Cost containment and physician payment methods in The Netherlands.
Cost containment in the Netherlands has been partly achieved by negotiated agreements between insurers and physician associations. The negotiating system in the Netherlands involves the determination of capitation and fee-for-service rates, based on negotiated norms for personal remuneration, practice costs, and practice size. Physician practice patterns are monitored in an effort to control volume. Selected aspects of the negotiating structure could be adopted by Medicare and HMOs to clarify issues in negotiations with physicians and to reimburse physicians more equitably. However, establishment of standardized fees and volume monitoring may not be as effective as global expenditure controls.
Kirkman-Liff
B L
BL
School of Health Administration and Policy, Arizona State University, Tempe 85287.
D003363:Cost Control / Q000379:methods; D005251:Fees, Medical; D007357:Insurance, Physician Services / Q000458:organization & administration*; D009313:National Health Programs / Q000191:economics*; D009426:Netherlands; D010818:Practice Patterns, Physicians' / Q000191:economics; D012051:Reimbursement Mechanisms; D014481:United States