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Reading: Population Health Management for Healty Regions in The Netherlands – First experiences


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Population Health Management for Healty Regions in The Netherlands – First experiences


Marc Bruijnzeels ,

Leiden University Medical School, Netherlands, NL
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Leonie Voragen,

HealthKic Foundation, NL
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Carl Verheijen

Noaber Foundation, NL
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Introduction: The main challenge in this program is to tilt the PHM approach in The Netherlands to a next level in such a manner that we break with the current trend of more unhealthy life expectancy and increasing expensive health care. Through a combination of theoretical reflection and practical real-world experiences we learn from the mechanisms that yield effect and societal impact of this PHM strategy. Since 2017 we have developed an implementation strategy for this ambition, called the PLOT model. And we took an approach that allowed us to learn from our experiences and adjust our implementation strategy accordingly.

Methods/Program: PLOT model consists of: (1) organize differently as regional accountable health organization, (2) finance differently through alternative payment models stimulating health and (3) monitor differently to assess the progress on health individually and at population level. The plan of activities is based on Population Health Management. After several selection rounds 20 regions were eligible (sufficient urgency, community involvement and an emerging regional governance). The Kavelmodel was implemented in two regions from January 2020 with the acceleration phase which aims at formulating an overarching plan of activities and a minimal progress on the prerequisites. This phase is accompanied with action research.

First observations: The Kavelmodel is active in Achterhoek (300.000 inhabitants) and Gelderse Vallei (250.000 inhabitants). Some observations:

-In both regions a sustainable regional infrastructure focused on an aligned regional ambition is being built. In this process different stake holders bear different interests and ambitions. The position of the community is still under discussion.

-The pace of the development of a regional data infrastructure differs; one region shows remarkable progress in using linked data, whereas the other region shows almost no activity.

-We experience within and between both regions great variation in urgency, necessity and attention for financing differently.

-The energy in the regions is being diverted towards operational activities to improve the health of the population based on community and professional experiences, instead of applying Population Health Management.

-The supporting organization balances between the legitimacy of its activities/role within the region, the perceived ownership of the organizations and the necessary steps to realize the ambition (a ‘prisoners dilemma’).

Conclusions: Based on our ambition and experience, we conclude that each phase needs its own governance to realize the largest possible small step forward. This requires a very strong and solid program theory being executed by strong regional leadership combined with experienced external competences on several domains. A stronger focus on community involvement at all levels of the Rainbowmodel is still a challenge.


To realize a sustainable transition towards a health focused organization in The Netherlands, these experiences will be shared through a newly set up national knowledge network based on the Quadruple Helix. This not-for-profit network will exchange lessons learned, successful methodologies and instrument and training and education. 

How to Cite: Bruijnzeels M, Voragen L, Verheijen C. Population Health Management for Healty Regions in The Netherlands – First experiences. International Journal of Integrated Care. 2022;22(S3):274. DOI:
Published on 04 Nov 2022.


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