The Administrative Jurisdiction Division of the Council of State (CBb) ruled on November 18 that the Dutch Healthcare Authority (NZa) insufficiently substantiated the general practitioner tariffs for 2023, 2024, and 2025 on two points as cost-covering. The National General Practitioners Association (LHV), the Association of General Practitioners in Practice (VPH), and De Bevlogen Huisartsen filed this lawsuit because they disagree with the tariff levels. The NZa must recalculate the tariffs within six months. We take this ruling seriously and will actively work on it. In the short term, we will consult with general practitioner organizations, health insurers, and other involved parties about an appropriate approach.
Cost price research method stands firm
The tariffs for general practitioner care over the past three years have been set by the NZa based on cost price research. In the ruling the CBb rules that the way we conducted this research is correct. Both the measured costs and the way these costs are allocated to the tariffs may be used to determine the tariffs.
Reassessment of housing and labor costs is necessary
However, the CBb rules that the NZa must reassess two components of the tariffs and adjust them where necessary. These concern the housing costs and labor costs of the practicing general practitioner, the so-called normative labor cost component. According to the judge, the current tariffs assume too tight housing for practices that are growing and need more space. Also, according to the judge, we have insufficiently taken into account the gatekeeper function of practitioners when determining the labor costs of practice holders.
The role of the NZa
The NZa safeguards the accessibility and affordability of care for all residents of the Netherlands. To protect the social interest of continuity of care provision and affordability of premiums, we periodically recalibrate tariffs in healthcare using cost price research. The tariffs in healthcare must not be too low and must cover the average costs for care, personnel, and housing. The tariffs must also not be too high, because then patients and insured persons pay too much for care. We attach great importance to a vital primary care, such as general practitioner care, and actively commit ourselves to it. In the coming months, together with all parties in general practitioner care, we will follow up on the ruling.
