Regulated markets and rationalised myths: an institutional perspective on value-based purchasing in the Netherlands
In the Dutch health care system of regulated competition, health insurers are assigned the crucial role of prudent purchasers and expected to critically contract providers based on the quality and prices of their services. Thus far, however, these organisations have struggled to fulfil this role. Th...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
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| Series: | Health Economics, Policy and Law |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S174413312500012X/type/journal_article |
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| author | Gijs Steinmann Hester van de Bovenkamp Antoinette de Bont Lonneke Timmers Diana Delnoij |
| author_facet | Gijs Steinmann Hester van de Bovenkamp Antoinette de Bont Lonneke Timmers Diana Delnoij |
| author_sort | Gijs Steinmann |
| collection | DOAJ |
| description | In the Dutch health care system of regulated competition, health insurers are assigned the crucial role of prudent purchasers and expected to critically contract providers based on the quality and prices of their services. Thus far, however, these organisations have struggled to fulfil this role. This study sheds new light on the purchasing behaviour of Dutch health insurers. We examine how insurers perceive the context in which the value-based purchasing of hospital care should take shape, and we draw on insights from institutional theory to frame our analysis. Our findings are based on a series of semi-structured interviews (n = 18) with employees and representatives of several insurer companies whose combined market shares add up to over 90 per cent of all premium payers. Our analysis highlights an environment in which market mechanisms are tangled up with historically rooted budgeting practices, where insurers are pressured to sustain rather than critique hospitals, and where self-regulating medical professionals are firmly supported by society’s deep-seated belief in the quality of their services. Like many other organisations, Dutch health insurers tend to conform to their institutional environment. While this conformity may aid them in organisational stability and survival, it also restricts their ability to purchase prudently. |
| format | Article |
| id | doaj-art-e312045123df4a57ad8f73eed60fbf61 |
| institution | Kabale University |
| issn | 1744-1331 1744-134X |
| language | English |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Health Economics, Policy and Law |
| spelling | doaj-art-e312045123df4a57ad8f73eed60fbf612025-08-20T03:27:47ZengCambridge University PressHealth Economics, Policy and Law1744-13311744-134X11610.1017/S174413312500012XRegulated markets and rationalised myths: an institutional perspective on value-based purchasing in the NetherlandsGijs Steinmann0https://orcid.org/0000-0002-9478-3725Hester van de Bovenkamp1Antoinette de Bont2Lonneke Timmers3Diana Delnoij4Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The NetherlandsErasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The NetherlandsTilburg University, Tilburg, The NetherlandsZorginstituut Nederland, Diemen, The NetherlandsErasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands Zorginstituut Nederland, Diemen, The NetherlandsIn the Dutch health care system of regulated competition, health insurers are assigned the crucial role of prudent purchasers and expected to critically contract providers based on the quality and prices of their services. Thus far, however, these organisations have struggled to fulfil this role. This study sheds new light on the purchasing behaviour of Dutch health insurers. We examine how insurers perceive the context in which the value-based purchasing of hospital care should take shape, and we draw on insights from institutional theory to frame our analysis. Our findings are based on a series of semi-structured interviews (n = 18) with employees and representatives of several insurer companies whose combined market shares add up to over 90 per cent of all premium payers. Our analysis highlights an environment in which market mechanisms are tangled up with historically rooted budgeting practices, where insurers are pressured to sustain rather than critique hospitals, and where self-regulating medical professionals are firmly supported by society’s deep-seated belief in the quality of their services. Like many other organisations, Dutch health insurers tend to conform to their institutional environment. While this conformity may aid them in organisational stability and survival, it also restricts their ability to purchase prudently.https://www.cambridge.org/core/product/identifier/S174413312500012X/type/journal_articlevalue-based purchasingregulated marketinstitutional theoryhealth carehealth insurance |
| spellingShingle | Gijs Steinmann Hester van de Bovenkamp Antoinette de Bont Lonneke Timmers Diana Delnoij Regulated markets and rationalised myths: an institutional perspective on value-based purchasing in the Netherlands Health Economics, Policy and Law value-based purchasing regulated market institutional theory health care health insurance |
| title | Regulated markets and rationalised myths: an institutional perspective on value-based purchasing in the Netherlands |
| title_full | Regulated markets and rationalised myths: an institutional perspective on value-based purchasing in the Netherlands |
| title_fullStr | Regulated markets and rationalised myths: an institutional perspective on value-based purchasing in the Netherlands |
| title_full_unstemmed | Regulated markets and rationalised myths: an institutional perspective on value-based purchasing in the Netherlands |
| title_short | Regulated markets and rationalised myths: an institutional perspective on value-based purchasing in the Netherlands |
| title_sort | regulated markets and rationalised myths an institutional perspective on value based purchasing in the netherlands |
| topic | value-based purchasing regulated market institutional theory health care health insurance |
| url | https://www.cambridge.org/core/product/identifier/S174413312500012X/type/journal_article |
| work_keys_str_mv | AT gijssteinmann regulatedmarketsandrationalisedmythsaninstitutionalperspectiveonvaluebasedpurchasinginthenetherlands AT hestervandebovenkamp regulatedmarketsandrationalisedmythsaninstitutionalperspectiveonvaluebasedpurchasinginthenetherlands AT antoinettedebont regulatedmarketsandrationalisedmythsaninstitutionalperspectiveonvaluebasedpurchasinginthenetherlands AT lonneketimmers regulatedmarketsandrationalisedmythsaninstitutionalperspectiveonvaluebasedpurchasinginthenetherlands AT dianadelnoij regulatedmarketsandrationalisedmythsaninstitutionalperspectiveonvaluebasedpurchasinginthenetherlands |