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The 2015 long-term care reform in the Netherlands: Getting the financial incentives right?

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  • Alders, Peter
  • Schut, Frederik T.

Abstract

In 2015 the system of long-term care (LTC) financing and provision in the Netherlands was profoundly reformed. The benefits covered by the former comprehensive public LTC insurance scheme were split up and allocated to three different financing regimes. The objectives of the reform were to improve the coordination between LTC, medical care and social care, and to reinforce incentives for an efficient provision of care by making risk-bearing health insurers and municipalities responsible for procurement. Unintentionally, the reform also created a number of major incentive problems, however, resulting from the way: (i) LTC benefits were split up across the three financing regimes; (ii) the various third party purchasers were compensated; and (iii) co-payments for the beneficiaries were designed. These incentive problems may result in cost shifting, lack of coordination between various LTC providers, inefficient use of LTC services and quality skimping. We discuss several options to get the financial incentives better aligned with the objectives of the reform.

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  • Alders, Peter & Schut, Frederik T., 2019. "The 2015 long-term care reform in the Netherlands: Getting the financial incentives right?," Health Policy, Elsevier, vol. 123(3), pages 312-316.
    • Handle: RePEc:eee:hepoli:v:123:y:2019:i:3:p:312-316
    DOI: 10.1016/j.healthpol.2018.10.010
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    References listed on IDEAS

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    1. Alders, Peter & Schut, Frederik T., 2019. "Trends in ageing and ageing-in-place and the future market for institutional care: scenarios and policy implications," Health Economics, Policy and Law, Cambridge University Press, vol. 14(1), pages 82-100, January.
    2. Maarse, J.A.M. (Hans) & Jeurissen, P.P. (Patrick), 2016. "The policy and politics of the 2015 long-term care reform in the Netherlands," Health Policy, Elsevier, vol. 120(3), pages 241-245.
    3. Kraus, Markus & Riedel, Monika & Mot, Esther & Willemé, Peter & Röhrling, Gerald & Czypionka, Thomas, 2010. "A Typology of Long-term Care Systems in Europe," MPRA Paper 105160, University Library of Munich, Germany.
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    4. Kotschy, Rainer & Bloom, David, 2022. "A Comparative Perspective on Long-Term Care Systems," CEPR Discussion Papers 17213, C.E.P.R. Discussion Papers.
    5. Maud H. Korte & Gertjan S. Verhoeven & Arianne M. J. Elissen & Silke F. Metzelthin & Dirk Ruwaard & Misja C. Mikkers, 2020. "Using machine learning to assess the predictive potential of standardized nursing data for home healthcare case-mix classification," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(8), pages 1121-1129, November.
    6. de Vries, Hein & Vahl, Jos & Muris, Jean & Evers, Silvia & van der Horst, Henriëtte & Cheung, Kei Long, 2021. "Effects of the reform of the Dutch healthcare into managed competition: Results of a Delphi study among experts," Health Policy, Elsevier, vol. 125(1), pages 27-33.
    7. Portrait, France & Krabbe-Alkemade, Yvonne & Budding, Tjerk & Canoy, Marcel, 2023. "Passing on the hot potato. Dutch municipalities under financial pressure have incentives to shift the costs of social care for older people to the central government," Health Policy, Elsevier, vol. 137(C).
    8. Alders, Peter & Schut, Frederik T., 2022. "Strategic cost-shifting in long-term care. Evidence from the Netherlands," Health Policy, Elsevier, vol. 126(1), pages 43-48.

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