Financial continuity during COVID
In the spring of 2020, Dutch hospitals were suddenly faced with the challenge of treating thousands of COVID patients. The impact on their organization and finances was enormous. Not only were they called on to deliver extra care for these patients, they also had to scale back regular care to free up capacity and prevent infection. Without intervention, hospitals could have gone bankrupt as a result. Hospitals and health insurers therefore agreed a compensation scheme together for the extra costs and lost revenue: the CB scheme (continuity contribution scheme).
On behalf of Zorgverzekeraars Nederland (the Dutch association of health insurers), Gupta helped to design and execute the CB scheme for 2020, 2021 and 2022. The core of the 2020 scheme was: continue revenues based on contractual agreements (even though less care had been delivered) and compensate specific COVID costs with fixed percentages and per-patient amounts. In the years that followed, the CB scheme evolved with the dynamics of the pandemic.
For this project to succeed, it was necessary to map out for each hospital, in detail, the contractual agreements with each insurer, the care that had been delivered (production data) and the volume of COVID care provided. That may sound straightforward, but it required a careful and intensive process. In every phase, hospitals and health insurers supplied production data, prices and contractual agreements. Gupta compared these inputs, calculated the (provisional) compensation and discussed the results with each hospital (715 conversations in total!). Hospitals and insurers then aligned bilaterally where required.
The execution of the schemes was an intensive process involving 10 health insurers and 161 hospitals and other care providers. This resulted in more than 3,000 bilateral agreements. The fact that the medical-specialist CB schemes were established together with all parties, and delivered within the agreed time frame, is a testament to the strength of collaboration in the sector.
