This master thesis studies the role of health insurers in stimulating the transition towards circular hospitals in the Netherlands, addressing a critical gap in current research. The Dutch healthcare sector contributes significantly to national carbon emissions, with hospitals being major contributors. As the government targets a fully circular economy by 2050, understanding how health insurers can facilitate this transition is vital.

Conducted within a master thesis internship at Zilveren Kruis, the largest Dutch health insurer, this research employs a complex systems perspective. The methodological framework consists of three phases, primarily using system diagrams and semi-structured interviews. The first phase involved a literature study and interviews with health insurers, leading to the development of the Insurer-driven Circular Hospitals model. The second phase included additional interviews with health insurers and hospitals to identify the effects of possible interventions and system barriers. The third phase focused on substantiating the responsibility roles of health insurers, based on the interviews.

Findings show that health insurers can use their financial, facilitating, and connecting roles to stimulate circularity in hospitals. Eight potential interventions were identified, with the most promising being: going into conversation with hospitals to provide suitable support, sharing good examples to enhance knowledge exchange, and offering financial support to counter financial barriers. Additional interventions include improving the measurability of hospital progress, including circularity criteria in procurement policy, collaborating with suppliers, collaborating with all health insurers, and involving patients.

The research highlights that achieving circular hospitals is a shared responsibility within the healthcare sector, necessitating collaborative efforts. The study contributes to the existing knowledge base by applying a systems approach to circular healthcare, validating known barriers such as financial constraints and procedural standards, and emphasizing the importance of awareness and collaboration. Future research should expand the participant base, explore system transformation approaches, quantify intervention impacts, and broaden the definition of circular hospitals to include recycling strategies.