Nivel (Netherlands Institute for Health Services Research), Utrecht, the Netherlands.
Maastricht University, Maastricht, the Netherlands.
PLoS One. 2019 Nov 8;14(11):e0224829. doi: 10.1371/journal.pone.0224829. eCollection 2019.
With managed competition, selective contracting and the appointing of preferred providers are important instruments for health insurers to improve their bargaining position in the healthcare purchasing market. Insurers can offer enrollees extra services, such as advice about their healthcare, to attract them, ensure that they remain loyal, and to channel them to preferred providers. We investigate which advice services insurers in the Dutch system of managed competition offer enrollees, how they inform them about services, and if enrollees use and appreciate them.
From November to December 2017, two researchers independently analyzed the websites of all health insurers in the Netherlands. We also conducted a questionnaire study among 1,500 members (response 44.5%, N = 668) of the Nivel Dutch Health Care Consumer Panel.
All insurers offer one or more services. Most enrollees do not know if their insurer offers advice (67-87% per service). Twelve per cent (N = 76) of the enrollees indicate that they ever made use of a service, mostly regarding the choice of provider (N = 42). Respondents who used healthcare advice were satisfied with it. Of all enrollees, 41% indicate that they would probably/certainly, contact their insurer for advice and 37% would appreciate it if their insurer approached them. Among enrollees, 40% indicated the potential advice has some or a major influence on their choice of insurer.
While all insurers offer at least one service, enrollees generally are unaware of them. Only a minority ever made use of such a service. However, a reasonable proportion do appreciate their insurers' advice services and indicate that they would like to have contact with their insurer if they need care. Insurers do not appear to make the best use of the potential for giving healthcare advice and need to think about ways to increase coverage of those services.
在管理竞争、选择性承包和指定首选供应商的背景下，健康保险公司利用这些手段来改善其在医疗保健采购市场中的谈判地位。保险公司可以为参保人提供额外的服务，如有关其医疗保健的建议，以吸引他们、确保他们保持忠诚，并引导他们选择首选供应商。我们调查了荷兰管理竞争体系中的保险公司为参保人提供了哪些建议服务，他们如何向参保人宣传这些服务，以及参保人是否使用并欣赏这些服务。
在 2017 年 11 月至 12 月期间，两名研究人员独立分析了荷兰所有健康保险公司的网站。我们还对 Nivel 荷兰医疗保健消费者小组的 1500 名成员（响应率为 44.5%，N=668）进行了问卷调查。
所有保险公司都提供一项或多项服务。大多数参保人不知道他们的保险公司是否提供建议（每种服务的知晓率为 67%-87%）。12%（N=76）的参保人表示他们曾经使用过某项服务，主要是关于选择供应商（N=42）。使用医疗保健建议服务的受访者对此表示满意。在所有参保人中，41%表示他们可能/肯定会联系他们的保险公司寻求建议，37%表示如果他们的保险公司主动联系他们，他们会很感激。在参保人中，40%表示潜在的建议对他们选择保险公司有一定或重大影响。
虽然所有保险公司都提供至少一项服务，但参保人通常对此并不了解。只有少数参保人曾经使用过此类服务。然而，相当一部分人确实很欣赏他们保险公司的建议服务，并表示如果需要医疗保健，他们希望与保险公司联系。保险公司似乎没有充分利用提供医疗保健建议的潜力，需要考虑如何增加这些服务的覆盖范围。
