“Transparency remains a key issue in the Dutch healthcare system, since citizens can only make informed decisions if they have access to clear and comprehensible information. Currently there are many different health plans, which are difficult to compare. The Dutch Healthcare Authority plans to investigate whether this hampers the proper functioning of the market (Dutch Healthcare Authority, 2015b). In 2015 the Minister of Health agreed with Health Insurers Netherlands, the umbrella organization of the Dutch health insurers, to improve comparability of information for the insured population. Insurers should provide standardized information on the profit they make, the composition of the premium, whether financial reserves have been used to lower the premium, and the different conditions across offered health plans. In addition, they should clearly communicate that all citizens are accepted for the basic package. Furthermore, health insurers plan to make switching easier for persons who use medical devices or disposables by automatically adopting the authorizations of the former insurer. Lastly, health insurers decided to include care products (actual provided care) within the DBC on the patient’s bill (Ministry of Health, Welfare and Sport, 2015b).

“The Dutch Healthcare Authority is working on regulations that target clear communication on which care is subject to the mandatory deductible and on making transparent beforehand what will be the cost of treatment. Furthermore, the Authority is planning to bring in regulation of web sites that compare health plans, to make the information more reliable and comparable. In the first years after the reform, a government-funded agency provided a web site that compared health plans and providers, but more recently the site has only provided information on providers, since sufficient comparative information on health insurers was available on commercial web sites. However, commercial sites differ in the way they select and present their data, resulting in different results for similar requests for comparison, and the selection criteria are not always clear.”

Source: Kroneman M, Boerma W, van den Berg M, Groenewegen P, de Jong J, van Ginneken E (2016). The Netherlands: health system review. Health Systems in Transition, 2016; 18(2):1–239.

“In the Dutch health care system, competing insurers are expected to play a key role in improving quality through contract negotiations with health care providers (see Section 4). In practice, insurers emphasise volume and price more than quality in their contracting decisions, partly due to the fragmentation and administrative burden of collecting quality indicators. The Dutch Health Care Institute has been tasked with developing reliable and meaningful quality indicators and drawing up a multi-year care improvement agenda, in consultation with all parties involved in health care. These initiatives can then be used to improve care, enhance shared decision making and ultimately guide contracting with providers.

“Furthermore, some insurers have started creating bottom-up longer-term contracts with providers centred on value-based care, where providers and professionals can define key performance indicators for quality of care and delivery innovations. Medical professional groups and the government also contribute to quality improvement activities, such as a new long-term care quality framework aims to improve the quality of care in nursing homes. An initiative to provide “the right care at the right place” (de juiste zorg op de juiste plek) also has gained momentum, and has helped physicians and patients to determine the appropriate setting for COVID-19 treatment (see Section 5.3).”

“The 2006 reform changed the role of government from direct controller of volumes and prices to rule-setting and overseeing a proper functioning of the markets. Insurers were supposed to act as quality-driven active purchasers and were given tools to selectively contract providers. More than a decade later considerable progress has been made, but the majority of hospital contracts have a one year duration and often lack agreements on quality of care or patient outcomes (Section 5.1). The Netherlands Council for Health and Society (RVS), an independent advisory body to the government, criticised current purchasing practices, arguing they have led to uniformity in care supply, low trust levels in insurers, high administrative costs, and limited care innovation and prevention. Several political parties including those in government have shifted their focus from competition in health care to achieving better care coordination and quality.”

Source: OECD/European Observatory on Health Systems and Policies (2019), The Netherlands: Country Health Profile 2019, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.

Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and sixteen other nations.

Page last updated Nov. 10, 2022 by Doug McVay, Editor.