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

  • Tsiachristas, Apostolos
  • Hipple-Walters, Bethany
  • Lemmens, Karin M.M.
  • Nieboer, Anna P.
  • Rutten-van Mölken, Maureen P.M.H.
Registered author(s):

    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.

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    File URL: http://www.sciencedirect.com/science/article/pii/S0168851010003076
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    Article provided by Elsevier in its journal Health Policy.

    Volume (Year): 101 (2011)
    Issue (Month): 2 (July)
    Pages: 122-132

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    Handle: RePEc:eee:hepoli:v:101:y:2011:i:2:p:122-132
    Contact details of provider: Web page: http://www.elsevier.com/locate/healthpol

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    1. J. Oostenbrink & F. Rutten, 2006. "Cost assessment and price setting of inpatient care in the Netherlands. The DBC case-mix system," Health Care Management Science, Springer, vol. 9(3), pages 287-294, August.
    2. van de Ven, Wynand P.M.M. & Beck, Konstantin & Van de Voorde, Carine & Wasem, Jurgen & Zmora, Irit, 2007. "Risk adjustment and risk selection in Europe: 6 years later," Health Policy, Elsevier, vol. 83(2-3), pages 162-179, October.
    3. van der Linden, Barbara A. & Spreeuwenberg, Cor & Schrijvers, Augustinus J. P., 2001. "Integration of care in The Netherlands: the development of transmural care since 1994," Health Policy, Elsevier, vol. 55(2), pages 111-120, February.
    4. Michiel Bijlsma & Arno Meijer & Victoria Shestalova, 2008. "Vertical relationships between health insurers and healthcare providers," CPB Document 167, CPB Netherlands Bureau for Economic Policy Analysis.
    5. Wynand P. M. M. Van de Ven & Frederik T. Schut, 2009. "Managed competition in the Netherlands: still work-in-progress," Health Economics, John Wiley & Sons, Ltd., vol. 18(3), pages 253-255.
    6. Frederik T. Schut & Wynand P. M. M. Van de Ven, 2005. "Rationing and competition in the Dutch health-care system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages S59-S74.
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