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ACM points out to health insurers its antitrust concerns over their joint plans regarding complex emergency medical services

The Netherlands Authority for Consumers and Markets (ACM) has pointed out to health insurers that their joint plans about concentrating emergency medical care in hospitals could reduce the options of patients and the insured. ACM was unable to establish any benefits to the reduction of options. ACM has warned health insurers that implementation of their plans may violate the Dutch Competition Act.

Health insurers are currently drawing up plans regarding the concentration of complex emergency medical services in hospitals. For example, health insurers wish to concentrate emergency care for strokes or heart attacks in specialized hospitals per region. These plans should result in better and more efficient emergency care. However, various hospitals and scientific associations of medical specialists do not recognize the benefits of these plans for patients and the insured. They see drawbacks such as the reduction of health care services in hospitals that lose their emergency rooms, which results in reduced health care quality for patients.

ACM believes that it is important to have options in health care. Although patients often do not have much to choose from when finding themselves in an emergency situation, emergency care is not an isolated discipline. ACM thinks that, in many cases, concentrating complex emergency care will also affect non-emergency care. If health insurers jointly decide where they buy complex emergency medical services, they are less able to separate themselves from each other when contracting other health care services as some of these are inextricably linked to the complex emergency medical services. ACM believes that differences between health insurers are important as it gives the insured something to choose from. This keeps the health insurers on their toes to continue to offer the best service at the best price. Coordination among health insurers concentrating health care services is only allowed if the benefits for patients and the insured outweigh the drawback of having fewer options.

Without any independent and well-established quality standards for complex emergency medical services, health insurers are unable to prove that the benefits they claim that the concentration of emergency medical services will have for patients and the insured outweigh the reduction of options. ACM therefore calls on the health insurers to support their plans with such quality standards. Only then will ACM be able to assess the plans’ effects on competition.