Dutch shared savings program targeted at primary care: Reduced expenditures in its first year

Area of Science:

• Health Economics
• Primary Care Management
• Healthcare Policy

Background:

• General Practitioners (GPs) are central to healthcare systems in many countries, including the Netherlands.
• Existing volume-based GP payment models may not adequately incentivize value-based care.
• Lack of value-based incentives can negatively impact overall healthcare system efficiency and patient outcomes.

Purpose of the Study:

• To evaluate the impact of a shared savings program for Dutch GPs on healthcare expenditures and quality.
• To assess whether shared savings contracts incentivize GPs to act as gatekeepers and coordinate care effectively.
• To determine the effect of shared savings on patient satisfaction and other quality indicators.

Main Methods:

• The study employed a difference-in-differences design.
• A regional control group of non-participating GPs was used for comparison.
• The program involved GPs sharing in savings of total healthcare expenditures, conditional on achieving quality targets.

Main Results:

• Program participation resulted in a 2% reduction in healthcare expenditures.
• Patient satisfaction remained unaffected by the program.
• Quality indicator results were ambiguous, but savings were primarily achieved by reducing specialist care utilization.
• Nearly all participating GPs exhibited cost-saving behaviors.

Conclusions:

• Shared savings contracts can effectively incentivize GPs to reduce healthcare costs.
• These contracts encourage cost-saving behaviors even when complementing existing payment models.
• Shared savings programs show potential for increasing the value of healthcare delivered by primary care physicians.