SiRM | Strategies in Regulated Markets

SiRM supports health insurer and multi-specialty health centers in developing, implementing and evaluating a ‘shared savings’ contract

A group of multi-specialty health centers and a health insurer work together to develop a contract tailored to the situation in terms of quality outcomes and costs that does justice to the commitment of both parties. SiRM is supporting them in developing and implementing the contract.

SiRM is developing the concept for the contract on the basis of the ‘shared savings’ principle and will subsequently design the required building blocks for implementation. SiRM is doing this based on multi-year performance analyses of the health center and the risk profiles of its patients. This approach by SiRM takes into account the possible consequences of these developments for risk equalization in the contractual relationship between the group of health centers and the health insurer. SiRM will also be in charge of the final evaluation of the effects of this new type of contract.

The contract will include indicators of both the costs of the care provided and the quality in terms of quality of life and patient experiences of their patients. To this end pseudonymized data are combined and analyzed by SiRM. For this specific part of the project, SiRM has also advised on the use of a trusted third party (TTP) in order to pseudonymize the data and transmit the data in this project in a secure manner to the secured SiRM server.

For care professionals this ‘shared-savings’ contract offers the possibility of providing a good, solid and affordable care package for a specified population of care users. Furthermore, it should be noted that this contract is based on the existing costing structure of primary care and the sets of performance indicators already developed. It is also sufficiently robust to cope with new developments in the costing structure and performance indicators. This means that this contract form can be used universally. Another feature of this contract is that cost-saving quality improvements do not by definition result in lower revenues for the care provider, as is often the case within the existing costing structure in the absence of a supplementary ‘shared savings’ contract with a health insurer.

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