Effects of the reform of the Dutch healthcare into managed competition: Results of a Delphi study among experts

In 2006 a major healthcare reform was introduced in the Netherlands, implying managed competition. This study explored level of consensus on outcomes and desired changes this new system, differences between stakeholder groups. A three-round Delphi-study conducted among Dutch insurers, health economists, professionals general practice (GP) care mental (MH) care. first round, 20 experts indicated most important advantages disadvantages competition, changes. Experts second (n = 106) third round (N 88) rated importance 88 factors identified round. Only insurers reached (i.e. improved efficiency; room for choice). Health economists almost no any factors. GP MH-care focus price over quality, increased bureaucracy) reduce bargaining power insurers; increase attention complex patients); half them suggested abolishment were dissatisfied several or even reform; mentioned some benefits. dissatisfaction indicates that there is improvement, preferably developed conjunction with stakeholders.