Price competitive policy reform and the influence on cooperative specialist networks

Abstract

Introduction: Literature is ambiguous towards the effect of price competition in healthcare. The year 2006 marked the introduction of several pro-competitive healthcare policy reforms in the Netherlands, in order to improve the price-quality ratios of delivered care. Currently, price is negotiable for 70% of hospital services. Although several new players have entered the market since 2006, it remains unclear to what extent healthcare providers actually compete or cooperate (i.e. integrate) in order to deliver the best and most efficient care. Methods: To investigate the behaviour of healthcare providers, we examined specialist networks. A cooperative relation between providers is established when a specialist simultaneously works for two or more providers. We consider such collaborative structures as forms of integration between providers. Using longitudinal social network analysis, we analyse horizontal integration behaviour of 5 medical specialties (dermatology, cardiology, neurology, internal medicine, and orthopaedics) between 2005 and 2013. Results and Conclusions: Preliminary evidence indicates that specialists' affiliation to multiple organizations has become increasingly widespread after the introduction of price-competitive policies. The resulting inter-organizational networks present significant variation across specialties and over time. The findings highlight that price-competitive regulation has triggered more cooperation between healthcare organizations through specialist sharing, which can have important implications for policymakers, practitioners, and the level of integrated care. [ABSTRACT FROM AUTHOR]