IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v19y2022i14p8831-d867523.html
   My bibliography  Save this article

Integrated Payment, Fragmented Realities? A Discourse Analysis of Integrated Payment in the Netherlands

Author

Listed:
  • Thomas Reindersma

    (Department of Health Services Management & Organisation, Erasmus School of Health Policy & Management, Erasmus University, Burgemeester Oudlaan 50, 3062 PA Rotterdam, The Netherlands)

  • Isabelle Fabbricotti

    (Department of Health Services Management & Organisation, Erasmus School of Health Policy & Management, Erasmus University, Burgemeester Oudlaan 50, 3062 PA Rotterdam, The Netherlands)

  • Kees Ahaus

    (Department of Health Services Management & Organisation, Erasmus School of Health Policy & Management, Erasmus University, Burgemeester Oudlaan 50, 3062 PA Rotterdam, The Netherlands)

  • Sandra Sülz

    (Department of Health Services Management & Organisation, Erasmus School of Health Policy & Management, Erasmus University, Burgemeester Oudlaan 50, 3062 PA Rotterdam, The Netherlands)

Abstract

The current models used for paying for health and social care are considered a major barrier to integrated care. Despite the implementation of integrated payment schemes proving difficult, such initiatives are still widely pursued. In the Netherlands, this development has led to a payment architecture combining traditional and integrated payment models. To gain insight into the justification for and future viability of integrated payment, this paper’s purpose is to explain the current duality by identifying discourses on integrated payment models, determining which discourses predominate, and how they have changed over time and differ among key stakeholders in healthcare. The discourse analysis revealed four discourses, each with its own underlying assumptions and values regarding integrated payment. First, the Quality-of-Care discourse sees integrated payment as instrumental in improving care. Second, the Affordability discourse emphasizes how integrated payment can contribute to the financial sustainability of the healthcare system. Third, the Bureaucratization discourse highlights the administrative burden associated with integrated payment models. Fourth, the Strategic discourse stresses micropolitical and professional issues that come into play when implementing such models. The future viability of integrated payment depends on how issues reflected in the Bureaucratization and Strategic discourses are addressed without losing sight of quality-of-care and affordability, two aspects attracting significant public interest in The Netherlands.

