The Netherlands’ largest health insurer has adopted practices based on our payment reform model, the Alternative Quality Contract (AQC), with stellar results.
Following the AQC blueprint, Dutch insurance giant VGZ asks hospitals to share accountability for the cost and quality of patient care. Currently, 11 hospitals and three behavioral health hospitals participate in the model. Each receives a budget for managing patient care and can share in any savings if they achieve certain quality metrics.
Just as our AQC has reduced health care costs while increasing quality, during the past three years, one hospital under VGZ’s model reduced utilization by 16% and another reduced utilization by 4%.
Provider support program is key
In 2016, VGZ executives came to the U.S. to meet with payers, hospitals, and physicians about global budget contracts. They said that a light bulb went on when they heard Dana Safran, our Chief Performance Measurement & Improvement Officer, speak about our AQC provider support model. The model includes actionable reports, education, and training for providers, as well as forums for sharing best practices.
“We realized that this was the missing piece of our payment model,” said Ab Klink, CEO of VGZ and Minister of Health in the Netherlands from 2006-2011. “We set about to add that support component into our model—including consulting with provider organizations about their transformation efforts, convening them to share best practices, and engaging in a new kind of payer-provider partnership.”
The participating organizations came together in April 2018 in a format much like our AQC Forums, with CEOs and clinical leaders from each organization sharing their experiences and learning from one another.
Payment reform origins
A 2014 mandate by the Netherlands Minister of Health required outcomes-based payment by 2020. As a result, Dutch health insurance industry leaders, academics, and policy makers invited Dana Safran to their country to introduce them to the AQC. They had read about the AQC in Health Affairs and The New England Journal of Medicine and believed that the model was a living example of what the Minister of Health was looking to achieve.