read as essentially representing the UTE’s overall activity—yielding approximately 128 million euros in revenue and about 6 million euros in advantages.
The discontinuation of the special management arrangement for the Torrevieja health zone came after the 15-year term outlined in the concession agreement expired. The regional government declined to extend the contract as the French operator Vivalto Santé expressed interest in taking over the next concession, including the one at Alzira Hospital in Valencia, signaling a shift in the public-private partnership landscape.
With the concession expired, Torrevieja Salud’s activities were no longer tied to the previous mechanism for asset and liability handling. Settlements remain to be agreed with the Generalitat, and the existing system, which pays monthly advances based on population and attendance metrics, sometimes covers patients from other nearby health areas or residents who require care at different hospitals. The fixed per-capita payments are settled later, often after a delay of years, with updates tied to factors such as regional health expenditure, state funding, and consumer price indices.
Closing the 2010-2012 liquidations and updating capital projections brought another advantage for the group: the leadership at Vinalopó Health noted strong revenues and profits in 2021. Specifically, Elche-Crevillente Salud SA reported last year a balance of 171.8 million euros, up from 129.7 million in 2020, with profits rising by about 12.3 million euros, nearly tripling the prior year’s figure.
French group Vivalto Santé acquires privately managed hospitals in Elche and Denia
Within this context, the company plays a partial role in driving the observed earnings gains. Public concession accounting requires providers to advance a portion of expected profits to cover taxes, a method originally designed for large-scale infrastructure projects such as toll roads. This approach often yields modest early returns but substantial end-of-term depreciation benefits, helping explain some of the updated financial parameters observed in recent years.
In the dedicated healthcare domain, Elche-Crevillente Salud supplied health insurance to about 151,000 people in the region last year. The operation handled roughly 79,000 emergency visits, processed 12,281 hospital discharges, and carried out nearly 10,000 surgeries, among other services. These metrics illustrate the scale of service delivery under the concession model and the impact of ownership changes on patient access and care provision.
Citations: These figures reflect public accounting disclosures and the ongoing realignment of hospital concessions within the regional health system. For context, analysts note that the shift toward Vivalto Santé ownership marks a broader evolution in the governance of private providers delivering public services across Spain, with attention to how capital structure, tax timing, and regional budgets shape outcomes.