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Towards integrated care for chronic conditions: Dutch policy developments to overcome the (financial) barriers

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  • Tsiachristas, Apostolos
  • Hipple-Walters, Bethany
  • Lemmens, Karin M.M.
  • Nieboer, Anna P.
  • Rutten-van Mölken, Maureen P.M.H.

Abstract

Chronic non-communicable diseases are a major threat to population health and have a major economic impact on health care systems. Worldwide, integrated chronic care delivery systems have been developed to tackle this challenge. In the Netherlands, the recently introduced integrated payment system - the chain-DTC - is seen as the cornerstone of a policy stimulating the development of a well-functioning integrated chronic care system. The purpose of this paper is to describe the recent attempts in the Netherlands to stimulate the delivery of integrated chronic care, focusing specifically on the new integrated payment scheme and the barriers to introducing this scheme. We also highlight possible threats and identify necessary conditions to the success of the system. This paper is based on a combination of methods and sources including literature, government documents, personal communications and site visits to disease management programs (DMPs). The most important conditions for the success of the new payment system are: complete care protocols describing both general (e.g. smoking cessation, physical activity) and disease-specific chronic care modules, coverage of all components of a DMP by basic health care insurance, adequate information systems that facilitate communication between caregivers, explicit links between the quality and the price of a DMP, expansion of the amount of specialized care included in the chain-DTC, inclusion of a multi-morbidity factor in the risk equalization formula of insurers, and thorough economic evaluation of DMPs.

Suggested Citation

  • Tsiachristas, Apostolos & Hipple-Walters, Bethany & Lemmens, Karin M.M. & Nieboer, Anna P. & Rutten-van Mölken, Maureen P.M.H., 2011. "Towards integrated care for chronic conditions: Dutch policy developments to overcome the (financial) barriers," Health Policy, Elsevier, vol. 101(2), pages 122-132, July.
    • Handle: RePEc:eee:hepoli:v:101:y:2011:i:2:p:122-132
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    1. Karimi, Milad & Tsiachristas, Apostolos & Looman, Willemijn & Stokes, Jonathan & Galen, Mirte van & Rutten-van Mölken, Maureen, 2021. "Bundled payments for chronic diseases increased health care expenditure in the Netherlands, especially for multimorbid patients," Health Policy, Elsevier, vol. 125(6), pages 751-759.
    2. Leijten, Fenna R.M. & Struckmann, Verena & van Ginneken, Ewout & Czypionka, Thomas & Kraus, Markus & Reiss, Miriam & Tsiachristas, Apostolos & Boland, Melinde & de Bont, Antoinette & Bal, Roland & Bus, 2018. "The SELFIE framework for integrated care for multi-morbidity: Development and description," Health Policy, Elsevier, vol. 122(1), pages 12-22.
    3. Islam, M. Kamrul & Kjerstad, Egil, 2017. "Is incentivizing by subsidizing a better way of managing chronic health conditions?," Working Papers in Economics 12/17, University of Bergen, Department of Economics.
    4. Stokes, Jonathan & Struckmann, Verena & Kristensen, Søren Rud & Fuchs, Sabine & van Ginneken, Ewout & Tsiachristas, Apostolos & Rutten van Mölken, Maureen & Sutton, Matt, 2018. "Towards incentivising integration: A typology of payments for integrated care," Health Policy, Elsevier, vol. 122(9), pages 963-969.
    5. Paulus, Dominique & Van den Heede, Koen & Gerkens, Sophie & Desomer, Anja & Mertens, Raf, 2013. "Development of a national position paper for chronic care: Example of Belgium," Health Policy, Elsevier, vol. 111(2), pages 105-109.
    6. Tsiachristas, Apostolos & Dikkers, Carolien & Boland, Melinde R.S. & Rutten-van Mölken, Maureen P.M.H., 2013. "Exploring payment schemes used to promote integrated chronic care in Europe," Health Policy, Elsevier, vol. 113(3), pages 296-304.
    7. Sterre S. Bour & Lena H. A. Raaijmakers & Erik W. M. A. Bischoff & Lucas M. A. Goossens & Maureen P. M. H. Rutten-van Mölken, 2023. "How Can a Bundled Payment Model Incentivize the Transition from Single-Disease Management to Person-Centred and Integrated Care for Chronic Diseases in the Netherlands?," IJERPH, MDPI, vol. 20(5), pages 1-20, February.
    8. Tsiachristas, Apostolos & Dikkers, Carolien & Boland, Melinde R.S. & Rutten-van Mölken, Maureen P.M.H., 2016. "Impact of financial agreements in European chronic care on health care expenditure growth," Health Policy, Elsevier, vol. 120(4), pages 420-430.

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