Integrating care by payment reform A workshop on the implementing of bundled payments for birth care in the Netherland

Abstract

Introduction: In recent years, various policies have been implemented in the Netherlands to improve quality of birth care and collaboration between birth care providers in order to lower the relatively high mortality rates. In 2017, the Dutch Ministry of Health, Welfare and Sport introduced a payment reform in order to further enhance the collaboration between different birth care providers. This voluntary payment reform consists of a bundled payment including all care services delivered by midwifes, gynecologists and maternity care providers. Currently, these providers are mainly reimbursed via a fee-for-services payment model. Bundled payment models shift financial and clinical accountability to a single provider-led entity that typically must manage a budget and ensure quality. The entity receiving the bundled payment earns a higher margin if a patient has utilized less care or when the services are delivered more efficiently, but also bears the financial risk of readmissions and complications. This payment model produces a strong incentive for providers to coordinate care across settings whilst not stinting needed care. Currently, within six regions bundled payment contracts are signed and more contracts are expected in 2018.Aim: The aim of this workshop is to discuss key premises of the Dutch bundled payment model and toshare experiences with implementation by birth care organizations.  Outline of the workshopDuring the session, we briefly present the key premises of the Dutch bundled payment model for birth care, and describe the current state of affairs regarding its implementation. Subsequently, one of the frontrunner integrated birth care organizations will share their experiences on how to implement the bundled payment model and to govern such a provider-led birth care organization by using concrete examples and results. In an interactive manner, common lessons learned will be identified and discussed with the audience.Target audience: Health care providers, researchers, consumers, policy makers, and health care organizations working with or interested in value-based payment models.Learnings/take away messages:To understand the Dutch bundled payment model for birth care and related theoretical considerationsInsight in the various ways regional birth care organizations are implementing the bundled payment for birth careTo understand key enablers and barriers in payment reforms and related integration interventions in real practice.