Handle with care! The strongest incentives for efficiency of elderly care.
Hervormingen nodig om ouderenzorg doelmatiger te maken
This report analyses three options for reform: stronger incentives for efficiency within the current institutional setting; incorporating elderly care in the existing mandatory basic health-insurance scheme; and transfer of responsibility for elderly care to municipalities. Each of these options implies possible trade-offs between efficiency on the one hand, and quality, accessibility and freedom of choice on the other. We conclude that incorporating elderly care in the basic healthinsurance scheme yields the strongest incentives for efficiency.
However, this option requires the fulfilment of a number of conditions related to, amongst others, risk-equalization, quality of care and to housing policies at the municipality level. If these conditions cannot be fulfilled, transfer of financial responsibility for elderly care to municipalities may be a more attractive option. It is desirable to initiate policies aimed at greater transparency of quality and to analyse coordination issues with municipalities, before deciding on a new purchasing model for elderly care.
This publication is in Dutch.