Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 14 1 2025 12 01 Why Substantial Budget Reallocations Are Not and Should Not Be a Major Factor in Active Purchasing in Dutch Healthcare; Comment on “Measuring Active Purchasing in Healthcare: Analysing Reallocations of Funds Between Providers to Evaluate Purchasing Systems Performance in the Netherlands” 1 3 4778 10.34172/ijhpm.9115 EN Fredo Schotanus School of Economics, Utrecht University, Utrecht, The Netherlands 0000-0001-5775-1225 Journal Article 2025 03 26 <span class="fontstyle0">This commentary discusses the study by Stadhouders et al, which analyzes budget reallocations among Dutch </span><span class="fontstyle0">healthcare providers as a result of one form of active purchasing. The study assumes that healthcare purchasers </span><span class="fontstyle0">aim to shift substantial funds from inefficient to efficient providers, yet finds little evidence of such shifts. This </span><span class="fontstyle0">commentary explains more explicitly why substantial volume shifts are not and should not be a major factor in the </span><span class="fontstyle0">Dutch context, citing factors such as the scarcity of underperforming providers, strong regional dependencies, data </span><span class="fontstyle0">quality limitations, and patient reluctance to change provider. More promising avenues for active purchasing include </span><span class="fontstyle0">fostering active collaboration and improving contractual arrangements.</span>  https://www.ijhpm.com/article_4778_085ccaddbd3aa270b1d72beef6bbc5ca.pdf