Netherlands
While Dutch residents are automatically insured by the government for AWBZ, everyone has to take out their own basic healthcare insurance (basisverzekering), except those under 18 who are automatically covered under their parents' premium. If you don't take out insurance, you risk a fine. Insurers have to offer a universal package for everyone over the age of 18 years, regardless of age or state of health – it's illegal to refuse an application or impose special conditions. In contrast to many other European systems, the Dutch government is responsible for the accessibility and quality of the healthcare system in the Netherlands, but not in charge of its management.
Buurtzorg Nederland
Buurtzorg Nederland is a Dutch home-care organization which has attracted international attention for its innovative use of independent nurse teams in delivering high-quality, relatively low-cost care. Buurtzorg is Dutch for “neighborhood care”.
It was founded in 2006 in the small city of Almelo by Jos de Blok and a small team of professional nurses who were dissatisfied with the delivery of health care by traditional home care organizations in the Netherlands. According to Sharda S. Nandram, the company has created a new management approach: “integrating simplification,” characterized by a simple, flat organizational structure through which a wide range of services, facilitated by information technology, can be provided.
When they go into a patient’s home, Buurtzorg’s nurses provide not only medical services but also many support services, such as dressing and bathing, that are usually delegated to lesser-trained and cheaper personnel. Self-governing teams of 10 to 12 highly trained nurses take responsibility for the home care of 50 to 60 patients in a given neighbourhood. This permits flexibility in work arrangements to meet both nurses’ and patients’ needs. The organization has the most satisfied workforce of any Dutch company with more than 1,000 employees. A study by KPMG published in January 2015 shows that the company is a low-cost provider of home-care services, and that this is not attributable to its patient mix. When the patients’ nursing home, physician, and hospital costs were added to the analysis, total per-patient costs were about average for the Netherlands.