Bundled payments for chronic diseases increased health care expenditure in the Netherlands, especially for multimorbid patients

Bundled payments aim to stimulate the integration of healthcare services and ultimately reduce healthcare expenditure growth through improved quality of care. The Netherlands introduced bundled payments for chronic diseases in 2010 by reimbursing providers annually for a bundle of primary care servi...

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Main Authors: Karimi, M, Tsiachristas, A, Looman, W, Stokes, J, van Galen, M, Rutten-van Molken, M
Format: Journal article
Language:English
Published: Elsevier 2021
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author Karimi, M
Tsiachristas, A
Looman, W
Stokes, J
van Galen, M
Rutten-van Molken, M
author_facet Karimi, M
Tsiachristas, A
Looman, W
Stokes, J
van Galen, M
Rutten-van Molken, M
author_sort Karimi, M
collection OXFORD
description Bundled payments aim to stimulate the integration of healthcare services and ultimately reduce healthcare expenditure growth through improved quality of care. The Netherlands introduced bundled payments for chronic diseases in 2010 by reimbursing providers annually for a bundle of primary care services related to COPD, Diabetes, or Vascular Risk Management. We aimed to assess the long-term effects of these bundled payments on healthcare expenditure. We used health insurance claims data from 2008 to 2015 to compare the healthcare expenditure between everyone who was included in bundled payments and a control group. We performed a difference-in-difference analysis in combination with propensity score matching and found that bundled payments consistently increased health care expenditure over seven years. The average half-year increase was €233 (95%CI: 204-262) for DM2, €609 (95%CI: 533-686) for COPD, and €231 (95%CI: 208-254) for VRM, representing 13%, 52%, and 20% of 2008 half-year cost. The increase was higher for those with multimorbidity compared to those without multimorbidity. This suggests that the expectations of the bundled payments are yet to be fulfilled.
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spelling oxford-uuid:5b159d2f-6c64-493f-8368-8ddbb4960c6a2022-03-26T17:20:00ZBundled payments for chronic diseases increased health care expenditure in the Netherlands, especially for multimorbid patientsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:5b159d2f-6c64-493f-8368-8ddbb4960c6aEnglishSymplectic ElementsElsevier2021Karimi, MTsiachristas, ALooman, WStokes, Jvan Galen, MRutten-van Molken, MBundled payments aim to stimulate the integration of healthcare services and ultimately reduce healthcare expenditure growth through improved quality of care. The Netherlands introduced bundled payments for chronic diseases in 2010 by reimbursing providers annually for a bundle of primary care services related to COPD, Diabetes, or Vascular Risk Management. We aimed to assess the long-term effects of these bundled payments on healthcare expenditure. We used health insurance claims data from 2008 to 2015 to compare the healthcare expenditure between everyone who was included in bundled payments and a control group. We performed a difference-in-difference analysis in combination with propensity score matching and found that bundled payments consistently increased health care expenditure over seven years. The average half-year increase was €233 (95%CI: 204-262) for DM2, €609 (95%CI: 533-686) for COPD, and €231 (95%CI: 208-254) for VRM, representing 13%, 52%, and 20% of 2008 half-year cost. The increase was higher for those with multimorbidity compared to those without multimorbidity. This suggests that the expectations of the bundled payments are yet to be fulfilled.
spellingShingle Karimi, M
Tsiachristas, A
Looman, W
Stokes, J
van Galen, M
Rutten-van Molken, M
Bundled payments for chronic diseases increased health care expenditure in the Netherlands, especially for multimorbid patients
title Bundled payments for chronic diseases increased health care expenditure in the Netherlands, especially for multimorbid patients
title_full Bundled payments for chronic diseases increased health care expenditure in the Netherlands, especially for multimorbid patients
title_fullStr Bundled payments for chronic diseases increased health care expenditure in the Netherlands, especially for multimorbid patients
title_full_unstemmed Bundled payments for chronic diseases increased health care expenditure in the Netherlands, especially for multimorbid patients
title_short Bundled payments for chronic diseases increased health care expenditure in the Netherlands, especially for multimorbid patients
title_sort bundled payments for chronic diseases increased health care expenditure in the netherlands especially for multimorbid patients
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AT loomanw bundledpaymentsforchronicdiseasesincreasedhealthcareexpenditureinthenetherlandsespeciallyformultimorbidpatients
AT stokesj bundledpaymentsforchronicdiseasesincreasedhealthcareexpenditureinthenetherlandsespeciallyformultimorbidpatients
AT vangalenm bundledpaymentsforchronicdiseasesincreasedhealthcareexpenditureinthenetherlandsespeciallyformultimorbidpatients
AT ruttenvanmolkenm bundledpaymentsforchronicdiseasesincreasedhealthcareexpenditureinthenetherlandsespeciallyformultimorbidpatients