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Collective refusal of primary-care contracts raises costs for patients

The Netherlands Authority for Consumers and Markets (ACM) has pointed out to primary-care providers that a collective boycott of care contracts is illegal. A collective boycott violates competition rules, harms consumers, and, at the end of the day, harms health care.

Collective boycotts are illegal

the coming weeks, health insurers have to conclude contracts with primary-care providers, such as physiotherapists and obstetricians. ACM is seeing that, within certain professional groups in primary care, many care providers are considering not to conclude a contract. ACM has also received indications that some of these care providers have coordinated this decision among each other. Such collective boycotts are illegal. Encouraging or facilitating boycotts, for example by recommending not to sign, too, may violate competition rules. Collective boycotts could lead to price increases without any improvements for patients and the insured in return. This will unnecessarily drive up health care costs.

A boycott is not a solution

Care providers must decide for themselves whether or not to conclude a contract with a health insurer. A collective boycott is not a solution to deadlocked negotiations. Differences of opinion on the substance of contracts should be resolved in another way. ACM is calling on care providers and health insurers to continue talking to each other, and taking into consideration each other’s interests and those of patients and the insured. If care providers and health insurers are unable to reach an agreement on a substantive level, they have the opportunity to call on the independent authority for healthcare contracting disputes.

Room for cooperation to improve care

In its ‘Basic principles for ACM’s oversight of primary-care providers’ (in Dutch: Uitgangspunten toezicht op de eerste lijn), ACM has shown that there is plenty of room for cooperation if such will benefit patients and the insured, for example, through improved treatment coordination or the development of innovative care projects. In addition, competition rules offer care providers the opportunity to discuss with health insurers the benefits and drawbacks of contract terms. The Basic principles also describe the boundaries of coordination between health insurers. Collective boycotts overstep those boundaries.

In the next few weeks, ACM will sit down with various parties involved. ACM will subsequently explain the boundaries of collaborations in negotiations. ACM may demand an adjustment of their practices, if so required.