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Reimbursement summary for angioplasty of arteries of lower extremities

This post presents an extract from our reimbursement analysis for angioplasty of arteries lower extremities using plain and drug-coated balloons (DCBs) for peripheral artery disease in England, France and Germany. Plain balloon angioplasty is reimbursement via DRG solely and DCBs are reimbursement via combination of DRG and add-on reimbursement.
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Sensible Care program of the Dutch Healthcare Institute replaced by Appropriate Care program

In 2013, the Dutch Healthcare Institute (ZIN) launched the Sensible Care program (Zinnige Zorg) for a systematic review of the diagnostic and treatment options within the current basic health insurance package to provide appropriate provision and use of medical care. The program is typically related to certain disease/disease groups and consists of four phases:

  • Screening phase: the ZIN examines with the parties involved which care is currently being provided and which subjects can be improved;
  • In-depth phase: ZIN determines for each topic what can be improved and discuss with the parties involved how they will achieve this;
  • Implementation phase: the parties implement the improvements. The ZIN supports them where necessary;
  • Evaluation phase: the final stage when ZIN checks whether the goals have been achieved.

At the request of the Minister for Medical Care, the ZIN and the Dutch Healthcare Authority (NZa) issued advice "Working together on appropriate care: the future is now" at the end of 2020. In this advice, the four basic principles for the Appropriate Care program are listed:

  • Appropriate Care is value-driven (gain in health and quality of life for patients at a reasonable price);
  • Appropriate Care is established together with the patient (joint decision on the most appropriate treatment);
  • Appropriate Care means the right care in the right place (closer where possible, further away if necessary, e-health);
  • Appropriate Care is not about illness but about health (looking at what someone can still do and prevention).

The ongoing 29 projects under the Sensible Care program will continue in the context of Appropriate Care.

The full details in Dutch can be found here.

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