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Collaboration between three hospitals benefits cancer patients

Three hospitals in the central Dutch province of Utrecht are allowed to collaborate in complex cancer care. The Netherlands Authority for Consumers and Markets (ACM) expects this collaboration to yield sufficient benefits for patients and the insured. The University Medical Center Utrecht (UMC Utrecht) in the city of Utrecht, the Meander Medical Center (MMC) in the city of Amersfoort and the St. Antonius Hospital in the cities of Utrecht and Nieuwegein wish to cooperate closely with regard to treatments of several rare types of tumors. These three hospitals had tested their planned collaboration to the Dutch Competition Act themselves first. They subsequently asked ACM for its opinion. ACM has come to the conclusion that the collaboration offers sufficient benefits.

Some types of cancer such as cancer of the liver, pancreas, stomach, and oesophagus are fortunately rare. If specialized surgical teams performed these types of operations more often, surgeons would be able to acquire sufficient knowledge and experience, so that the quality of the operations will improve. That is why these three hospitals wish to cooperate closely in order to concentrate complex cancer treatments in specific hospitals, and to coordinate care together. ACM believes that it is likely that the benefits of this collaboration outweigh the drawbacks to competition, for example, the reduction of options for patients.

Hospital collaborations in complex care

We are currently observing that more and more hospitals collaborate in complex care. The Dutch Competition Act does not stand in the way of collaborations that clearly benefit patients and the insured. It is essential, however, that hospitals and health insurers accurately identify the pros and cons of each individual collaboration, and that they take into consideration the consequences for the options that patients will have afterwards, for example.

Hospitals or care institutions that wish to collaborate need to do an investigation themselves first. The three hospitals in the province of Utrecht investigated first whether their planned collaboration would comply with the Dutch Competition Act. They also sat down with health insurers and patients’ associations to discuss the collaboration’s benefits and drawbacks. Finally, at the request of the hospitals involved, ACM tested all of this input against the Dutch Competition Act and the Guidelines for ‘assessing mergers and collaborations in hospital care’. According to ACM, this collaboration is likely to be in the interest of patients and the insured.

Points of attention for collaborations in health care

If hospitals wish to collaborate, ACM suggests them to look into the following points of attention:

  • Do not only identify the benefits of a collaboration, but also the drawbacks (potential and real).
  • Also identify the consequences of the restriction of competition.
  • Weigh the collaboration’s benefits and drawbacks with regard to quality, accessibility and affordability of health care.
  • With regard to the identified benefits and drawbacks, substantiate their projected effects as much as possible by providing factual data.

In such processes, make sure to involve all relevant parties such as health insurers and patients’ associations in order to get clarity about this information. All parties (health care providers, health insurers and patients’ associations) should ask each other tough and probing questions in order to identify properly the pros and cons.