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”

Articles in Press

Document Type : Commentary

Author

Utrecht University Centre for Public Procurement, School of Economics, Utrecht University, Utrecht, The Netherlands

Abstract

This commentary discusses the study by Stadhouders et al., which analyzes budget reallocations among Dutch healthcare providers as a result of one form of active purchasing. The study assumes that healthcare purchasers aim to shift substantial funds from inefficient to efficient providers, yet finds little evidence of such shifts. This commentary explains more explicitly why substantial volume shifts are not and should not be a major factor in the Dutch context, citing factors such as the scarcity of underperforming providers, strong regional dependencies, data quality limitations, and patient reluctance to change provider. More promising avenues for active purchasing include fostering active collaboration and improving contractual arrangements.

Keywords

International Journal of Health Policy and Management

Articles in Press, Accepted Manuscript
Available Online from 12 August 2025

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History

  • Received Date: 26 March 2025
  • Revised Date: 10 August 2025
  • Accepted Date: 11 August 2025
  • First Published Date: 12 August 2025

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