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Firstly, there was still a discount hanging over the market of 170 million euros annually due to the transfer of Wlz treatment to the Zvw. Other discounts that were previously delayed will also continue from 2025. The result is a reduction in the Wlz budgetary framework by 615 million euros in 2025, and a reduction of 655 million euros in each subsequent year. This is what outgoing minister Conny Helder writes in a letter to Parliament.
Rate reduction
The discount will take effect in 2025. To this end, the rates for care packages in elderly care and care for the disabled will be reduced. Two other measures from the coalition agreement of the previous cabinet will also continue. The cuts as a result of further development of the nursing home care quality framework and multi-year contracting with budget agreements were delayed by a year in 2023 and could therefore not take effect in 2024. This will now be included in the rates on a multi-year basis from 2025. In July this year, the NZa will present the new rates, based on 2023.
Medical generalist care
The much-criticized transfer of Wlz treatment and medicines to the Zvw has been postponed in July 2022. The change in law should have come into effect in 2025, but encountered too many problems in the field. Field parties have indicated that a careful transfer by 2025 will “place undesirably high pressure on the provision of care to the most vulnerable elderly and people with disabilities”. Helder then said that he was willing to sit down with the healthcare parties, on the condition that the planned cutbacks of 170 million euros would be achieved in a different way. These cuts will definitely take effect in 2025 and the Wlz sector will now be forced to make an ‘efficiency drive’, as the minister calls it.
Quality framework
On January 13, 2017, the Nursing Home Care Quality Framework was registered in the register of the Healthcare Institute and implemented. In 2017, an amount of 2.1 billion euros was released for this purpose. That amount has since been increased in connection with regular wage and price developments. The coalition agreement links the further development of the Nursing Home Care Quality Framework to a reduction in nursing home expenditure. Now that the reduction for the year 2024 has been reversed, this concerns an amount of 200 million euros in 2025 and 350 million structurally from 2026.
Multi-year contracts
The savings are related to improvements in business operations that healthcare providers can achieve if they are supported by multi-year contracts with financial agreements. The intended savings are 245 million euros in 2025 and 135 million euros structurally from 2026. The NZa should distribute this multi-year Wlz framework among the care office regions, so that the care offices have insight into the multi-year financial scope they have to make multi-year agreements. . This requires the Cross-Domain Cooperation (DOS) bill, which is currently being discussed in the House of Representatives. In accordance with this law, the NZa may distribute the Wlz framework on a multi-annual basis and ensure that the distribution of the Wlz framework across the regions runs smoothly. Additional provisions for objection and appeal have been included in the bill for this purpose. The NZa will establish its policy rules for healthcare purchasing 2025 on or around July 1, 2024.
2024
On January 16 this year, a majority of the House of Representatives voted against cuts in elderly care. They supported the amendment by SP Member of Parliament Sarah Dobbe. This meant that the announced cuts, amounting to 193 million euros for 2024, were off the table. This amount is made up of a cut of 117 million euros on the normative housing component that affects elderly care, care for the disabled and long-term mental health care, a net cut of 46 million euros linked to the measure separating housing and care and a cut of 30 million euros linked to the fall prevention item. Financing of the total amount should come from general resources in 2024.
