Unlocking value in healthcare: barriers and success factors in the introduction of value-based payment models in the Dutch healthcare system

This dissertation explores the barriers and success factors of VBP models that influence their design, implementation, and application within the context of NOC and transmural care in the Netherlands. In doing so, this dissertation is expected to further aid the VBHC reform in the country. This dissertation identifies elements that enhance or inhibit the design, implementation, and application/evaluation of VBP models. It also analyzes the impact of different types of models on outcomes and reviews what facilitating and inhibiting factors are associated to each model type. These facilitating and inhibiting elements are also studied considering stakeholders’ insights in a Dutch network. Furthermore, this dissertation explores the introduction of a VBP model monitoring method and shares the results of its application in the Netherlands. Lastly, this dissertation takes a step back from the VBP models and analyzes the complex elements that shape the contractual negotiations between hospitals and health insurers in the Netherlands, examining why VBHC, despite its advantages, has not received more attention in this negotiation process.