Two health insurers reprimanded for not doing enough to guarantee good healthcare

The Dutch Healthcare Authority (NZa) imposed “formal measures” on two health insurers for failing to fulfill their duty of care. They don’t do enough to guarantee good, appropriate, and timely healthcare. The insurers have six months to improve. If they don’t, the NZa will publish their names and the measures taken against them, the authority said on Tuesday.

The NZa investigated the largest health insurer in four regions with waiting times above the Treek standards for mental healthcare and hospital care. It found room for improvement at all four. But the shortcomings were bad enough at two of them that the NZa considered formal measures necessary.

According to the NZa, all four health insurers must be more proactive when it comes to fulfilling their duty of care. They don’t do enough to identify the bottlenecks in providing appropriate healthcare for what their region needs. And they need to do more to reduce waiting lists and waiting times. The regulator instructed the health insurers to take more action to guarantee appropriate and sufficient supply, evaluate their actions, and adjust them if necessary.

“Access to care is no longer a given. That is a complicated problem for which all parties in the healthcare system are responsible,” the NZa said. “Health insurers must work with healthcare providers to ensure that people receive the care that they need. The NZa expects health insurers to closely monitor and manage the healthcare demand and supply in the region. In this way, they can help their insured with timely, accessible, and appropriate care.”