Interview: There is a great deal of interest in community-based health care in the Netherlands

In 2014 the Dutch counterpart to OptiMedis AG, OptiMedis Nederland BV, was founded, with the intention of establishing integrated healthcare networks, such as Gesundes Kinzigtal, in various Dutch regions. The first community-based contract has already been concluded with Achmea, major health insurers, and applies to COPD and asthma patients in the community of Nijkerk, with some 35,000 inhabitants.

Jurriaan PröpperJurriaan PröpperIn an interview with OptiMedium, Jurriaan Pröpper, OptiMedis Nederland BV CEO, explains how integrated healthcare is developing in Nijkerk and what headway is being made in other regions.

What has happened in Nijkerk since the launch of OptiMedis Nederland?

In Nijkerk we collaborate with the two local healthcare centres which contain 95 percent of all healthcare providers, including outposts of two different hospitals. They have built these centres to jointly improve the health status of the inhabitants. OptiMedis has helped to develop and get a multiyear contract signed with the biggest healthcare insurer Achmea for a whole subpopulation of patients. All chronic lung care is in a three year contract including primary care, medicines and secondary care. Improving the health status of these patients with preventative interventions will lead to lower hospital admissions and care, thereby providing financial room to fund the extra prevention, innovation and organization in the healthcare centres. This will achieve the target of curbing the total cost growth of chronic lung care in Nijkerk for the insurer. This is the first contract in the Netherlands of this kind which targets achieving the Triple Aim and funding it from shared savings.

Map of the NetherlandsIs there also interest in community-based healthcare in other regions?

Yes, there is much interest in the ‘horizontal’ approach, integrating the whole healthcare chain for a specific population in a contract which shares the savings resulting from it to finance the extra activities. The ‘vertical’ approach of contracting effort per care provider per year is a dead-end street. We provide an alternative which gets all parties aligned and focused on the common goal of improving the health status with better matched care and thereby reducing the cost burden. This is seen as the way to keep healthcare affordable, available and sustainable.

What are your plans for the future?

We have started to copy the approach and contract model to the region of Nieuwegein. We work there with the four healthcare centres and the renowned St Antonius hospital on a truly integrated program for heart failure, cardiovascular diseases and diabetes. Because of the overlap there is much to improve together if you take the fences down between primary and secondary care. We have just started to support Vital Vechtvalley in Hardenberg, which tries to copy Gesundes Kinzigtal as much as possible, with a special Vital Vechtvalley insurance with extra programs, but without an integrated contract so far. And are talking about three other regions to start up with another insurer Menzis. It requires a lot of time and effort to get all stakeholders on board including the major insurer in the region and to get funding for the initial development until the contract starts. In that sense we have the same challenges as in Germany. We are missionaries.