Selective contracting by health insurers: the perspective of enrolees

The healthcare system in the Netherlands is based on regulated competition, whereby health insurers and healthcare providers compete to ensure the quality and the affordability of care.
One of the pillars of regulated competition is selective contracting, which means that health insurers send their policy-holders to contracted healthcare providers. Healthcare providers compete to become one of these contracted providers. However, selective contracting is rarely implemented out of fear that insurance companies will not accept it. This dissertation examined the mechanisms driving the acceptance of selective contracting. Policy-holders who required the most care were less likely to choose a healthcare policy based on selective contracting. More confidence and transparency reduced the negative view policy-holders have of selective contracting. Finally, this dissertation also found that subtle guidance methods can be an effective way to steer policy-holders towards preferred healthcare providers. Further research is necessary to determine whether this provides enough incentive to allow healthcare providers to compete.