Which reimbursement for my innovation?
When you are aiming for sustainable implementation of your innovation one important question to ask is: who is paying the use of the innovation when it is incorporated in standard care?
Below we list the main options of financing models, including examples. For many innovations in diagnostics and treatment the health insurance route will apply. For applications concerned with quality of care or lifestyle interventions the other financiers can also be an option. For E-health solutions careful consideration is necessary, because this is a relatively new playing field. Hogeschool Windesheim has made an informative website on the innovation routes of e-health products (in Dutch).
Who is responsible for reimbursement?
- Health insurer
For medical applications and care that are covered by the basic or extended health care insurance. This includes care provided by medical specialists and medication. The Zorgverzekeringswet (ZvW) applies. Examples are new drugs, or diagnostic applications. Read more on the Zorgverzekeraarsroute (Dutch).
- Municipality (gemeente)
Innovation that contribute to self-reliance for patients at home or support for informal care (mantelzorg). The "Wet maatschappelijke ondersteuning (WMO) applies. Examples are: a program that supports partners of cancer patients, or products available at the drugstore. Read more on the Gemeenteroute (in Dutch).
If the innovation is not covered by health insurers and the patient can use the innovation without a doctor's referral. Such as e-health applications or medical aids that are not covered by the insurance package. Read more on the Consumentenroute (Dutch).
- Health care provider
An application that saves the healthcare provider time and money and for which there is support in the organization. For exampen an electronic client file hosted externally by a service provider. In general, health care providers only finance applications that support the execution of care. The care itself will be covered by health care insurance, in a sustainable financing model. In temporary financing models health care providers can play a role. Read more on the Zorgaabiedersroute.