Overview of the Dutch Healthcare Authority. This overview is a summary of the information available on the Dutch website.
The Dutch Healthcare Authority (NZa) is an autonomous administrative authority, falling under the Dutch Ministry of Health, Welfare and Sport (VWS). The duties and tasks of the NZa have been laid down in the Healthcare Market Regulation Act. The NZa has over 400 employees.
Address and route to the NZa
Visiting address
Newtonlaan 1-41
3584 BX Utrecht
T: +31 30 296 81 11
Identification
To access the NZa building, visitors are required to provide a valid proof of identity. Visitors can identify themselves by means of a passport, driver's license, identity card or government pass. Visitor cannot enter the premises without identification.
How to get to the NZa
By public transport
From Utrecht Central Station, take city bus 28 towards ‘De Uithof’. Get off at the stop ‘Rijnsweerd-Noord’ (Pythagoraslaan). Our office is on the other side of the street. Plan your trip from door-to-door at:
By car
From the Ring Utrecht Oost (A27) and from Amersfoort (A28):
- Take the exit Rijnsweerd at the Rijnsweerd junction.
- Turn right at the traffic lights (Waterlinieweg).
- Take the first street on your right in the direction of Rijnsweerd (Pythagoraslaan).
- Turn right immediately (Boylelaan), turn left (Newtonlaan); our building is on your right hand side, the NZa office is the last building on your right hand side.
Mission
The Dutch Healthcare Authority (NZa) protects the interests of citizens with regard to accessibility, affordability, and quality of healthcare in the Netherlands. With that in mind, the NZa sets rules, conducts oversight over healthcare providers and health insurers, and gives recommendations to the Ministry of Health, Welfare and Sport (VWS). We put the interests of citizens first in anything we undertake. This means that we constantly make sure that healthcare remains affordable for those who need it, that health care is available in a timely manner, and that the quality of health care is excellent.
Our core values are:
- competence
- independence
- reliability
Duties
The NZa sets the tariffs and treatment descriptions in the healthcare market
The NZa determines what types of healthcare can be charged to patients by healthcare providers, and what such healthcare may cost at the most, for example, treatments by GPs or dentists, or healthcare provided to people with disabilities. For most treatments, health insurers and healthcare providers sit down and make arrangements about what each treatment entails, what its quality should be, and what its price can be.
The NZa conducts oversight over health insurers and healthcare providers
Based on the NZa's own analyses and on reports filed by consumers, the NZa checks whether healthcare providers and health insurers comply with the rules and regulations. For example, health insurers must accept everyone for the basic health insurance package, regardless of age, income, lifestyle or health. Also, healthcare providers must correctly charge their treatments to patients. In addition, they are required to provide clear information about the price and quality of the healthcare they offer. Are the interests of consumers at issue? Then the NZa will step in.
Why a Healthcare Authority
Healthcare costs have dramatically increased for the past few years. As prosperity increases, the need for healthcare increases as well. On top of that the population is getting older, and medical technology is constantly innovating. In order to ensure that healthcare remains accessible 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’: having high-quality healthcare for a competitive price, as well as having sufficient options from which consumers can choose.
The Dutch healthcare system consists of 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 Dutch healthcare system is characterized by market-based regulations: it will only work if market participants act afficiently, and are given the right incentives to do so. The NZa is the regulator healthcare market, helping new markets get off the ground wherever possible. The NZa's aim is to provide consumers with accessible, affordable and high quality healthcare.
The NZa itself is able to set a large part of its own agenda. The NZa's aims call for a proactive approach. The organization is set up in accordance with the ‘lean and smart’ principle: an effective and small organisation with skilled professionals, state-of-the-art systems and smart tools. That is how the NZa stays lean and decisive, while producing a high output.
Working methods
The NZa uses a combination of tools to strike the right balance. The aim is always to achieve effective oversight 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 creating favourable conditions and an effective overall framework.
Where possible, market-based regulatory methods will be used to realize efficient market behaviour. The promotion of competition is a natural process of meeting the needs of consumers. Therefore, in principle, other methods such as the simulation of market forces are only employed as a secondary measure.
