8/14/2019 Visit Chinese Delegation Jan Taco
1/16
1
Visit Chinese delegation
Care purchase
by
Jan Taco te Gussinklo
8/14/2019 Visit Chinese Delegation Jan Taco
2/16
2
The health care insurance market
Procurement: theory & practice
Its all about consumer empowerment
Visit Chinese delegation
8/14/2019 Visit Chinese Delegation Jan Taco
3/16
3
Insured
Supplementary insurance
AWBZ
Priva
tehealth
insu
rance
Public
health
insura
nce
The old system
8/14/2019 Visit Chinese Delegation Jan Taco
4/16
8/14/2019 Visit Chinese Delegation Jan Taco
5/16
5
Costs go upMore s enio rs 65+Technolo gy
Per centa ge 65+:now 14 %
23 % in 2040Pressu re on
eco nomy Tens io non labo ur mark et.Health Care Cost:
no w 9,7 % 14% in 20 40 Per forma nce ofthe health ca re
syst em ha s togo up
8/14/2019 Visit Chinese Delegation Jan Taco
6/16
6
Who is paying the health system?
employerIncome related premium
50%
government
customer
GovernmentcontrolledRisk/Costsharing
procedures
Insurancecompany
Healthproviders
Tax money5%
Flat rate insurance premium45%
Consumer allowance
claims
8/14/2019 Visit Chinese Delegation Jan Taco
7/16
7
What happened last year?
1942 German system was ended.
From now: everyone in the same, obliged basic
insurance package.
Huge shift of insureds (25% changed from insurance
company)
Growth of collective contracts (employers, unions,
affinity groups)
Strong price (premium) competition leading to cost
pressure on the insurance companies
Zero sum game?.. (M. Porter)
8/14/2019 Visit Chinese Delegation Jan Taco
8/16
8
What business are we in?
Achmea health care procurement
Some facts & figures
8/14/2019 Visit Chinese Delegation Jan Taco
9/16
9
Traditional Procurement Process
Specify
Needs
Select
SupplierOrder Control
Delivery
Pay &
after care
Operational:
procure to pay processing
Tactical:
frame agreements
Contract
Supplier
8/14/2019 Visit Chinese Delegation Jan Taco
10/16
10
The market of contracting
Moving from regulated towards more market-oriented
Mergers insurance companies: 10 insurers have 90% of
the market
Fragmented suppliers market
Complex, uncoordinated governance of the market
Complex market-entries (barriers)
More price- than quality-oriented competition
8/14/2019 Visit Chinese Delegation Jan Taco
11/16
11
contracts
29880total
500other
6000dental
12000paramedic
150Birth/maternity
10transport
2000supplies
7500Family doctor
1600pharmacies
120hospitals
8/14/2019 Visit Chinese Delegation Jan Taco
12/16
12
Procurement volumes
2187-BV3.4-15D.17
Impact Finance
Estimates 2006 ( mln)
70Birth services/ maternity care
240End user equipment
921Pharma
285Dental
180Fysiotherapists etc.
333Local / personal doctors aid
2.700Hospitals
5.361
5158
92
17
Approx
2006 ( mln)
Total
Short term mental aid / hospitalisation
Business Clients specific services
Transport
Supplier market
International services (mainly hospitals)
8/14/2019 Visit Chinese Delegation Jan Taco
13/16
13
Changing landscape
Transformation focus:
secure nation wide, for all ourcustomers just in time availabilityof high quality, affordable healthservices
performance level of the healthsystem and its members must goupwards !
Collaboration between themembers is crucial. Otherwiseconflicts will probably drive up the
costs and drive down the quality
8/14/2019 Visit Chinese Delegation Jan Taco
14/16
14
Our strategic goals:
1. High quality and cost control (and predictability)
2. Operational excellence
3. Improved customer focus (demand driven procurement)
4. Good supplier relations(management)
5. Competent and involved employees
8/14/2019 Visit Chinese Delegation Jan Taco
15/16
15 2187-BV3.4-15D.4
availability
Consumer intimicy
Health &
wellbeing
Quality
Options for the future
We guarantee financial
coverage of costs and
availability of all basic
health services
Financial en logistical
value concept
We guarantee availability
of group wise costumized
healt services
Quality value concept
We integrate health with
other comfort, well-being
and security etc. services
(income, health, sucurity,
pensions, housing etc.)
Value
impact
coverage
We guarantee financial
coverage of costs of all
basic health services
Financial
value concept
8/14/2019 Visit Chinese Delegation Jan Taco
16/16
16
A few issues to consider
Free choice of health care supplier by the insured
Health & prevention vs illness
Cost containment (low premium) vs the best care for the
patient (two faces)
How to navigate the patient
Information asymmetry
Relation doctor patient vs Relation insurer - insured
Top Related