On June 2, the FHI Medical Technology sector signed an agreement to halt the rapid growth in the number of lawsuits between healthcare providers and health insurers. Chairmen of no fewer than twenty-five interest groups signed the document together with the chairman of Zorgverzekeraars Nederland, André Rouvoet. Rob de Vroet signed on behalf of FHI-Medical Technology.
Through the agreement, the parties commit to the role of a newly established 'Independent Dispute Resolution Body for Dispute Resolution and Settlement in Healthcare Contracting'.
What's the story behind this? “We have seen completely new purchasing models in the healthcare sector in recent years,” says Oscar de Goederen, CEO of Mathot Medische Speciaalzaken and board member of the FHI sector. “Several health insurers have switched from traditional purchasing models to tenders. The development of chain care projects is new. The question remains how these projects will be purchased in the long term. The consequence of this development and the uncertainty surrounding it is that a boom in lawsuits has developed.” Nobody was happy about that, except perhaps a few lawyers with high hourly rates.
Minister Schippers, “a strong minister” according to sector chairman Rob de Vroet, was not happy with that. Complaints abounded about slow and expensive procedures. By definition, there is also a cost-increasing element in the market where cost growth must and wants to be inhibited.
But how does setting up a dispute committee help here? Parties who have a dispute can now request mediation, binding advice or arbitration via the committee at the Netherlands Arbitration Institute, NAI. The parties that signed the agreement thereby say that they will accept the ruling that follows.
Furthermore, every complainant retains the right to choose whether to go to the dispute committee or to the judge. “As an industry we have weighed and weighed whether we should participate,” says De Vroet. “When the minister managed to get the insurers interested in this, we started to believe in it.” This is consistent with the statement by Health Insurers Chairman André Rouvoet in his New Year's speech: “Where parties cannot reach an agreement, an active role for the government can be useful and even necessary in my opinion.”
Oscar de Goederen is located in the market segment where this plays a major role, extramural care, at the patient's home. “We do see the positive sides of chain care. For example, we are involved in wound care as a spearhead. It is important that primary care, the hospital and home care work well with each other and with the supplier. As a company, we can implement various steps in the chain and thereby achieve efficiency.”
The board members are cautiously optimistic about the elaboration of the agreement. “We are very curious whether it will indeed work and whether we will have fewer lawsuits,” says Rob de Vroet. “We are of course still dealing with the aim of health insurers to purchase tens of percent cheaper in the short term and to pay less attention to cost control in the longer term, through prevention.” De Goederen does see opportunities: “The dispute committee makes it easier to resolve a dispute. It must now be possible to do it faster.” Also notable is the addendum to the agreement regarding a contribution to the costs of arbitration for 'small healthcare providers'. Apparently people still expect that an arbitration route will also cost a lot of money. See also: Report 3, 2016
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