E&F - lecture 7

Question 1

Managed competition model (Health Insurance Act)

Answer 1

• Employers, citizens / patients pay taxes, premiums, co-payments
• Governmental bodies partly fund purchasers and compensate risks via the risk equalization scheme, and partly fund providers directly
• Purchasers contract with providers and pay claims

Question 2

OBJECTIVES MONITOR

Answer 2

Gain insights in:
* the experiences with organizing an integrated maternity care organization (imco) and working with bundled payments
* The effects on quality of care and medical spending and health outcomes of maternity care (Today’s presentation)

Question 3

Key messages Bundled payment for maternity care in the Netherlands

Answer 3

• Experiences
  o All actors positive about collaboration
  o Administrative burden is an enormous bottleneck
  o Transition in culture not yet realized
• First tangible effects
  o Small changes in place of births and activities
  o Smaller spending growth
  o No effects on health outcomes
• Discussion
  o Administrative burden risk for maintaining support
  o How incentive translate into practice differs
  o Longterm effects unknown

Question 4

Concluding Remarks (APM’s in general)

Answer 4

• Provider-led entities which assume financial risks are still in their early stages…
• Translating of provider incentives differs between settings: context matters
• Knowledge base is growing supporting the potential of payment reforms as a strategy toward more value-based health care delivery
• Joy of the workforce is too often neglected!
• Real outcome-based payment models still in its infancy