Suggested Citation

  • 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.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:14:p:8831-:d:867523
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/19/14/8831/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/19/14/8831/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Judith Green, 2004. "Book Review: Qualitative Methods and Health Policy Research," Sociological Research Online, , vol. 9(4), pages 108-109, November.
    2. Cattel, Daniëlle & Eijkenaar, Frank & Schut, Frederik T., 2020. "Value-based provider payment: towards a theoretically preferred design," Health Economics, Policy and Law, Cambridge University Press, vol. 15(1), pages 94-112, January.
    3. 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.
    4. Ian Wash, 2020. "Interpreting public policy dilemmas: discourse analytical insights," Palgrave Communications, Palgrave Macmillan, vol. 7(1), pages 1-12, December.
    5. Hussey, P. & Anderson, G. F., 2003. "A comparison of single- and multi-payer health insurance systems and options for reform," Health Policy, Elsevier, vol. 66(3), pages 215-228, December.
    6. 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.
    7. Baekgaard, Martin & Christensen, Julian & Dahlmann, Casper Mondrup & Mathiasen, Asbjørn & Petersen, Niels Bjørn Grund, 2019. "The Role of Evidence in Politics: Motivated Reasoning and Persuasion among Politicians," British Journal of Political Science, Cambridge University Press, vol. 49(3), pages 1117-1140, July.
    8. Ellen Nolte & Lena Woldmann, 2021. "Financing of and Reimbursement for Integrated Care," Springer Books, in: Volker Amelung & Viktoria Stein & Esther Suter & Nicholas Goodwin & Ellen Nolte & Ran Balicer (ed.), Handbook Integrated Care, edition 2, chapter 0, pages 341-364, Springer.
    9. 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.
    10. Klasa, Katarzyna & Greer, Scott L. & van Ginneken, Ewout, 2018. "Strategic Purchasing in Practice: Comparing Ten European Countries," Health Policy, Elsevier, vol. 122(5), pages 457-472.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Reindersma, Thomas & Fabbricotti, Isabelle & Ahaus, Kees & Bangma, Chris & Sülz, Sandra, 2024. "Inciting maintenance: Tiered institutional work during value-based payment reform in oncology," Social Science & Medicine, Elsevier, vol. 347(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. 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.
    2. 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.
    3. 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.
    4. Smith, Peter C. & Sagan, Anna & Siciliani, Luigi & Figueras, Josep, 2023. "Building on value-based health care: Towards a health system perspective," Health Policy, Elsevier, vol. 138(C).
    5. 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.
    6. Yordanov, Dimitar & Oxholm, Anne Sophie & Prætorius, Thim & Kristensen, Søren Rud, 2024. "Financial incentives for integrated care: A scoping review and lessons for evidence-based design," Health Policy, Elsevier, vol. 141(C).
    7. Francesca Gennari, 2023. "The transition towards a circular economy. A framework for SMEs," Journal of Management & Governance, Springer;Accademia Italiana di Economia Aziendale (AIDEA), vol. 27(4), pages 1423-1457, December.
    8. 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.
    9. Fu, Hwai-Hui & Tsai, Hsien-Tang & Lin, Ching-Wei & Wei, Duan, 2004. "Application of a single sampling plan for auditing medical-claim payments made by Taiwan National Health Insurance," Health Policy, Elsevier, vol. 70(2), pages 185-195, November.
    10. Elisabeth Paul & Garrett Wallace Brown & Valéry Ridde, 2020. "Misunderstandings and ambiguities in strategic purchasing in low‐ and middle‐income countries," ULB Institutional Repository 2013/309855, ULB -- Universite Libre de Bruxelles.
    11. Noort, Bart A.C. & Ahaus, Kees & van der Vaart, Taco & Chambers, Naomi & Sheaff, Rod, 2020. "How healthcare systems shape a purchaser’s strategies and actions when managing chronic care," Health Policy, Elsevier, vol. 124(6), pages 628-638.
    12. Barbara Vis & Sjoerd Stolwijk, 2021. "Conducting quantitative studies with the participation of political elites: best practices for designing the study and soliciting the participation of political elites," Quality & Quantity: International Journal of Methodology, Springer, vol. 55(4), pages 1281-1317, August.
    13. Anders Kärnä & Patrik Öhberg, 2023. "Misrepresentation and migration," Kyklos, Wiley Blackwell, vol. 76(4), pages 503-525, November.
    14. Pauline Katharina Mantell & Annika Baumeister & Stephan Ruhrmann & Anna Janhsen & Christiane Woopen, 2021. "Attitudes towards Risk Prediction in a Help Seeking Population of Early Detection Centers for Mental Disorders—A Qualitative Approach," IJERPH, MDPI, vol. 18(3), pages 1-13, January.
    15. Guzman, Viveka & Doyle, Frank & Foley, Ronan & Wilson, Penny & Crowe, Noelene & Craven, Peter & Pertl, Maria, 2024. "“When we were allowed to go back … the freedom, the vista, the delight … It was just magic”: Disruption and adaptation among people ageing-in-place in Ireland during COVID-19," Social Science & Medicine, Elsevier, vol. 351(C).
    16. 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).
    17. Häggström, Felix & Borsch, Anne Sofie & Skovdal, Morten, 2020. "Caring alone: The boundaries of teachers' ethics of care for newly arrived immigrant and refugee learners in Denmark," Children and Youth Services Review, Elsevier, vol. 117(C).
    18. Guldbrandsson, Karin & Bremberg, Sven, 2020. "Cross-sectoral cooperation at the ministerial level in three Nordic countries - With a focus on health inequalities," Social Science & Medicine, Elsevier, vol. 256(C).
    19. Martin Baekgaard & Nicola Belle & Søren Serritzlew & Mariafrancesca Sicilia & Ileana Steccolini, 2019. "Performance information in politics: How framing, format, and rhetoric matter to politicians’ preferences," Journal of Behavioral Public Administration, Center for Experimental and Behavioral Public Administration, vol. 2(2).
    20. Stokes, Jonathan & Lau, Yiu-Shing & Kristensen, Søren Rud & Sutton, Matt, 2019. "Does pooling health & social care budgets reduce hospital use and lower costs?," Social Science & Medicine, Elsevier, vol. 232(C), pages 382-388.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:19:y:2022:i:14:p:8831-:d:867523. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.