The 2nd HPD report - Health Policy Monitor

Integrated care
triggering private
service
monopolies?
Public Visibility
Impact
Transferability
interdepartmental committee oversees the endeavor; pilot projects
on integrated care receive subsidies; budgets can include
special arrangements or care products based on integrated care.
The boundaries within the health care sector and between different
sectors are increasingly permeable, thanks to new combinations
and arrangements of care that involve elements from all
necessary providers and sectors.
Idea
Pilot
Policy Paper
Legislation
Adoption
Evaluation
Change
As the plan took effect and private service organizations developed,
a wave of merger euphoria occurred. The Dutch Competition
Authority (“Nederlandse Mededingingsautoriteit,” NMA)
controls monopoly positions that are tantamount to mergers even
though they were presented as integrated care. However, this
regulation has not yet had an effect.
Integrated care is an incremental process; the Dutch health
care system is still in the process of evaluating and improving the
more detailed provisions of integrated care for the elderly.
Spain: Second plan for integrating health and social care in
Castilla y Léon
In the autonomous region of Castilla y León, a more ambitious
second plan for integrating health and social care (building on
one approved in 1998) took shape when the region assumed
control of its health care system in 2003. Castilla y León has some
characteristics that facilitate implementation of the measures to
improve integration of health and social care:
– Castilla y León has the highest share of elderly in the Spanish
population (22.3 percent aged 65 or older, compared with 18
percent in Spain as a whole).
– Social service provision is more generous than in the rest of
Spain.
– There is a single Ministry for Health and Social Welfare.
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