Hybrid Business Model for the Dutch Mental Care of 2030

Abstract

This project’s research question is: How is society able to organize a mental healthcare system, that serves people’s individual care needs and is collectively economically viable? This research question regards a business model on a system level and the hybridity is reflected in the tension between the individual interest of fulfilling a care need and the collective interest of keeping the system economically viable.

In the healthcare system before 2005, care providers had freedom to match their care to the need of clients. The insuring institution, mainly the government, paid for the provided care, based on the care provider’s activities of last year. As the costs for care provision kept on growing, it was decided to put more focus on controlling the costs. Now, insuring institutions can contract care providers and negotiate on “care products”. These care products contain a certain diagnosis and treatment trajectory for a certain price. As care providers must act within the rules of this system in order to cover their expenses, they are less able to match their care provision to the client’s need. Furthermore, the administration that insurers require from care providers result in high system costs.

So what if there would be a stakeholder in the system that intertwines the collective interest of the economic viability of the system and the individual’s interest of fulfilling a mental care need? To embody this role, a new stakeholder is proposed called the “care scout”.

The care scout fulfils a special role. He must understand what a client needs and matches the client with appropriate care. He must not solely act from the client’s care need, but also from the perspective of what that care will cost. So he should independently determine the right price and quality. The care scout is a generalist specialist on mental care. Someone who is able to oversee the full spectrum of mental needs, and even aspects that influence that mental need.

If the care scout thinks help is needed, he will explore what further explore the client’s needs. The care scout will stay involved in the client’s process to adjust the care provision in such a way that the client will have sufficient result of the provided care. Once the care provision ends, the care scout will see that the care provider is being paid for his effort and will document the made match and its result in the learning system. This accumulated knowledge will support care scouts to improve future matchmaking.

The client’s incentive to do his work properly is incentivized through client feedback and through the costs of the called in care provision stated in the digital system. Supervisors will regularly assess the care scout’s performance.

The system is designed to drive sufficient result by dynamically adapting care provision to a client’s unique need and by decreasing ineffective care provision, through ongoing involvement of the care scout. Documenting match results and evaluating the performance of the care scouts, will improve matchmaking and the affordability of care over time.