Future market structures elderly care

On behalf of ActiZ, SiRM explored the possible market structures of elderly care in the future. Due to the challenges the sector is facing, it is conceivable that the regulation of the collectively funded elderly care package will change. SiRM has outlined three scenarios for the future.

Elderly care is facing major challenges: the demand for care for the elderly is growing strongly, while the supply on the labour market is lagging behind. ActiZ (Dutch Association for Health Care Providers in Elderly Care) wants to gain insight into how these developments and the possible system changes resulting from them may influence the market structure of elderly care.

SiRM identified the relevant trends for ActiZ and mapped out their possible influence on the market structure. We used the results of our own previous data analyses and studied a large number of policy reports, studies and advice on the (future) of elderly care.

We concluded that, in response to (staff) scarcity, the market for elderly care is expected to be split into four parts: a system function around intensive care and integrated care, plannable care, support care and housing. Of these, the regulation of plannable care and the system function, and the demarcation between the two, are the most uncertain.

Based upon this uncertainty, we developed three scenarios:

  • Regional monopolies or duopolies for both the system function and plannable care
  • The formation of large regional providers who take up the system function, partly in collaboration with other providers and network partners
  • A sharp division between a regional system function and a great diversity of providers of plannable care.

In all three scenarios, support care and housing fall outside the collective package in the long term.

The scenarios were presented at various ActiZ meetings as part of a broader discussion between ActiZ members about the future of elderly care.


Jan-Peter Heida
Mainly active in Healthcare, Strategy consulting, Regulated markets and Competition
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