ABSTRACT

The short-term investment needed to set in motion options for patients and providers to reengineer and innovate to compete for savings dollars is easily recovered through the process as well as by reshaping chronic care management for the 20% of patients who will use 80% of the services/dollars in the system. The Netherlands began to overhaul its health system in 1987 after a government committee concluded that the best approach was managed competition, an idea first proposed by Professor Enthoven of Stanford. Measurement was developed based on three categories of care: labor intensive, individual, and group performance. As for the monthly revenues at institutions, which are distributed to employees as legal contribution payment, every other employee could have a share based on his/her individual performance and score. According to the Ministry of Health’s publication, the performance system has been implemented within the context of some different models.