The Dutch Healthcare Authority (NZa) announced today that it is imposing a formal measure on two health insurers for failure to fulfil their duty of care.
The NZa is an autonomous administrative authority, falling under the Dutch Ministry of Health, Welfare and Sport (VWS).
The NZa said it had investigated the largest health insurer in four regions with waiting times above the standards for mental health care and hospital care.
The research showed that there are opportunities for improvement for all health insurers in carrying out their duty of care. Two of those insurers have been given six months to improve.
The NZa has not named the four insurers but added: “If they do not take this sufficiently seriously, the NZa can publish the measure.
“The two health insurers that received a formal measure scored insufficiently on some components. But all four health insurers must improve the fulfilment of their duty of care. “
The biggest areas for improvement are identifying the bottlenecks in the supply, the actions they take in response and evaluating and adjusting these actions.
“The NZa expects all four health insurers to follow up on the points for improvement. Further research should reveal whether more steps are necessary.”
The NZa research mapped out whether health insurers are proactive when it comes to fulfilling their duty of care.
“The proactive attitude of health insurers was also examined when it comes to sufficiently fulfilling their management role in the region and reducing waiting lists and waiting times.
The NZa said: “Access to care is no longer a given.
“This is a complicated problem for which all parties in the healthcare system are responsible.
“Health insurers and healthcare providers must work together to ensure that people receive the care they need.
“The NZa expects health insurers to closely monitor and manage healthcare demand and supply in the region. In this way they can help their insured persons with timely, accessible and appropriate care.”