Managing Director
Tomoyuki Nakajima
MBA / CFA / CMA
(’21~)
✓ Joined Nihon PMI Partners Inc.
(‘00~’21 at Nomura Asset Management Co., Ltd.)
✓ Engaged in Planning and marketing of financial products.
✓ Invested in Japanese stocks with ¥10-300 billion discretionary account for
overseas government funds, corporate pension funds , based on research for more
than 800 major Japanese companies, evaluation for their long-term business
strategies.
✓ Engaged in management & M&A strategies.
Q1. Why do you focus specifically on three areas within Japanese healthcare—home-based care, healthcare ICT, and fertility treatment? What “structural investment opportunities” do you see in these segments?
A. The common challenge across these three areas is productivity. Healthcare is a labor-intensive sector, and demand is expanding rapidly due to policy shifts toward home-based care and the extension of public insurance coverage to fertility treatments. However, labor supply has not kept pace with this growing demand.
While productivity improvement is essential to close this widening supply-demand gap, initiatives to address it remain insufficient. This gap is precisely why we launched Japan’s first healthcare-focused private equity fund. These three areas are also national policy priorities, and we aim to lead transformational change among operators in these strategically important segments.
Q2. Where do you see the key leverage points in healthcare investing?
A. The most critical leverage point is a shift in management mindset. Healthcare organizations are staffed by highly specialized professionals who are deeply committed to service quality and patient care. However, they are often less effective in non-clinical areas such as documentation, marketing, or strategic planning for regional healthcare needs.
When management performance deteriorates, investment in people and infrastructure inevitably suffers. By improving management capabilities, increasing profitability, and achieving scale, operators can reinvest in talent and ICT systems—creating a virtuous cycle that leads to better workplaces and higher-quality care.
Q3. What KPIs do you prioritize in post-merger integration (PMI)?
A. The number of patients served per employee. In healthcare, reimbursement levels are largely fixed per patient due to the fee-for-service framework. Therefore, our PMI initiatives focus on exceeding industry averages in patients-per-employee metrics.
We enhance service quality through employee training, improve working conditions, and extend employee tenure—all of which contribute to higher productivity per staff member.
Q4. What are the common characteristics of cases where productivity improvement initiatives fail?
A. A lack of understanding of frontline operations. Successful DX implementation requires experts who understand both on-the-ground healthcare workflows and IT literacy. This is precisely where our team, as a group of healthcare specialists, can add significant value.
Q5. What do you emphasize as healthcare-specific value creation?
A. Empowering frontline teams. We help professionals who understand clinical operations acquire management skills, transforming organizations into ones that improve performance through bottom-up initiatives.
Through PMI subcommittees, we actively involve younger staff and build systems to develop talent within our portfolio companies. We believe it is critical to move away from rigid top-down cultures and toward organizations where frontline teams continuously improve KPIs—such as cost awareness in care delivery, organizational capabilities, and value creation for patients.
Q6. What changes in the market environment should LPs pay particular attention to?
A. One key area is reimbursement for home-based care. For example, the reduction in reimbursement for certain home-care services in the 2024 revision has raised concerns among LPs. However, this does not imply an overall decline in home-care reimbursement.
Japan’s transition from hospital-centered care to community-based integrated care is a core national policy. Demand for home-based services continues to grow, while labor shortages persist. As a result, aggregate reimbursement levels for home-care services have increased steadily over the past decade.
Looking ahead to the 2026 revision, a major theme is the shift from “asset-based” to “people-based” reimbursement. Past revisions have consistently de-emphasized facilities and equipment while increasing compensation for human-centered care, such as home visits, visiting nursing services, multidisciplinary collaboration, and care for high-acuity patients. This direction aligns with hospital bed reallocation, healthcare cost containment, and the policy goal of enabling elderly individuals to continue living in their communities.
Given this clear long-term policy trajectory—from assets to people, and from facilities to home-based care—we expect policy support for home healthcare and related services to strengthen further in the 2026 revision.
In addition, fertility treatment has become increasingly mainstream since its inclusion in public insurance coverage in 2022. Today, one in nine children born in Japan is conceived through fertility treatment. However, there remains a significant shortage of skilled professionals such as embryologists, as well as pharmaceuticals and other resources. This imbalance underscores the need for timely investment and hands-on management support.
Q7. Finally, how would you summarize “why Japanese healthcare private equity, and why now,” in one sentence?
A. An investment opportunity at the frontier of the most critical challenge facing advanced economies.
Unlocking the Silver Alpha: From Fragmentation to Institutional Excellence.