Price setting and contracting help to ensure equitable access in the Netherlands
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World Health Organization
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3 p.
This country report examines how pricing and contracting mechanisms for long-term care (LTC) services contribute to equitable access in the Netherlands. As part of the WHO series on purchasing long-term care, the publication describes the organization, financing and governance of the Dutch LTC system, which provides universal access to a broad range of nursing, home-care and social support services. The report explains how care is financed through three public schemes – social long-term care insurance, social health insurance and the Social Support Act – and how responsibilities for purchasing and contracting services are distributed among regional purchasing offices, health insurers and municipalities. The document analyses the role of price setting, integrated payment models and contracting arrangements in ensuring affordability, accessibility and sustainability of LTC services. It highlights key features of the Dutch approach, including needs-based eligibility, low copayments, separation of eligibility determination from pricing decisions, and integrated pricing for broad packages of care. The report also discusses challenges related to coordination across financing schemes, alignment of incentives and quality measurement. Lessons are presented for other settings on balancing financial risk, decision-making authority, care quality and efficiency within LTC purchasing systems.
This country report examines how pricing and contracting mechanisms for long-term care (LTC) services contribute to equitable access in the Netherlands. As part of the WHO series on purchasing long-term care, the publication describes the organization, financing and governance of the Dutch LTC system, which provides universal access to a broad range of nursing, home-care and social support services. The report explains how care is financed through three public schemes – social long-term care insurance, social health insurance and the Social Support Act – and how responsibilities for purchasing and contracting services are distributed among regional purchasing offices, health insurers and municipalities. The document analyses the role of price setting, integrated payment models and contracting arrangements in ensuring affordability, accessibility and sustainability of LTC services. It highlights key features of the Dutch approach, including needs-based eligibility, low copayments, separation of eligibility determination from pricing decisions, and integrated pricing for broad packages of care. The report also discusses challenges related to coordination across financing schemes, alignment of incentives and quality measurement. Lessons are presented for other settings on balancing financial risk, decision-making authority, care quality and efficiency within LTC purchasing systems.
Keywords
Aged, Aged, 80 and over, Aging, Long-Term Care, Home Care Services, Social Support, Nursing Homes, Insurance, Health, Social Security, Health Services Needs and Demand, Health Services for the Aged, Quality of Health Care, Healthcare Financing, Health Expenditures, Financial Management, Costs and Cost Analysis, Federal Government, Netherlands, economics