Bundled payments for chronic diseases increased health care expenditure in the Netherlands, especially for multimorbid patients

Karimi, M., Tsiachristas, A., Looman, W., Stokes, J. , van Galen, M. and Rutten-van Mölken, M. (2021) Bundled payments for chronic diseases increased health care expenditure in the Netherlands, especially for multimorbid patients. Health Policy, 125(6), pp. 751-759. (doi: 10.1016/j.healthpol.2021.04.004) (PMID:33947604)

Abstract

Bundled payments aim to stimulate the integration of healthcare services and ultimately reduce healthcare expenditure growth through improved quality of care. The Netherlands introduced bundled payments for chronic diseases in 2010 by reimbursing providers annually for a bundle of primary care services related to COPD, Diabetes, or Vascular Risk Management. We aimed to assess the long-term effects of these bundled payments on healthcare expenditure. We used health insurance claims data from 2008 to 2015 to compare the healthcare expenditure between everyone who was included in bundled payments and a control group. We performed a difference-in-difference analysis in combination with propensity score matching and found that bundled payments consistently increased health care expenditure over seven years. The average half-year increase was €233 (95%CI: 204-262) for DM2, €609 (95%CI: 533-686) for COPD, and €231 (95%CI: 208-254) for VRM, representing 13%, 52%, and 20% of 2008 half-year cost. The increase was higher for those with multimorbidity compared to those without multimorbidity. This suggests that the expectations of the bundled payments are yet to be fulfilled.

• Item Type: Articles
• Additional Information: The SELFIE project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No 634288.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Stokes, Dr Jonathan
• Authors: Karimi, M., Tsiachristas, A., Looman, W., Stokes, J., van Galen, M., and Rutten-van Mölken, M.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
• Journal Name: Health Policy
• Publisher: Elsevier
• ISSN: 0168-8510
• ISSN (Online): 1872-6054
• Published Online: 15 April 2021
• Copyright Holders: Copyright © 2021 The Authors
• First Published: First published in Health Policy 125(6): 751-759
• Publisher Policy: Reproduced under a Creative Commons License