VWS wards off criticism of PBM funding

In late February, VWS announced the launch of a tender. "We are doing this because as VWS we want to focus more on user-friendliness and that requires a different way of financing," the ministry said in an explanation of the tender. The ultimate goal of the tender is "the selection and funding of three good and user-friendly PBMs for all residents of the Netherlands."

Selective funding

Until recently, all 14 PBM suppliers could claim reimbursement based on the number of connections. Under this Open House arrangement, some €7 million went to the suppliers in recent years. Under the new funding, the majority will fall out of the scheme. But, VWS stresses, "we will continue to invest in PBMs ('the money tap will not close') and even more than we do now, but the distribution will be more selective."

Deadline

PBM providers feel cornered by the actions of VWS. That there will be a new form of financing, most can accept. But the way in which this is being done they find unacceptable. For example, it is unclear when the tender will be completed. The original deadline was July 1, but those involved say a date in the fall is more likely.

Shake out

Thus, in order to participate in the tender, PBM providers must overcome months without revenue. Many PBM providers therefore fear they will not survive the budget freeze. There is a feeling among providers that VWS has begun an unofficial shakeout before the procurement can run its course. If any PBM providers fall over, it means discontinuation of services for thousands of users.

VWS acknowledges that the exact course of the tender is difficult to predict. "The procedure has many opportunities to ask questions and raise objections," the ministry responds. "This promotes diligence, but may lead to longer duration of the tender."

Discontinuation

This should not lead to serious problems, according to VWS. "You can expect the larger PBMs to be able to bridge a period of time. So the risk of 'discontinuation of services to many thousands of users' is relatively low. If any PBM vendors fall over, they will most likely be vendors with virtually no users."

Primary source of income

Also, according to VWS, PBM is "not the main or only source of income" for most providers. Thereby, the previous subsidy scheme was never intended to be a primary source of income. Moreover, the de facto PBM market is already largely crystallized; 95 percent of the market is in the hands of four providers, according to VWS. "The limited number of active suppliers is also partly the reason for the more selective form of funding," VWS said. "To illustrate: of the 25 suppliers who received funding at the start of the scheme, almost half have not reached the stage of a working PBM. For them, 'the curtain never went up'."

Impact user

The consequences of any bankruptcies will be limited for users, according to VWS. "If a PBM goes bankrupt, then according to the MedMij Appointment System it must be able to deliver a portability report to the user," the ministry informs. "This is a format of all the data contained in the PBM. So a user can easily take this with him to another PBM. The user then chooses a new PBM in which the data can be retrieved again. The PBM that goes bankrupt also immediately loses the ability to exchange data via MedMij."

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