The advantages and disadvantages of insurer-provider intergration: what are implications for Dutch health care policy?

Background: Health care costs in the Netherlands are rising rapidly. One possible contribution to slow down the growth of health care costs and increase quality is the alignment of incentives of health care providers and health care insurers through insurer-­‐provider integration. The Dutch minister of Health, Edith Schippers presented a law proposal opting a prohibition of insurer-­‐provider integration (with certain minor exceptions). This research tries to examine advantages and disadvantages of vertical integration and the implications it might have for Dutch health care policy. Methods: Advantages and disadvantages of vertical integration were collected by literature review. Both theoretical and empirical implications of vertical integration were found, mainly in US literature. Besides, some interviews are executed with different actors in the Dutch health care field to hear opinions about vertical integration. Findings: Vertical integration can lead to various positive outcomes, like better health outcomes and cost reductions. This thesis therefore concludes that a prohibition might exclude major potential benefits. To prevent the market from negative consequences, competition is required, regulatory agencies play an important role.