1. The Netherlands Presentation IPPTA May 2 nd 2015

2. Some figures Population: 16.7 million Physiotherapists: 26.300 6.300 in hospitals, rehabilitation centres etc. 3.500 members KNGF 20.000 in primary care 8.800 self employed private practioners 7.900 members KNGF 11.200 employees 7.400 members KNGF

3. Public (mandatory) insurance 25% < 18 years Chronic diseases 100% Other conditions 9 treatments (depending on result: + 9) > 18 years Chronic diseases and post-surgery > 20 treatments + € 375,- own risk Turnover: 450 million

4. All other indications 100% market regulation Number of treatments depending on coverage (over 250 packages: range 0 – 100% coverage) Barriers based on medical selection Reimbursement (contracted/non-contracted provider) Turnover physiotherapy: € 1.1 billion Private (voluntary) insurance 75%

5. Current issues 1.Decreasing coverage in private insurance packages 2.Differentiation in contracts & preferred providers 3.Quality assurance

6. Decreasing coverage Focus on: value of physiotherapy

7. Decreasing coverage Focus on: the importance of supplement insurance

8. Differentiation & preferred providers Lobby for transparent, objective, non-discriminatory criteria in contracting (level playing field, good contracting practices) Focus on patient preferences with patient organisations Empowerment physiotherapists Statement open/closed networks Focus on quality

9. Quality assurance Developments Guideline development 2.0 Institute of Quality commissioned by the government Library with guidelines, measuring instruments, quality indicators Actions: Guideline for guidelines 2.0 Framework measurement tools Masterplan Quality

10. 1. KNGF/the profession determines the quality of physiotherapy 2. Recognition of the professional standard 3. One National system to measure quality

11. Masterplan Quality

12. Other activities Physiotherapy as conditional intervention Focus on cost effectiveness Utilize changes in legislation (municipalities) New arrangements with stakeholders: Employers Trade unions Insurance companies other than healthcare insurance companies

13. Questions?

14. Practice LDF (National Database Physiotherapy) Feedback Assessment & Improvement EPD Report