Private clinics in a pinch: treatment ceiling is reached | 1Limburg

Private clinics could help some of the patients on a waiting list. That alternative is becoming more difficult now that institutions such as the Maastricht Annadal clinic have reached their treatment ceiling.

The private clinics make agreements with the health insurers about the number of operations they can perform per year.

‘No longer operate’
“We are already at that healthcare cost ceiling,” says Leo Verhagen, director of the Sint Annadal clinic. “That means that we can no longer operate on some patients, while in principle we can still grow more than 25 percent.” The signal is confirmed by the national umbrella organization of independent hospitals. “Last year the ceiling came into view around September, a number of clinics have already reached the ceiling this summer.”

Appointments MUMC+ and Zuyderland
Because the health care funds in the Netherlands are divided in advance, there is hardly any flexibility when improvisation has to be made. Now that regular hospitals are having great difficulty in planning catch-up care, the alternative route via private clinics has become extra complex.

The Annadal clinic has made agreements with both Zuyderland and Maastricht UMC+ to continue operating, with the costs being paid by the regular hospitals. “As a director, I therefore have to talk to the board of the AZM to see how care for patients from the region will be paid,” said Verhagen. “The health insurers say: we are not going to reimburse you as Annadal. Get the money elsewhere. That is why I am happy that we can make good agreements with Maastricht UMC+ and Zuyderland. Afterwards we have to sit down together to see how we can cover the costs. to settle.”

Also read: Thousands of Limburgers are still waiting for surgery

To retrieve
Thousands of Limburgers are still on a waiting list because the Limburg hospitals are barely able to reduce the mountain of catch-up care. Due to absenteeism and staff turnover, the waiting lists in South Limburg remain twice as high as before. Since many of the pending surgeries are not acute, the private clinics can take over some of those surgeries. This is complicated by the bureaucratic hurdles that come into view. “We can scale up a quarter more,” says Leo Verhagen. “Those patients would be better sent to the Annadal clinic in terms of budget. Fortunately, we have an excellent cooperation in the region.”

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