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Barriers to payment reform: Experiences from nine Dutch population health management sites

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  • de Vries, Eline F.
  • Drewes, Hanneke W.
  • Struijs, Jeroen N.
  • Heijink, Richard
  • Baan, Caroline A.

Abstract

Population health management (PHM) initiatives aim for better population health, quality of care and reduction of expenditure growth by integrating and optimizing services across domains. Reforms shifting payment of providers from traditional fee-for-service towards value-based payment models may support PHM. We aimed to gain insight into payment reform in nine Dutch PHM sites. Specifically, we investigated 1) the type of payment models implemented, and 2) the experienced barriers towards payment reform. Between October 2016 and February 2017, we conducted 36 (semi-)structured interviews with program managers, hospitals, insurers and primary care representatives of the sites. We addressed the structure of payment models and barriers to payment reform in general. After three years of PHM, we found that four shared savings models for pharmaceutical care and five extensions of existing (bundled) payment models adding providers into the model were implemented. Interviewees stated that reluctance to shift financial accountability to providers was partly due to information asymmetry, a lack of trust and conflicting incentives between providers and insurers, and last but not least a lack of a sense of urgency. Small steps to payment reform have been taken in the Dutch PHM sites, which is in line with other international PHM initiatives. While acknowledging the autonomy of PHM sites, governmental stewardship (e.g. long-term vision, supporting knowledge development) can further stimulate value-based payment reforms.

Suggested Citation

  • de Vries, Eline F. & Drewes, Hanneke W. & Struijs, Jeroen N. & Heijink, Richard & Baan, Caroline A., 2019. "Barriers to payment reform: Experiences from nine Dutch population health management sites," Health Policy, Elsevier, vol. 123(11), pages 1100-1107.
  • Handle: RePEc:eee:hepoli:v:123:y:2019:i:11:p:1100-1107
    DOI: 10.1016/j.healthpol.2019.09.006
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    References listed on IDEAS

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    Cited by:

    1. Thomas Reindersma & Isabelle Fabbricotti & Kees Ahaus & Sandra Sülz, 2022. "Integrated Payment, Fragmented Realities? A Discourse Analysis of Integrated Payment in the Netherlands," IJERPH, MDPI, vol. 19(14), pages 1-14, July.
    2. 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.
    3. Scheefhals, Zoë T.M. & de Vries, Eline F. & Struijs, Jeroen N. & Numans, Mattijs E. & van Exel, Job, 2024. "Stakeholder perspectives on payment reform in maternity care in the Netherlands: A Q-methodology study," Social Science & Medicine, Elsevier, vol. 340(C).
    4. Małgorzata Gałązka-Sobotka & Aldona Frączkiewicz-Wronka & Iwona Kowalska-Bobko & Hanna Kelm & Karolina Szymaniec-Mlicka, 2021. "HB-HTA as an implementation problem in Polish health policy," PLOS ONE, Public Library of Science, vol. 16(9), pages 1-24, September.
    5. Tobias Romeyke & Elisabeth Noehammer & Harald Stummer, 2022. "Incentives for Combining Structure and Process Quality to Improve Outcome in Rheumatic Treatment," SAGE Open, , vol. 12(3), pages 21582440221, September.
    6. 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.
    7. van Vooren, N.J.E & Steenkamer, B.M. & Baan, C.A. & Drewes, H.W., 2020. "Transforming towards sustainable health and wellbeing systems: Eight guiding principles based on the experiences of nine Dutch Population Health Management initiatives," Health Policy, Elsevier, vol. 124(1), pages 37-43.
    8. Lips, S.R. & Molenaar, J.M. & Schuitmaker-Warnaar, T.J., 2020. "Transforming maternity care: obstetric partnerships as a policy instrument for integration," Health Policy, Elsevier, vol. 124(11), pages 1245-1253.

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