July 5, 2022

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Omrup Flevoland - News - Clashes between St Jansdale and health insurance companies over payment of 2022 dues

Omrup Flevoland – News – Clashes between St Jansdale and health insurance companies over payment of 2022 dues

St Jansdal Hospital and health insurers disagree with each other over agreements for the coming year. As a result, it remains unclear which insurance companies will reimburse for new hospital treatments from January. No deal has been concluded yet with any insurance company.

St Jansdal wants to receive a final offer from insurers by Monday, December 6 at the latest. Then the hospital evaluates. It will then notify you about health insurance company agreements that have been made. People can then take this into account when choosing a healthcare policy for 2022.

Be careful not to pay it back (in full)
The moment a health insurance company does not have agreements with a hospital, this means that the care there is not automatically and fully reimbursed. In recent years, it has become increasingly common for contracts to be concluded only at the last minute.

St Jansdal says the positions of health insurers and the hospital are currently very different. The talks have been held since October but have so far come to nothing.

During these negotiations, most insurers are committed to providing much less care to patients and reducing the size of the hospital by 2022. “St Jansdal does not recognize the idea of ​​these insurers that care is being provided too much or unnecessary.”

‘Socially unacceptable’
“We provide the proper care that policyholders need and we can also prove this using forms developed by the insurance companies themselves,” says driver Arend Jan Poelarends. “It is socially unacceptable for the scope of care to be reduced. Flevoland has had turbulent years. Stability is certainly very important and shrinkage cannot be an issue. But we also want to expand IC and renovate the nursing wards in Harderwijk.”

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Silver Cross and VGZ
The main health insurance companies in St Jansdal are Zilveren Kruis and VGZ. 75 percent of St Jansdal patients are insured with these companies. The hospital describes talks with Zilveren Kruis as “constructive” and hopes this will quickly lead to a contract.

St Jansdal says of negotiations with VGZ that it “takes a lot of time”. The hospital says other health insurers, including Menzis and ASR, are ‘focusing on reducing the provision of care’ with its latest proposal.

Possible cuts
If a deal with the insurers does not materialize, the hospital fears it will have to implement “significant cuts” and that it will have to scale back care in Harderwijk and Lelystad. In a letter to the insurers, the hospital wrote: “Of course we are willing to continue looking with you on how to provide care in a smarter and therefore cheaper way. This only requires more time and cannot be asked of us during the coronavirus crisis. Turn to.”

Feedback from health insurance companies
Zilveren Kruis announced that negotiations are already underway. The health insurance company expects to conclude a contract in the short term, in which there is no deflation. Things are going well and consultations will continue this week. The ASR notes in a written response that talks are still in full swing. He added, “In the interest of policy holders, patients as well as care workers, we are confident that we can reach good agreements for 2022 in the coming period.”

Menzies does not recognize himself in the image of Saint Jansdale
Health insurer Menzis has announced that it does not recognize itself in the picture that St Jansdal has painted about phasing out its sponsorship offer. “While health care professionals are now working hard to keep health care going again in this wave, we are committed to keeping health care available in the future, along with hospital administrators.” According to the health insurance company, corona is part of the conversations. “Just like the shared ambition to reduce hospital care growth to 0% by 2022.” Additionally, Menzis focuses on prevention, proven value-added care, and remote care options.

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Situation Antonius Hospital
Antonius Hospital, which has sites in Sneek and Emelward, says about 70 percent of patients are fixed with health insurer de Friesland. A long-term contract has been concluded with this insurance company, which will be valid next year. Such a long-term contract also applies with the insurance company CZ. About 8 percent of patients are insured.

New agreements are being negotiated with the insurance company VGZ. Progress in these negotiations has not been announced. About 12 percent of patients in Sint Antonius have a VGZ as their insurance company.

Aside from negotiations, Antonius Hospital hopes to get compensation for Corona care. It had to be handed over in recent months, but this was not taken into account during previous negotiations. “A public procedure is needed where we can get compensation for this care,” a spokesperson said.

Flevoziekenhuis will comment later on how discussions with health insurers are progressing.

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