WILLEMSTAD – “The Curaçao Medical Center (CMC) is in fact bankrupt.” This is apparent from the report of the Dutch Health Care Authority (NZA) on the hospital’s financial situation. Minister of Finance Javier Silvania has sent the controversial report to Parliament.
WILLEMSTAD
– “The Curaçao Medical Center (CMC) is in fact bankrupt.” This is apparent from the report of the Dutch Health Care Authority (NZA) on the hospital’s financial situation. Minister of Finance Javier Silvania has sent the controversial report to Parliament.
“The document is now public,” says the minister. Silvania and Health Minister Pietersz-Janga were previously critical of the report. Because the hospital management disagrees with the contents of the report, the Dutch Healthcare Authority has made certain passages illegible. At the request of Silvania, the uncensored version was still sent.
“The document is now public,” says the minister. Silvania and Health Minister Pietersz-Janga were previously critical of the report. Because the hospital management disagrees with the contents of the report, the Dutch Healthcare Authority has made certain passages illegible. At the request of Silvania, the uncensored version was still sent.
This report describes the results of the research into the financial manageability of the Curaçao Medical Center. The researchers also advise on a possible funding method that promotes efficiency but also does justice to the specific context in which the CMC is located.
This report describes the results of the research into the financial manageability of the Curaçao Medical Center. The researchers also advise on a possible funding method that promotes efficiency but also does justice to the specific context in which the CMC is located.
The researches indicate that they have mapped out the cost and production development from 2017 to 2022. “As expected, capital costs are showing an increase. This also applies to personnel costs and laboratory costs. Based on the figures submitted, we are unable to establish a good relationship between production expressed in patient days and costs. We cannot make statements about efficiency and possible savings based on the information made available to us.”
The researches indicate that they have mapped out the cost and production development from 2017 to 2022. “As expected, capital costs are showing an increase. This also applies to personnel costs and laboratory costs. Based on the figures submitted, we are unable to establish a good relationship between production expressed in patient days and costs. We cannot make statements about efficiency and possible savings based on the information made available to us.”
When it comes to capital costs, CMC-Vastgoed has outlined a number of scenarios to reduce costs. In all scenarios, the principle is maintained that CMC-Vastgoed reserves for maintenance, renovation and replacement new construction. There is a strong correlation between the scenarios with regard to the capital costs and the development of the operating figures. The scope of the lenders to make agreements about debt restructuring is limited as long as the CMC operation does not have a balanced multi-year budget.
When it comes to capital costs, CMC-Vastgoed has outlined a number of scenarios to reduce costs. In all scenarios, the principle is maintained that CMC-Vastgoed reserves for maintenance, renovation and replacement new construction. There is a strong correlation between the scenarios with regard to the capital costs and the development of the operating figures. The scope of the lenders to make agreements about debt restructuring is limited as long as the CMC operation does not have a balanced multi-year budget.
We have experienced that there is a lot of discussion about the current funding model for the CMC. 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 (also with SVB insured parties) a strict PxQ (price times quantity) funding based on existing services and rates. In practice, there is a budget model for care for SVB insured persons, in which the Ministry of GMN determines the budget. We do not consider a pure PxQ model to be recommended, given the undesired production stimulus that this entails. We advise to further flesh out the budget system. In our opinion, an integral budget model, with a fixed and a variable part, on which the parties involved must reach agreement, is recommended in order to prevent production from becoming too low. This should include the reimbursement of care for the (SVB and private) insured persons as well as for undocumented migrants and for entries on the island. Production can be recalculated in such a model. Several variants are possible. We have developed a variant that contains an incentive to maintain production levels and where additional payments do not exceed the additional variable costs.
We have experienced that there is a lot of discussion about the current funding model for the CMC. 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 (also with SVB insured parties) a strict PxQ (price times quantity) funding based on existing services and rates. In practice, there is a budget model for care for SVB insured persons, in which the Ministry of GMN determines the budget. We do not consider a pure PxQ model to be recommended, given the undesired production stimulus that this entails. We advise to further flesh out the budget system. In our opinion, an integral budget model, with a fixed and a variable part, on which the parties involved must reach agreement, is recommended in order to prevent production from becoming too low. This should include the reimbursement of care for the (SVB and private) insured persons as well as for undocumented migrants and for entries on the island. Production can be recalculated in such a model. Several variants are possible. We have developed a variant that contains an incentive to maintain production levels and where additional payments do not exceed the additional variable costs.
Insight into and agreements on the total acceptable costs in relation to the care to be provided are 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.
Insight into and agreements on the total acceptable costs in relation to the care to be provided are 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 researchers, a long-term agreement is necessary for the country, the Social Insurance Bank (SVB) and the CMC to be able to draw up policy 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 about the method of budget determination, the amount of the annually available resources and a dispute settlement procedure. The Curaçao Healthcare Authority can play a role in this.
According to the researchers, a long-term agreement is necessary for the country, the Social Insurance Bank (SVB) and the CMC to be able to draw up policy 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 about the method of budget determination, the amount of the annually available resources and a dispute settlement procedure. The Curaçao Healthcare Authority can play a role in this.
https://www.curacaochronicle.com/post/main/dutch-report-on-cmc-public/
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