The current funding for the Personal Health Environment (PBM) will end at the end of April. The Ministry of Health, Welfare and Sport has informed the PBM suppliers of this. The ministry is aiming for a new form of financing, but this is linked to a European tender procedure. According to those involved, it is unclear when this tender will be completed.
There is great unrest among the thirteen providers of PBMs. Many fear they will not survive the budget freeze. If any PBM suppliers fail, it also means discontinuation of services to many thousands of users. It is not clear what happens to their data in the event of a premature bankruptcy of their PBM provider.
Limited budget
In recent months, VWS used a so-called Open House funding where suppliers could claim based on the number of connections. For the last round, there was already "a limited budget" of up to 1.5 million euros. "Last month we made an advance announcement that the expectation was that the budget would run out in March," VWS informed participants. "Through this message we want to let them know that the budget will run out after April 2024."
Three good PBMs
As far as the budget allows, PBM providers can declare for the last time for the month of April. If everything goes according to plan, VWS will come up with new money in July. Regardless, this will not benefit all PBM providers. In late February, VWS announced the launch of a tender aimed at "selecting and funding three good and user-friendly PBMs for all residents of the Netherlands."
Tender
The curtain falls for ten suppliers. While they may continue to offer their product, they no longer have to count on a contribution from the VWS subsidy pot. As things stand, this is the main, if not only, source of income for most providers. Given the still limited number of connections, the fee can barely cover the start-up and development costs. Consequently, there is a feeling among providers that VWS has already begun an unofficial shake out even before the tender can run its course. There should be white smoke by early July, but according to those involved, VWS is not going to meet this deadline for completion of the tender.
Crucial step
The financial demise of PBM providers is yet another chapter in the troubled genesis of PBMs. Then-Minister Bruins presented the PBM in the late 10s as a crucial step in the further digitization of healthcare. In a technical sense, a PBM is an app that allows the patient to store, manage and share his or her own medical data. This gives patients greater control over their own care and health. This is of obvious importance as the healthcare sector is increasingly overburdened. To keep healthcare affordable, the government is shifting more and more responsibility for own care and health to the citizen. PBMs must enable citizens to do this.
Patient Portal
A full-fledged PBM depends on the cooperation of healthcare providers. They must ensure that users have access to their medical data before they can manage, supplement or share it with others. Although this is a substantially different facility, many hospitals feel that they can already adequately communicate digitally with patients through their patient portals.
As early as a year and a half ago, PBM vendors warned of failure of the PBM pathway. Even Health Insurers Netherlands (ZN) repeatedly stirred the drum indoors. Health insurers put some 20 million euros annually into the PBM pathway. To the insurers' frustration, this has not yet translated into large user numbers.
Unknown
By next year there should be 1 to 2 million users. For now, there are about 200 thousand. Thanks to the completion of the MedMij agreement system and new legal obligations around data exchange, as laid down in the Wegiz, some progress is being made. But awareness is still low. Of healthcare users, 66 percent have never heard of a PBM, RIVM noted in a recent survey. Interestingly, within the core target group of people with a chronic condition, as many as 79 percent have never heard of a PBM.
