How Can a Bundled Payment Model Incentivize the Transition from Single-Disease Management to Person-Centred and Integrated Care for Chronic Diseases in the Netherlands?

Sterre S. Bour*, Lena H.A. Raaijmakers, Erik W.M.A. Bischoff, Lucas M.A. Goossens, Maureen P.M.H. Rutten-van Mölken

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)
50 Downloads (Pure)

Abstract

To stimulate the integration of chronic care across disciplines, the Netherlands has implemented single-disease management programmes (SDMPs) in primary care since 2010; for example, for COPD, type 2 diabetes mellitus, and cardiovascular diseases. These disease-specific chronic care programmes are funded by bundled payments. For chronically ill patients with multimorbidity or with problems in other domains of health, this approach was shown to be less fit for purpose. As a result, we are currently witnessing several initiatives to broaden the scope of these programmes, aiming to provide truly person-centred integrated care (PC-IC). This raises the question if it is possible to design a payment model that would support this transition. We present an alternative payment model that combines a person-centred bundled payment with a shared savings model and pay-for-performance elements. Based on theoretical reasoning and results of previous evaluation studies, we expect the proposed payment model to stimulate integration of person-centred care between primary healthcare providers, secondary healthcare providers, and the social care domain. We also expect it to incentivise cost-conscious provider-behaviour, while safeguarding the quality of care, provided that adequate risk-mitigating actions, such as case-mix adjustment and cost-capping, are taken.

Original languageEnglish
Article number3857
JournalInternational Journal of Environmental Research and Public Health
Volume20
Issue number5
DOIs
Publication statusPublished - Mar 2023

Bibliographical note

Funding Information:
This research was funded by ZonMw, grant number 839110024 and by a subsidy of VEZN (Versterking Eerstelijn Zuid-Nederland).

Publisher Copyright:
© 2023 by the authors.

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