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Healthcare contracting, barriers and success factors Empirical research on healthcare contracting of general practitioners and physiotherapists by health insurers

Willink, D.J. (2016) Healthcare contracting, barriers and success factors Empirical research on healthcare contracting of general practitioners and physiotherapists by health insurers.

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Abstract:This thesis aims to identify critical success factors and barriers in healthcare contracting for General Practitioners and Physiotherapists. First interviews and a literature research let to the identification of possible start factors, which were manually filtered and resulted in Long List Factors. Second a survey under healthcare professionals is conducted to confirm presence of these Long List Factors and their perceived importance. Short list factors and discriminating success factors are identified. For the physiotherapists, twelve short list factors were identified, with three discriminating critical success factors which together determine 70,5% of the cases to the correct group: “Uniform conditions for obtaining a higher tariff from the health insurers”, “Agreement of both parties for the contract signing” and “Legible and understandable contracts”. For the General Practitioners, thirteen short list factors were identified, with four discriminating critical success factors who together can divide 84,2% of the cases into the correct group: “A platform proposed by the insurer to upload data, to monitor the quality of care”, “Differentiation in contracts and rewards between different performing healthcare providers”, “Agreement of both parties on clear and realistic objectives”, “Communications throughout the year via newsletters and or presentations on the purchasing policy of the insurer”. More understanding of the contracts and the opportunity within the contracts seems a possible positive influence for outcomes. A mismatch regarding the critical success factors (what is important) and the perceived success factors (what seems important) is identified. Also in context of purchasing theories it is seen that a mismatch between health insurer and health professional is evident. Physiotherapeutic care is perceived as a leverage product and General Practitioners care as a strategic product by health insurers, whereas the health professionals themselves both see their products as core products. Also differences between health insurers are identified and differences based on health insurer size are identified. At small health insurers more prerequisites for successful healthcare contracting seem present. Furthermore it is found that there is a mismatch in the guidelines for good contracting provided by the Dutch Healthcare Authority (NZa) versus what seems really important for good contracting as evidenced.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:85 business administration, organizational science
Programme:Health Sciences MSc (66851)
Link to this item:http://purl.utwente.nl/essays/71198
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