The Dutch Healthcare Authority
Overview of the Dutch Healthcare Authority. This overview doesn't contain all content on this 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.
The Dutch Healthcare Authority (NZa) protects the interests of citizens with regard to accessibility, affordability, and quality of health care in the Netherlands. With that in mind, the NZa sets rules, regulates health care providers and health insurers, and gives advice 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 health care stays 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:
The NZa sets the tariffs and the treatment descriptions in the health care market
The NZa determines what types of health care can be charged to patients by health care providers, and what such health care may cost (at the most), for example treatments by GPs or dentists, or health care provided to people with disabilities. For most treatments, health insurers and health care providers sit down and make arrangements about what each treatment entails, what its quality should be, and what its price can be.
The NZa regulates health insurers and health care providers
Based on analyses of its own and on reports filed by consumers, the NZa checks whether health care 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, health care providers must charge their treatments to patients correctly. In addition, they are required to provide clear information about the price and quality of the health care they offer. Are the interests of consumers at issue? Then the NZa will step in.
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 three members.
chairwoman Executive Board Marian Kaljouw
Marian Kaljouw has been the Chairwoman of the Executive Board since June 1, 2015.
Ms. Kaljouw has had an extensive career in health care, 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.
member Executive Board René Jansen
On August 1, 2015, René Jansen was appointed member of the Executive Board. Mr. Jansen's portfolio includes regulation and oversight.
Mr. Jansen holds a master's degree in organizational sociology, and has extensive experience of oversight and regulation. From 1998 until 2009, he was involved in competition oversight and sectoral regulation, and he was a member of the Board of the then Netherlands Competition Authority (NMa), one of the predecessors of the current Netherlands Authority for Consumers and Markets (ACM). Until August 1, 2015, he has been management consultant in cooperation with consultancy firm Twynstra Gudde on, among other topics, regulatory and governance issues in the health care industry.
member Executive Board Wim Sijstermans
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 tasks included the development, implementation and maintenance of a vision on 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 proactive modernization of the services range for the IT infrastructure within the Dutch central government. 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.
The Advisory Board consists of up to five members, meets at least twice a year, and acts as an independent advisor to the Executive Board. It gives advice 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. We expect to appoint two more members soon.