Diabetes Care in The Netherlands: - Novo Nordisk

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11Recommendation 1: Refine economic incentives to encourageintegratedRecommendationcare and1:qualityRefineimprovementeconomic incentives to encourageintegrated care and quality improvementBarrierCurrenteconomicincentives donot encouragequalityimprovementand innovationDiagnosis• Insurers are supporting quality improvement, but theyare confronted with (perceived) financial disincentives- High quality care is perceived to only delay complications andcost (however, an indicative analysis suggest ~25% life timecost reduction if complications are delayed with 3 years)- Differences in risk exposure for specialist and primary care- Higher quality diabetes care may attract more loss-makingpatients for the insurer- (Hospital) capacity that is freed up by quality improvementstends to fill up with other patients (leading to double cost)• Limited collaboration incentive for primary care andspecialist care• Quality improvement initiatives are frustrated byfragmented budgeting (and ad hoc budget cuts)• Individual quality incentives are lacking for Primary Care,Specialists and Patient• Significant evidence gaps in basic statistics and intreatment evidence suggest insufficient supportingincentives for critical researchRecommendationInsurer• Integrate contracting of primarycare and specialist care in networks• Provide patient incentive forcompliance (bonus miles, gainsharing)• Enable research funding fromregular budgetGovernment• Adjust risk equalization scheme toensure small profit margin ondiabetes patients for insurers• Create an integrated funding modelfor primary and specialist carenetworksBooz & Company 14 November 2011Prepared for Novo Nordisk714
22Recommendation 2: Engage employers, UWV and participativecareRecommendationin diabetes care2: Engage employers, UWV and participativecare in diabetes careBarrier Diagnosis RecommendationEmployers,UWV andparticipativecare are stilllittle engaged indiabetes care• Ageing will create an extremely tight labour market overthe coming decade• Labour shortage from late nineties illustrates the risk forour economy• Diabetes has a high prevention potential for lostproductivity- 92,000 of working disabled have diabetes,• However, curative and participative care (arbo- andbedrijfsarts) are still two different worldsInsurer• Offer collective insurance modules fordiabetes to increase the participationof diabetes patients• Integrate contracting of participativeand curative careCompanies and UWV• Invest in collective insurance foremployees and welfare recipientsParticipative care• Ensure a working environment thatencourages compliance andmotivates to work as long as possibleBooz & Company 14 November 2011Prepared for Novo Nordisk815
Page 6 and 7: SummaryDiabetes is a serious and de
Page 8: diabetes care. Extra compensation w
Page 11 and 12: ContentsSummarized findings and rec
Page 13 and 14: 11Diabetes is a major and underesti
Page 15: 33Further improving health of of di
Page 19 and 20: 44Recommendation 4: Introduce condi
Page 21 and 22: Already more than 1M diabetes patie
Page 23 and 24: Costs of of complications and treat
Page 25 and 26: Number of patients reaches ~1.4M in
Page 27 and 28: Increase in lost productivity is dr
Page 29 and 30: Diabetes care clearly improved in t
Page 31 and 32: Better compliance can be stimulated
Page 37 and 38: Delaying complications saves medica
Page 39 and 40: LimitedLimitedcollaborationcollabor
Page 41 and 42: Individual quality incentives are l
Page 43 and 44: Recommendation 1: Insurer should in
Page 47 and 48: Labour shortage from late nineties
Page 49 and 50: However, curative and participative
Page 53 and 54: Non-compliance leads to severe comp
Page 55: Facilitated patient networks are su
Page 58 and 59: Recommendation 3:Facilitate network
Page 62 and 63: But new medication could add a lot
Page 66:
Booz & Company is a global manageme
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Diabetes Care in The Netherlands: - Novo Nordisk

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