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The role of health insurer Menzis in the development of primary care plus

Engberts, G.J. (2018) The role of health insurer Menzis in the development of primary care plus.

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Abstract:BACKGROUND In order to create a sustainable healthcare changes need to be made. A frequently mentioned solution is substitution of secondary to primary care, the practical appearance is called Primary Care Plus (PCP) (in Dutch: anderhalvelijnszorg). Health insurer Menzis wanted to know what role it should take in the development of PCP. METHOD A literature research has been conducted and five experts, four PCP practices and all stakeholders in Twente have been interviewed. Based on the results and on two problems which Menzis experiences as most important, two scenarios with two different roles for Menzis were drafted. RESULTS & DISCUSSION A health insurer can take different roles in (the development of) PCP, namely a facilitating, stimulating or a directing role. Next to that are different incentives, appropriate to these roles, identified which could be used in the development of PCP. The most suitable role for a health insurer depends on its context and subject. Although, no ideally organized setting for PCP exists, seven enablers are identified which could be used. In addition, sixteen success and failure factors are identified, of which normative enablers are considered to be of more importance than functional enablers in the development of PCP. The found opportunities, risks and needs for Twente could also apply to other regions in the Netherlands because it has many similarities with the found enablers and success and failure factors. Based on the drafted scenarios, we advise that Menzis should start with taking a directing role in the development of PCP in the region of Twente. Because the starting point of the directing role will give Menzis best opportunity to respond to potential reconsideration of stakeholders opinions and to the context of the care field. CONCLUSION Three different roles are suitable for Menzis in the development of PCP, namely a facilitating, stimulating or directing role. But the context of the care field, in which Menzis wishes to develop PCP, is important (almost leading) for determining its role.
Item Type:Essay (Master)
Clients:
Menzis, Enschede, Netherlands
Faculty:TNW: Science and Technology
Subject:01 general works, 85 business administration, organizational science
Programme:Health Sciences MSc (66851)
Link to this item:http://purl.utwente.nl/essays/74888
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