Visit Chinese Delegation Jan Taco

8/14/2019 Visit Chinese Delegation Jan Taco

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Visit Chinese delegation

Care purchase

by

Jan Taco te Gussinklo


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The health care insurance market

Procurement: theory & practice

Its all about consumer empowerment

Visit Chinese delegation


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Insured

Supplementary insurance

AWBZ

Priva

tehealth

insu

rance

Public

health

insura

nce

The old system


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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


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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


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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)


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What business are we in?

Achmea health care procurement

Some facts & figures


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Traditional Procurement Process

Specify

Needs

Select

SupplierOrder Control

Delivery

Pay &

after care

Operational:

procure to pay processing

Tactical:

frame agreements

Contract

Supplier


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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


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contracts

29880total

500other

6000dental

12000paramedic

150Birth/maternity

10transport

2000supplies

7500Family doctor

1600pharmacies

120hospitals


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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)


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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


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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


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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


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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

Documents

Visit Chinese Delegation Jan Taco