Multiple interventions by ACM because of disruptions to individual health care contracting processes
In the recent contracting period between health care providers and health insurers, the Netherlands Authority for Consumers and Markets (ACM) intervened several times, including twice with trade associations for health care providers, and also once with health insurers. In all cases, the basic principle of individual negotiations was violated as a result of the sharing of commercial information, thereby risking higher prices or deteriorating heatlh care outcomes. After ACM had confronted the market participants involved, they adjusted their behavior.
What were these cases about?
Two trade associations of health care providers shared non-public information with their members through reports published on their websites that could possibly affect the negotiations with health insurers, such as self-calculated price index figures. In both situations, ACM received indications that health care providers actually used these price index figures in contract negotiations with health insurers to command higher prices. The intervention with the health insurers was prompted by indications that price information from previous years that had been shared between health insurers negatively affected the negotiations.
In health care contracting, the starting point is that individual health care providers and individual health insurers make arrangements between each other. In that way, health care providers and health insurers are able to make arrangements with each other about the care that best meets the needs in a particular region. In that process, health care providers and health insurers must be able to set their own prices and other contractual conditions without any interference.
ACM investigated the indications, and has confronted the parties involved with their behavior. Health insurers subsequently stopped sharing price information. One of the two trade associations for health care providers has removed the information in question from its report. The other trade association has emphasized to its members that their own situations must serve as the starting points in negotiations with health insurers.
Health care contracting processes and trade associations
Trade associations have many options for supporting their members in health care contracting processes. For instance, they are allowed to give their members factual information about upcoming legislation, accompanied by their interpretations of the consequences for members. However, it is not permitted to give information that may influence the contracting processes between health care providers and health care buyers because members will then no longer determine their negotiation targets independently.
For more information about trade associations and health care contracting, see the Guidelines regarding trade associations and health care contracting (in Dutch).