An overview of all Dutch population management initiatives and their strategies

Abstract

Introduction : A new playing field between municipalities, health care professionals, insurers and citizens is introduced by the transition towards a more decentralized organization of health and social services in the Netherlands. The so-called 3-D transitions (including youth, social support and work and income) requires more collaboration between all actors, such as health care providers, citizens, insurers and municipality on a local/regional level. In order to achieve this, regional collaboration initiatives are introduced to realize a sustainable and more integrated provision of prevention, health and social care for their population. Therefore these initiatives can be framed as population management initiatives. It is yet unknown where and how these initiatives are organized. The National Institute for Public Health and the Environment (RIVM) has identified Dutch population management initiatives in 2015. This presentation gives an overview of all Dutch population management initiatives, including their scope and strategies to realize their goals. Theory/methods : This study compiles two stages. The first stage focused on the identification of population management initiatives. Potential population management initiatives were identified by interviews with various Dutch experts/ linking pins and alerts by the Primary Care foundation. Identified initiatives were included as population management initiative in this study when they focus on a pre-defined non-disease specific population and include at least two or more interventions, two or more domains (prevention, care and welfare) and at least three organizations. The second stage of this study focused on a comprehensive description of the population management initiatives. The following characteristics were identified: 1) aims of the population management initiative; 2) structure (legal entity, involved organizations and their roles, governance); 3) risk stratification and population identification; 4) financing and incentives and 5) included interventions. These characteristics of the population management initiatives were first roughly described based on publicly available data. Subsequently, the completed formats were refined and validated during interviews with the project leaders of the initiatives. Results : Twenty population management initiatives were identified in the Netherlands and are spread all over the country. All initiatives are partnerships including at least primary care providers. Municipalities and insurers are mostly both involved. Risk stratification and tailoring are not yet based on a full overview of the population; though some initiatives explore/ apply innovative ways to identify their first priorities. New payment models, in which for instance municipalities and health care providers bundle their budget(incentives), are slightly introduced. During our presentation, we will elaborate on specific innovative and implementation strategies of the population management initiatives (such as new paymentmodels and governance structures). Discussion : Population management initiatives are increasingly introduced in the Netherlands. New partnerships, governance structures and payment models are developed and explored, such as shared savings and legal entities ‘led’ by citizens. More information should be shared between population management initiatives, as they all struggle how to best design their population management initiative. Conclusion : This study gives an overview of the Dutch population management initiatives. A few introduce new strategies, e.g. new type of organizational structures and partnerships and financial incentives, which are transferable and of interest to deal with challenges in other regions and countries.