Tools
The NZa keeps a close watch on trends and developments in markets and their submarkets. Its market monitors serve as input for its decision-making process about what tools to use in what markets.
The NZa fulfils its advocacy role by issuing recommendations about policy and regulations based on implementation assessments and oversight assessments. The NZa provides recommendations on request and proactively, meaning of the NZa’s own accord, with an eye to further development of the Dutch healthcare system, both in the curative markets as well as in the care markets.
The range of statutory instruments at its disposal offers the NZa many opportunities for setting the general conditions of the different healthcare markets, such as performance descriptions, cost-allocation principles, smart price caps, and regulatory rules concerning, for instance, misleading advertising. In addition, the NZa can take action in individual cases, for example if competitive conditions are distorted because of a provider having significant market power. The NZa seeks to find the proper balance between taking industry-wide actions, for example by setting the general conditions of the different markets, and taking action in individual cases. The balance must be a combination in which effective and ‘light’ actions go hand-in-hand.
In its enforcement of compliance with the rules, the NZa uses a combination of proactive and responsive behaviour. To this end, a so-called ‘Risk Analysis Model’ (RAM) will be used to provide insight on a permanent basis into those sectors and markets where market developments must be followed either more closely or less closely. The system will prevent the administrative burdens for stakeholders from increasing. In addition, reports and indications submitted by market participants are also important for the NZa's oversigth efforts.
The NZa is developing a vision of the way in which regulatory tools will be used. The NZa consults market participants about the annual work program. Such consultation serve various purposes:
- The NZa must be well informed about what is happening in the market.
- For the sake of regulatory certainty, confidence and support, market participants should know what the NZa's considerations and reasons are.
- The NZa must be able to apply its own public assessment.
- In the development of its tools, the NZa uses consultation documents and policy regulations, so that the market participants can be involved in the opinion-forming process and to provide clarity on the way in which powers are applied. This also increases regulatory certainty, which is important for a healthy investment climate in the healthcare markets.
Executive Board
The Executive Board consists of the following members:
- Marian Kaljouw, chairwoman of the Executive Board
- Wim Sijstermans, member of the Executive Board
Marian Kaljouw has been the Chairwoman of the Executive Board since June 1, 2015. Ms. Kaljouw has had an extensive career in healthcare, both professionally and academically. She worked as a nurse, earned a Ph.D. degree, and was Chairwoman of the Board of the Dutch Nurses' Association (V&VN) between 2005 and 2012. Her dissertation was on 'The needs of relatives of intensive-care patients.' In addition, she was the Director of the Antonius Academy of the St. Antonius hospital in the city of Utrecht. And she was a member of the Transition Committee of the Social Domain.
On January 1, 2016, Wim Sijstermans was appointed member of the Executive Board. Mr. Sijstermans' portfolio includes IT and Corporate Services.
Mr. Sijstermans was Chief Technology Officer for the Dutch central government between 2013 and 2015. His duties included the development, implementation and maintenance of a vision of the technology range for the IT infrastructure within the Dutch central government. In that period, he was the founder and Chairman of the CTO Council. The CTO Council is responsible for the choices and coordination of the modernization of the services range for the central government's IT infrastructure. Furthermore, he was Chief Information Officer at the Dutch Tax Administration, at Schiphol Group, and at Sony Netherlands, and he worked for Shell as Global IT Audit manager, among other positions.
Advisory Board
The Advisory Board consists of up to five members, meets at least twice a year, and acts as an independent advisory body to the Executive Board. It gives recommendations on strategic policy themes, the NZa's strategic agenda, and on national and international developments that are relevant to the NZa. The Executive Board informs the Minister of Health, Welfare and Sport about the recommendations that the Advisory Board gives, and explains what it has done with them.
Dirk Ruwaard, Ph.D., has been appointed Chairman of the Advisory Board of the NZa. This appointment is for four years, and can be renewed once. The Advisory Board’s other members are: Marjolein ten Kroode, MSc.MCM.MIM, Koen Harms, MSc.