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Hospitals themselves are responsible for arrangements between medical specialists

Management of hospitals are responsible for any arrangements that medical specialists set up with specialists from other hospitals. Medical specialists and their hospital form a single unity, because one cannot exist without the other.

This is the position of the Netherlands Authority for Consumers and Markets (ACM) following questions about its assessment of arrangements between medical specialists and of mergers of partnerships of medical specialists from different hospitals. In recent years, more and more partnerships have merged, resulting in an increase in questions about such mergers, particularly about regional partnerships. By publishing its position, ACM gives certainty about who is responsible for anticompetitive arrangements that harm patients and insurers.

Medical specialists in hospitals form partnerships per specialism. In recent years, more and more partnerships of different hospitals form partnerships of their own, which are called city or regional partnerships. ‘A partnership that consists of medical specialists of different hospitals is considered a collaboration between the hospitals in question,’ comments Chris Fonteijn, Chairman of the Board of ACM. ‘That means that any arrangement within such partnerships that restrict competition are considered cartel agreements concluded by the hospitals in question.’

Management of hospitals should thus know exactly what goes on in such partnerships with regard to mutual collaborations, because, ultimately, they are responsible for such collaborations. ACM has drawn up a document (in Dutch), ‘ACM’s position on partnerships and hospitals,’ which covers the most important questions and answers about this particular topic.

The creation of city or regional partnerships and the arrangements that are concluded in the context thereof may help realize a higher level of quality or accessibility such as offering care services 24/7. However, arrangements made between partnerships may also involve anticompetitive elements, such as market-sharing arrangements between hospitals regarding health care, which may negatively affect health care quality and/or affordability. ACM takes action if consumers do not benefit from collaborations. When deciding whether or not to take action, ACM will take into account the opinions of patient organizations and health insurers.

The Dutch Healthcare Authority (NZa) shares ACM’s position on partnerships and hospitals forming a single unity. The NZa, too, has powers to take action if regional partnerships are involved. If necessary, ACM and the NZa will act in close consultation with each other, and will complement each other in their actions.