Diederik Schrijvershof and Leah Peeters have been interviewed by the TV program Radar about care limits in the procurement of care.
Such a limit is a type of budget. It means that healthcare providers have to provide all care for that year within the agreed budget - a maximum amount for billable care. In the broadcast, Leah Peeters and Diederik Schrijvershof discussed the negative consequences of this budget for healthcare providers and referring physicians such as general practitioners and patients.
Healthcare providers usually have no choice but to introduce a patient stop when the cap is reached. This is, in light of the already long waiting lists in the healthcare system, undesirable. Furthermore, experience shows that healthcare providers often 'lose' in indexation negotiations and the process of additional contracting is difficult. Moreover, care caps that are too low defeat their purpose. Patient stops due to too low caps exacerbate patient complaints. As a result, the final treatment often becomes more complex and expensive. These social costs do not always fall on the health insurance company alone, but on society as a whole. General practitioners also suffer. Because of mental health waiting lists, general practitioners remain responsible for patients while they themselves are not equipped to provide the necessary (mental) health care. This creates several problems including the fact that less time is left for providing care to other patients of the GPs involved.
Maverick Advocaten assists healthcare providers on a daily basis in the context of healthcare contracting when they are in danger of failing to reach an agreement with the healthcare insurers. Maverick regularly manages to achieve a raise in the care budget for them. This is partly because care purchasers have to do this on the basis of their care (purchasing) obligation.
For years, Maverick Advocaten has advocated the enforcement by the NZa of the duty of care (purchasing), see here. In that context, Maverick Advocaten assists healthcare providers with an enforcement request to the NZa, asking the NZa to take enforcement action based on the duty of care of healthcare insurers.
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