Bestuur & Management Consultants (BMC) Wolfsheze, 20 september - PowerPoint PPT Presentation

Bestuur & Management Consultants (BMC) Wolfsheze, 20 september 2007 Gert Cazemier GC/2007 1

Funders behaviour in perspective Strategic en non-strategic behaviour of funders in a ‘regulated’ and competitive health market GC/2007 2

Roadmap 1. Funders and collectivism 2. Funders and individualism 3. Funders and emerging strategies GC/2007 3

GC/2007 4

Funders and collectivism • Public health care system: private initiatives, ‘selfregulation’ & mutual solidarity • Government responsible for legislative-scheme and cost-containment and fair access and quality • Insurance-Companies and Health Providers are dominant partners • Weak Clients and Consumerorganizations GC/2007 5

Funders: insurance companies • Low risks / high profile • Relatively non-competitive • Administrative oriented organizations • Traditionally more focus on selling contracts to consumers, than purchasing. GC/2007 6

Funders: insurance companies (2) • Short term target: increasing market share • Long term targets diverge • Scaling en Mergers of insurance companies (horizontal, vertical and Europe) • Introducing tenders (Europe) • Huge reductions on purchasing staff • Benchmarks become extremely important GC/2007 7

Transition from collectivism to individualism Old world Strictly regulated system, focus on the relation Funders <-> Providers New world Less regulated system, focus on the relation Providers <--> Clients/Consumerorganisations GC/2007 8

Individualism in the insurance scheme • Reshaping structures health care system (new basic insurance for curative care) • Reshaping positions of surveillance • Still reduction of growth of expenditures (government) • Individualized defrayment (ZZP, DBC) • Individual budgets (cash) GC/2007 9

Transition • Old world New world • Uncertainty: new positions • Many strategies GC/2007 10

Emerging strategies of funders (1) • Re-positioning en re-profiling insurrance companies • Organizing new collectivisms (collective contracts for groups: employers, consumeroganizations, e.d.) • Converge of Health care and prevention disease absence and inability of work GC/2007 11

Emerging strategies of funders (2) • Developing health products/complementary health insurances (fitness, health resorts, e.d.) • Developing and participating in new providers • Scaling and mergers GC/2007 12

Emerging strategies of funders (3) • Selective contracting (first providers, profiled providers, e.d.) • .................................... • .................................... GC/2007 13

Developments: New Collectivism and Integration • Clients en Consumerorganizations become more important • Inspections on health and market behaviour • Insurance companies become social and health care provider • Europe ! GC/2007 14

Statements for discussion 1. Providers focusing on satisfied clients will always be able to survive as organizations relatively easy. 2. The paradigm of a ‘regulated’ market in health care and social services is a fiction and will never work. GC/2007 15

Are there opportunities for Social Service and Health Providers in a ‘regulated” market ? GC/2007 16

Bestuur & Management Consultants (BMC) Drs. G. (Gert) Cazemier Postbus 308 3830 AJ Leusden (Netherlands) Phone: +31(0)621265575 +31(0)334965200 @mail: gertcazemier@bmc.nl Internet www.bmc.nl GC/2007 17