Overview of the Dutch Healthcare Authority. This overview doesn't contain all content on this website.
The Dutch Healthcare Authority (NZa) is the supervisory body for all the healthcare markets in the Netherlands. The NZa supervises both healthcare providers and insurers. The NZa was established on 1 October 2006, is located in Utrecht (Netherlands).
“The NZa creates and monitors properly functioning healthcare markets. The interests of the consumers are central in the performance of these tasks. Efficiency, both in the short and long term, market transparency, freedom of choice, access to healthcare and quality are guaranteed. This gives the consumer the best value for his or her healthcare euros.”
If the interests of the consumer suffer, the NZa intervenes. However, the NZa strives to achieve the greatest possible measure of independence for consumers and other market parties. Where possible, responsibility must be accepted by all parties on the healthcare markets. In this way, unnecessary administrative burdens are also avoided. In other words: set conditions and basic principles, and enforce them when necessary.
The NZa logo is a modern guardian angel. This angel symbolises the protective role of the NZa with regard to the interests of the healthcare consumer. At the same time, the angel symbolises the authority and expertise of the NZa, which gives insurers and healthcare providers the proper motivation to provide good and efficient healthcare to the consumer.
Why a Healthcare Authority
Healthcare expenses have been increasing dramatically for years. As prosperity increases, the need for healthcare increases as well. On top of that there is also the ageing of the population as well as technological innovations. In order to ensure that healthcare remains available and affordable for everyone, significant advances must be made in terms of efficiency. Efficiency is an economic concept. The social reality behind this concept is ‘value for money’: good healthcare for a competitive price. As well as options from which consumers can choose.
The new healthcare system includes basic insurance for everyone, provided by private insurers. Acceptance is mandatory. In other words, no one is excluded, and there is a duty of care. The insurers negotiate with healthcare providers in order to obtain good healthcare at competitive prices.
The healthcare system is based on regulated market forces: it will only work if the players act efficiently and are given the correct incentives to do so. The NZa is the healthcare market supervisor, which gets the new markets going that emerge in the healthcare sector whenever it can. The aim of doing so is to provide consumers with accessible, affordable and proper healthcare.
The NZa itself determines a large part of its agenda. The aims demand a proactive approach from the supervisory body. The ‘lean and smart’ principle applies to its organisation: an effective and small organisation with smart people, systems and tools. In this way the supervisory body remains small and decisive with a very productive output.
The NZa uses a combination of tools to achieve a good mix. The aim is always to achieve effective supervision in a light, proportional manner that allows the optimum amount of room for individual freedom. In this context the NZa does not wish to focus so much on normative results but rather primarily on good conditions and a good overall framework.
Where possible, methods of (regulated) market operation will be used to achieve efficient market behaviour. The promotion of competition is a natural process of tailoring to the wishes of consumers. Therefore, in principle, other methods such as the simulation of market forces are only employed as a secondary measure.
Monitoring will outline developments in markets and submarkets. Monitors provide the basis for forming an opinion about the use of tools on the markets.
The NZa performs its advocacy role – providing recommendations about policy and regulations – based on implementation assessments and supervision assessments. Recommendations are provided not only on request but also proactively – on the NZa’s own initiative – in the interests of the further development of the healthcare system, both in the curative and the care markets.
The array of legal instruments available offers the NZa options for establishing general conditions for the healthcare markets such as performance descriptions, cost allocation principles, smart price ceilings and supervisory rules concerning, for instance, deceptive advertising. In addition, the NZa can take action in individual cases, such as in the case of a provider that has a position of significant power on the market, if the competitive conditions are distorted. The NZa intends to establish a good balance between taking action by setting general conditions and taking action in individual cases. That must be a mix in which effective and ‘light’ action go hand-in-hand.
For supervision of compliance, a combination of proactive and responsive behaviour will be employed. To this end, a so-called ‘Risk Analysis Model’ (RAM) will be used to provide systematic insight into those sectors and markets where the market developments must be followed intensively or less intensively. The system prevents an increase in the administrative burdens for stakeholders. In addition, signals from the market are important for maintaining supervision.
The NZa is developing a vision of the way in which control tools will be used. The NZa consults the market parties with regard to the annual work programme. Consultation serves various purposes:
The supervisory body must be well informed about what is happening in the market.
The market must know what considerations and reasons the supervisory body applies, with a view to regulatory certainty, confidence and support.
The supervisory body must be able to apply its own public assessment.
For the development of tools, the NZa works with consultation documents and policy regulations so that the market parties are involved in the opinion-forming process and to provide clarity regarding the way in which powers are applied. That also increases regulatory certainty, which is important for a good investment climate in the healthcare markets.
The Executive Board has two members:
Chairman of the Executive Board
Member of the Executive Board
Photographs copyrighted by Michel Groen.
The Advisory Board is referred to in the administrative regulations of the Dutch Healthcare Authority as follows: "The Dutch Healthcare Authority has an Advisory Board. The Advisory Board consists exclusively of external members invited to join by the Executive Board. The members of the Advisory Board are not bound by instructions or consultation procedures. The Advisory Board determines its working methods in consultation with the Executive Board (frequency of meetings, compensation, preparation, status of advisory reports, etc.)".
Members of the Advisory Board
- Mr. A.W. Kist
- Prof. dr. G. H. Blijham
- Prof. dr. M.G. Boekholdt
- Prof.dr. C. van Ewijk
- Mr. J.T.A. de Keijzer
- Drs. M.A.M. Leers
- Drs. M.J. van Rijn
- Prof. dr. E. Schokkaert
- Mr. W.F.C. Stevens
- Prof. dr. P.A.M. Vierhout
- Prof. dr. G. van der Wal
- Drs. M.H.A. de Weijer
The Advisory Board is supported by the staff of the Executive Board of the Dutch Healthcare Authority.