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An assessment of the Dutch experience with health insurers acting as healthcare advisors

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  • A Victoor
  • A E M Brabers
  • T E M van Esch
  • J D de Jong

Abstract

Introduction: With managed competition, selective contracting and the appointing of preferred providers are important instruments for health insurers to improve their bargaining position in the healthcare purchasing market. Insurers can offer enrollees extra services, such as advice about their healthcare, to attract them, ensure that they remain loyal, and to channel them to preferred providers. We investigate which advice services insurers in the Dutch system of managed competition offer enrollees, how they inform them about services, and if enrollees use and appreciate them. Materials and methods: From November to December 2017, two researchers independently analyzed the websites of all health insurers in the Netherlands. We also conducted a questionnaire study among 1,500 members (response 44.5%, N = 668) of the Nivel Dutch Health Care Consumer Panel. Results and discussion: All insurers offer one or more services. Most enrollees do not know if their insurer offers advice (67–87% per service). Twelve per cent (N = 76) of the enrollees indicate that they ever made use of a service, mostly regarding the choice of provider (N = 42). Respondents who used healthcare advice were satisfied with it. Of all enrollees, 41% indicate that they would probably/certainly, contact their insurer for advice and 37% would appreciate it if their insurer approached them. Among enrollees, 40% indicated the potential advice has some or a major influence on their choice of insurer. Conclusions: While all insurers offer at least one service, enrollees generally are unaware of them. Only a minority ever made use of such a service. However, a reasonable proportion do appreciate their insurers’ advice services and indicate that they would like to have contact with their insurer if they need care. Insurers do not appear to make the best use of the potential for giving healthcare advice and need to think about ways to increase coverage of those services.

Suggested Citation

  • A Victoor & A E M Brabers & T E M van Esch & J D de Jong, 2019. "An assessment of the Dutch experience with health insurers acting as healthcare advisors," PLOS ONE, Public Library of Science, vol. 14(11), pages 1-13, November.
    • Handle: RePEc:plo:pone00:0224829
    DOI: 10.1371/journal.pone.0224829
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    References listed on IDEAS

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    1. Boonen, Lieke H. H. M. & Schut, Frederik T., 2011. "Preferred providers and the credible commitment problem in health insurance: first experiences with the implementation of managed competition in the Dutch health care system," Health Economics, Policy and Law, Cambridge University Press, vol. 6(2), pages 219-235, April.
    2. Duijmelinck, Daniëlle & van de Ven, Wynand, 2016. "What can Europe learn from the managed care backlash in the United States?," Health Policy, Elsevier, vol. 120(5), pages 509-518.
    3. Pauly, Mark V., 1987. "Monopsony power in health insurance: thinking straight while standing on your head," Journal of Health Economics, Elsevier, vol. 6(1), pages 73-81, March.
    4. Bes, Romy E. & Curfs, Emile C. & Groenewegen, Peter P. & de Jong, Judith D., 2017. "Selective contracting and channelling patients to preferred providers: A scoping review," Health Policy, Elsevier, vol. 121(5), pages 504-514.
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    1. van der Hulst, Frank J.P. & Holst, Laurens & Brabers, Anne E.M. & de Jong, Judith D., 2022. "To what degree are health insurance enrollees in the Netherlands aware of the restrictive conditions attached to their policies?," Health Policy, Elsevier, vol. 126(7), pages 693-703.

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