Dutch shared savings program targeted at primary care: Reduced expenditures in its first year

In countries where GPs fulfill a central role in the health care system, like Netherlands, lack of value-based incentives GP payment systems may have negative consequences for value delivered other parts spectrum. We evaluate an experiment which were allowed to share savings total expenditures, conditionally on achieving quality targets. At least theory, these so-called ‘shared contracts’ incentivize become critical gatekeepers, coordinate provision and substitute specialist services when appropriate. This study evaluates Dutch shared program targeted at GPs. employs difference-in-differences design using regional control group non-participating find that participation led expenditures (-2%), while patient satisfaction was unaffected results indicators ambiguous. Additional analyses show been predominantly realized by lowering volume care, almost every participating displayed cost-saving behavior. finding suggests contracts, even added as mere complemented existing volume-based models, already elicit substantive effort increase provided.