ACM underlines room for cooperation in primary care

General practitioners (GPs), physical therapists, psychotherapists, speech therapists, and all other primary-care providers are given sufficient room for cooperation in order to improve health care. That is the main message of the publication titled ‘Basic principles for the oversight of primary care’ (in Dutch: ‘Uitgangspunten toezicht eerstelijnszorg’) that has been released by the Netherlands Authority for Consumers and Markets (ACM).

Chris Fonteijn, Chairman of the Board of ACM, explains: “What I see is that primary-care providers are holding back from working together, even in situations where cooperation would be in the interest of patients and the insured. The impression has arisen that the Dutch Competition Act prohibits many forms of cooperation with the threat of fines constantly looming.” This was also evident from the recent discussions about competition rules in the GP market, which had been prompted by a manifesto that thousands of GPs have signed (called ‘Het Roer Moet Om,’ which means ‘Change the Course’). Mr. Fonteijn continues: “To ACM, it is important that there is sufficient room for innovation and health care-related cooperation. Such room exists, and we try to make that clear in this document.”

Basic principles for the oversight of primary care

ACM encourages all actors in the industry to take primary care to the next level while keeping in mind the interests of patients and the insured. In many situations, the benefits for patients and the insured compensate for the drawbacks, and such initiatives can be implemented without any problems. However, if ACM does receive indications that a collaboration may produce harmful effects, ACM can demand that initiative be adjusted. If parties adjust their initiative swiftly and conclusively, ACM will then see no reason for taking any further action. Mr. Fonteijn adds: “With this document, we wish to avoid getting bogged down in theoretical discussions with the sector. The motto is: “Avoid the unnecessary paralysis, and work together to improve health care!”

Cooperation

The publication of this document does not mean that competition rules have changed. ACM explains how it wishes to stimulate collaborations that are in the interest of patients and the insured within the rules, and how it wishes to prevent harmful collaborations. Collaborations in the interest of patients and the insured may include collaborations to improve the quality of treatments or to introduce new treatment options and innovative technologies. In addition, holding joint meetings about trends and developments in the health care market in a particular region or city is also allowed.

Where market participants bargain collectively, for example, in order to negotiate a higher price, or where they share patients among themselves, patients and insured are harmed. These types of arrangements drive up health care costs, and reduce the number of options for patients. That is why such arrangements are not allowed, and, in such cases, ACM will step in and put an end to such harmful collaborations. Mr. Fonteijn concludes: “We have confidence in the industry, but we also depend on indications we receive from the parties involved such as health insurers, patient organizations or professionals that feel harmed.’