The National Health Care Institute (Zorginstituut Nederland) carries out tasks relating to two Dutch statutory health insurance schemes: the Health Insurance Act (Zorgverzekeringswet) and the Long-Term Care Act (Wet langdurige Zorg, Wlz). The National Health Care Institute’s role in maintaining the quality, accessibility and affordability of health care in the Netherlands involves four tasks:
- managing the basic health care package;
- encouraging improvements in health care quality;
- advising on innovations in health care professions and education;
Health Care Coverage
Health Care Coverage is one of the National Health Care Institute’s programmes. This programme’s main role is managing the basic health care package in order to ensure that it contains all necessary care, but no more than is required. We achieve this by:
- advising the Dutch Minister of Public Health, Welfare and Sport on the content of the basic package and on the Health Insurance Act and the Wlz, on the basis of financial and social considerations;
- clarifying the basic package, for instance, in response to disputes between health insurers and insured clients.
Health Care Quality
Health Care Quality contributes to good health care by helping the parties involved continually improve health care and helping patients find their way to good-quality care. The programme achieves this by:
- encouraging and supporting the health care parties responsible for drawing up quality standards and relevant measuring instruments.
- encouraging health care parties to comply with these quality standards, use ‘good practices’
- providing insight into the quality of care provided. The programme collects data on quality of care and ensures these data are accessible. This information helps patients make choices in health care and facilitates the supervision of health care.
Health Care Professions
The National Health Care Institute’s Innovative Health Care Professions programme advises the Dutch Minister of Health, Welfare and Sport on innovations and improvements in health care professions and education. The programme plans to develop a new classification of professions and to design the right educational structure for the entire health care sector. The Health Care Professions programme’s starting points are future demand for health care, and social and technological developments in the provision of care.
The National Health Care Institute has the following tasks relating to funding of the Health Insurance Act and the Wlz:
- manages all contributions that employers and benefits agencies pay for health care expenses; i.e. income-dependent contributions for the Health Insurance Act and Wlz contributions.
- divides contribution funds among health insurers (risk adjustment) and health care liaison offices, and issues health insurers and health care liaison offices with budgets for administrative expenses within the framework of the Wlz.
- implements Wlz subsidy regulations, such as extramural treatment, ADL-assistance (ADL stands for Activities of Daily Living) and primary care residence.
- supports implementation of the Wlz and the Social Support Act (Wet maatschappelijke ondersteuning, Wmo) by managing information standards (iWlz and iWmo)