WILLEMSTAD – The report of the Dutch Healthcare Authority NZa about the new hospital in Curaçao states that the debts are greater than the assets and that there is therefore a technical bankruptcy.
WILLEMSTAD –
The report of the Dutch Healthcare Authority NZa about the new hospital in Curaçao states that the debts are greater than the assets and that there is therefore a technical bankruptcy.
The NZa mapped out the cost and product development from 2017 to 2022. It is apparent that in the start-up years of the Curaçao Medical Center (CMC), compared to the end years of the old hospital (SEHOS), the costs in relation to the benefits have risen sharply.
The NZa mapped out the cost and product development from 2017 to 2022. It is apparent that in the start-up years of the Curaçao Medical Center (CMC), compared to the end years of the old hospital (SEHOS), the costs in relation to the benefits have risen sharply.
For the CMC, this amounts to a negative financial result of around ANG 50 million for the year 2021. The 2022 budget shows a comparable underfunding of the expenses.
For the CMC, this amounts to a negative financial result of around ANG 50 million for the year 2021. The 2022 budget shows a comparable underfunding of the expenses.
Conflict
Conflict
One of the major points of conflict between the government and CMC concerns the current funding model for the new hospital.
One of the major points of conflict between the government and CMC concerns the current funding model for the new hospital.
Underlying is a more fundamental tension between a fixed available budget and expectations about what can be done to achieve it.
Underlying is a more fundamental tension between a fixed available budget and expectations about what can be done to achieve it.
In its 2022 budget, the CMC assumes a strict price multiplied by the amount of funding (also for SVB policyholders), the so-called PxQ model, based on existing performances and rates.
In its 2022 budget, the CMC assumes a strict price multiplied by the amount of funding (also for SVB policyholders), the so-called PxQ model, based on existing performances and rates.
In practice, however, there is a budget model for care for SVB (Social Insurance Bank) insured persons, in which the Ministry of Health determines the budget.
In practice, however, there is a budget model for care for SVB (Social Insurance Bank) insured persons, in which the Ministry of Health determines the budget.
Not recommended
Not recommended
The Healthcare Authority does not consider a pure PxQ model to be recommendable, because it entails an undesirable production stimulus. The more medical procedures are performed, the more can be claimed.
The Healthcare Authority does not consider a pure PxQ model to be recommendable, because it entails an undesirable production stimulus. The more medical procedures are performed, the more can be claimed.
The Dutch Healthcare Authority recommends further fleshing out the government’s budget system. According to the NZa, an integrated budget model, with a fixed and a variable part, on which the parties involved must reach an agreement, is recommended to prevent production from falling too low.
The Dutch Healthcare Authority recommends further fleshing out the government’s budget system. According to the NZa, an integrated budget model, with a fixed and a variable part, on which the parties involved must reach an agreement, is recommended to prevent production from falling too low.
This should include the reimbursement of care for the SVB and privately insured persons as well as for undocumented migrants and for entries on the island. Production can be recalculated in such a model.
This should include the reimbursement of care for the SVB and privately insured persons as well as for undocumented migrants and for entries on the island. Production can be recalculated in such a model.
Variants
Variants
Several variants are possible. The NZa has developed a variant that contains an incentive to maintain production at the same level and in which additional payments do not exceed the additional variable costs.
Several variants are possible. The NZa has developed a variant that contains an incentive to maintain production at the same level and in which additional payments do not exceed the additional variable costs.
Insight into and agreements about the total acceptable costs in relation to the care to be provided is necessary in view of the position of the CMC as the only hospital on the island. The relationship with the rest of the healthcare field, such as general practitioners, plays a role in this, according to the NZa.
Insight into and agreements about the total acceptable costs in relation to the care to be provided is necessary in view of the position of the CMC as the only hospital on the island. The relationship with the rest of the healthcare field, such as general practitioners, plays a role in this, according to the NZa.
The NZa says that a multi-year agreement is necessary for the Country, the SVB, and the CMC to be able to draw up policies for their own organization. It is up to the parties to decide which options and recommendations will be adopted and implemented.
The NZa says that a multi-year agreement is necessary for the Country, the SVB, and the CMC to be able to draw up policies for their own organization. It is up to the parties to decide which options and recommendations will be adopted and implemented.
As long as a binding legal framework has not yet been established, it will be necessary to make binding agreements in the intervening years regarding the method of budget determination, the amount of the annually available resources, and also a dispute settlement procedure. The Curaçao Healthcare Authority says it can play a role in this.
As long as a binding legal framework has not yet been established, it will be necessary to make binding agreements in the intervening years regarding the method of budget determination, the amount of the annually available resources, and also a dispute settlement procedure. The Curaçao Healthcare Authority says it can play a role in this.
https://www.curacaochronicle.com/post/main/curacao-hospital-is-technically-bankrupt/
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