Introduction of a fixed budget mechanism for Dutch emergency departments for 2027

On March 23, 2026, the Dutch Healthcare Authority (NZa) published Policy Rule on budgetary funding for emergency care and Emergency Care Budget Funding Regulation, following approval from the Ministry of Health, Welfare and Sport (VWS) to initiate budgetary funding for emergency departments (ED) in December 2025. The regulations enter into force on July 1, 2026.

The budget financing applies to hospitals with EDs that meet strict requirements for the staff and availability, including qualified emergency-trained physicians and nurses on site, as well as access to key medical specialists at all times, including nights and weekends.

A provisional budget is set in advance (year t-1), and a final budget is determined later (year t+2). The difference between the budget and actual revenues determines the final financial result. The healthcare providers and the health insurer(s) should jointly submit a bilateral, signed application for the budget. 

Hospitals must apply for a provisional budget before November 1 of year t-1, after which the NZa determines the provisional budget and tariff by December of that year. The application for the final budget is made before December 1 of year t+1, with the NZa determining the final budget and revenue outcome by March of year t+2.

For an emergency department that is open 24/7 throughout the year, the NZa has determined a standard budget of €4,630,563. If an emergency department is not open 24/7 or is closed for an extended period, a reduction in the standard budget may be applied.

A specific supplementary payment (OZP) 190094, “Costs of emergency care in the emergency department of a budgeted healthcare provider,” under the category “Other services,” will be introduced for billing ED care. The supplementary payment can be charged once per patient per day, billed separately from the DRG pathway, and must involve direct patient contact. The tariff for the supplementary services is calculated individually for each budgeted healthcare provider, with a fixed tariff.

See the full details here.

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