Diabetes Care in The Netherlands: - Novo Nordisk

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Higher quality diabetes care may attract more loss-makingpatients for the insurer• Diabetes patients typically have high per patient health care cost (cost that are assumed to be caused by diabetes plus otherhealth care expenditures). Total costs EUR 4,500 per diabetes patient versus EUR 1,650 average– ‘Diabetes patients typically have a wide range of health problems, not necessarily related to diabetes’– ‘Diabetes Type 2 is a lifestyle disease, but an unhealthy lifestyle can lead to a lot more problems than just diabetes’– ‘Diabetes is a disease of the system. It deteriorates your overall health to a wider extent than the regular diabetes complications’• Still a suspicion that the risk equalization scheme does not sufficiently compensate– Diabetes patients have historically been loss making (2006 EUR 74 per person loss after equalization; 2007 EUR 140 per personloss after ex-ante compensation – but differences not statistically different from zero)– The 2011 risk equalization proposal indicates a EUR 3,409 loss per self reported diabetic, which is equalized to a loss of EUR 235(which is statistically not significantly different from zero). (source: Prof. Van der Ven)– The classification criteria for diabetes within the risk equalization scheme are strict. As a result, the insurer does not receive ex-anterisk compensation for all its diabetes patients• Hence, there is a downside in offering higher quality, since insurers offering high quality would be likely to attract morepatientsSource:Booz & Company analysis. Expert interviews. Expert interview with Prof. van der Ven – Erasmus University36
LimitedLimitedcollaborationcollaborationincentiveincentiveforforprimaryprimarycarecareandandspecialistspecialistcarecarePrimary CarePOHGPObjectives Resource Constraints Practice that would resultfrom objectives, resourcesand constraints• Provide completeand comprehensivecare• Realize income• Applying the GPdiabetes protocol• Referring tospecialist• Lack of time fordedicated diabetesservice• Lack of specialistdiabetesknowledge• No control on whatis happening in thehospital• Most patients areeffectively treated• But some patientsmay be unnecessarilyreferred to medicalspecialists• Some patients mayreceive late referralsto specialistsRelatively little interactionand collaborationHospital careDiabetic nurseMedicalspecialist••Provide the bestdiabetes careRealize revenuesfor the hospital andhimself/herself• Applying hospitalservices• Applying Specialistknowledge• No information onpatients in primarycare• No influence onpatients in primary•‘Tends to keeppatients in thehospitalcareDespite limited collaboration incentives, care groups haveachieved much progress in quality of diabetes careOnce they have been here,surrounded by diabeticspecialist, it is hard to sendthem back to the first line’Medical SpecialistBooz & Company 14 November 2011Prepared for Novo Nordisk3037
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 and 16: 33Further improving health of of di
Page 17 and 18: 22Recommendation 2: Engage employer
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: Delaying complications saves medica
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

Diabetes Care in The Netherlands: - Novo Nordisk

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