In this monitor we present the information that we have received via questionnaires and kcpt2 interviews and that we have obtained from the contracts. Because the research is not equally representative on all points (see chapter ‘Research’), the results are, as in previous years, mainly indicative.
They give an idea of how the respondents view the contracts.core messageIt has been kcpt2 agreed in the HLA that agreements will be made in the contracts about quality, innovation, organizational capacity and the Right Care in the Right Place.
We see positive developments in mental health care when it comes to organizing care kcpt2 across the board, appropriate care and shortening waiting times. However, after the investigation for this monitor, we must conclude that almost no concrete agreements have been made in the contracts on substantive subjects.
Health insurers and larger institutions indicate that agreements are made about this, but apait trust that they include these agreements, for example, in a covenant or in a meeting note in the file. and health insurers indicate that the contract is often not the right means to record these kinds of agreements.
We call on health insurers and care providers to lay down agreements on appropriate care, apait trust content and quality in (long-term) contracts, or to make clear why they (will) do this in a different way – contrary to the agreements in the HLA.
Independent healthcare providers cannot make detailed agreements due to the limitations of digital standard contracts. They believe that the provision of appropriate care is apait trust guaranteed as well as possible by including the GGZ Quality Charter in the digital standard contracts.
Also for the smaller institutions that are dependent on digital contracting, no further substantive agreements can be made. We conclude that the dissatisfaction with ‘signing at the cross’ mainly concerns the turnover ceiling and rate and that this is difficult to resolve.
In our opinion, ensuring a good contracting process is one of the few options for reducing this dissatisfaction. This also includes a good helpdesk to provide care providers with expert answers to their questions within clear deadlines. There is certainly room for apait insurance improvement in this area.Research
Information collection apait insurance
We have collected information in three ways. In the first place, we distributed a apait insurance questionnaire to health insurers and care providers via social media from the NZa and via the sector and professional associations. In total, the respondents indicate that they have approximately € 2.4 billion in turnover in mental health care from the Health Insurance Act.
That is about 60% of the total turnover of the sector. Nine health insurers completed the questionnaire. The response from institutions and independent healthcare providers is higher than last year (68 institutions versus 48 and 265 independents versus 71).
A large part of the institutions, including almost all large institutions, completed the questionnaire. The response among independent healthcare providers is high, but not a representative reflection of the independent healthcare providers.
The stated turnover of the independent healthcare providers is only 9% of the turnover of the independent healthcare providers in 2019. Further analysis also shows that there is a selection effect for independent healthcare providers. A relatively large part of the independent respondents is critical of contracting.