Barriers and Enablers of Value-Based Procurement in Dutch Healthcare Providers

Document Type : Original Article

Authors

1 Coppa Consultancy, Arnhem, The Netherlands

2 Public Procurement Research Centre, Lunteren, The Netherlands

3 Faculty of Law, Economics and Governance, School of Economics, Utrecht University, Utrecht, The Netherlands

Abstract

Background 
Value-based procurement (VBP) is gaining traction in healthcare. This approach to procurement prioritizes obtaining the best health outcomes for patients while considering overall healthcare costs. Despite its recognized potential, VBP remains underutilized in hospitals. Little is known about the barriers and enablers of VBP in hospitals. This study aims to identify barriers and enablers specific to VBP in hospital procurement, utilizing the Theoretical Domains Framework (TDF).
 
Methods 
This qualitative study comprises semi-structured interviews with 20 Dutch purchasers working at hospitals. The interviews aim to capture diverse perspectives on VBP, with the data undergoing an extensive coding and analysis process. Using redefined domains of the TDF, themes for barriers and enablers are identified.
 
Results 
We explored the significance of broader barriers and enablers while also pinpointing new and distinctive ones specific to VBP in a hospital context. The newly identified barriers encompass challenges in procurement skills, low strategic priority, environmental context and resources, stakeholder influences, and outcome expectations. Noteworthy barriers include a cost saving focus, resistance to change, influence of the health insurer, and supplier preferences by end-users. Enablers involve stakeholder commitment, positive buyer-supplier relationships, effective storytelling, and demonstrated effectiveness of VBP. Stakeholder influence emerges as an important enabler, emphasizing the importance of the early involvement of medical specialists and other key stakeholders, overcoming resistance and fostering collaboration during VBP adoption in hospitals.
 
Conclusion 
VBP in healthcare prioritizes optimal patient outcomes and value over costs. Although this is a promising concept, we identified several barriers and enablers for implementing VBP. While facing barriers related to procurement skills and environmental context, successful implementation relies on, among other things, training and stakeholder involvement, including early involvement of key stakeholders such as medical specialists and healthcare insurers, ambassadorship, trust-building, and effective storytelling. 

Keywords

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History

  • Received Date: 29 March 2024
  • Revised Date: 14 March 2025
  • Accepted Date: 13 April 2025
  • First Published Date: 14 April 2025
  • Published Date: 01 December 2025

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