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

Milad Karimi, Apostolos Tsiachristas, Willemijn Looman, Jonathan Stokes, Mirte van Galen and Maureen Rutten-van Mölken

Health Policy, 2021, vol. 125, issue 6, 751-759

Abstract: 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.

Keywords: Bundled payment; Chronic disease; Multimorbidity; Cost (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (4)

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Persistent link: https://EconPapers.repec.org/RePEc:eee:hepoli:v:125:y:2021:i:6:p:751-759

DOI: 10.1016/j.healthpol.2021.04.004

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