Quality change and cost regulation in the Dutch medical coverage framework.


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Quality change and cost control in the Dutch medical coverage framework Wim Groot Maastricht College and Chamber for General Wellbeing and Human services in the Netherlands Washington, Walk 9, 2009 Points of health care coverage changes in the Netherlands in 2006
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Slide 1

Quality change and expense regulation in the Dutch wellbeing protection framework Wim Groot Maastricht University & Council for Public Health and Health Care in the Netherlands Washington, March 9, 2009

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Aims of wellbeing protection changes in the Netherlands in 2006 To join widespread scope and rivalry A more equivalent dissemination of the expenses of human services To enhance nature of consideration by enhancing transarancy and specific contracting

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Health protection changes in the Netherlands in 2006 All occupants are obliged to purchase essential bundle of wellbeing protection Basic bundle incorporates: general expert, therapeutic authority care clinic consideration, professionally prescribed medications, maternity care, obstetrics, specialized guides and dental watch over youngsters

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Universal access Insurers are obliged to acknowledge each candidate Community-appraised premium paying little mind to expected cases or previous conditions Once every year people have the chance to switch wellbeing back up plan

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Financing of wellbeing protection half of aggregate wellbeing consumptions are financed by pay related commitments These are put into Risk Equalization Fund (REF) Insurers get installment from REF in light of danger profile of guaranteed to make level playing field Community-evaluated premiums spread 45% of aggregate expenses

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Cost to the shopper Average protection premium is appr. $1400 every year Income related premium is 7% There is a necessary deductible of $200 Maximum willful deductible is $640 For consideration not in fundamental bundle there is deliberate supplementary protection

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Access for all Children underneath age of 18 are exempted for paying protection premiums Compensation for protection costs for individuals with low salary 98% of populace has essential bundle of wellbeing protection

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Effects of wellbeing protection changes Fierce value rivalry among guarantors Consolidation of wellbeing protection market Development of purchaser assemblages as countervailing energy to back up plans (through superintendent, union, patient gathering, and so forth.) Coalitions of safety net providers and patient gatherings have risen intended to enhance quality and patient-focused contracting of human services suppliers

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Incentives for expense control Risk Equalization Fund (and commitment to acknowledge each customer) has dispensed with unfriendly determination Price rivalry has prompted more concentrate on expense regulation and misfortunes for safety net providers Focus on specific contracting to enhance quality and lower expenses (quality and proficiency go together) Insurers have utilized business sector influence to lessen expenses of pharmaceuticals

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Conclusion: Health protection changes in the Netherlands has brought about Price rivalry on wellbeing protection market Incentive for wellbeing back up plans towards cost regulation More consideration for nature of consideration in contracting of social insurance.:

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