This appears to put an immediate end to the controversial GP chain. Insurers have emergency plans prepared for tens of thousands of patients. How patients can currently visit a GP varies by region.
Earlier this week, insurers CZ, VGZ, Menzis and Zilveren Kruis declared Co-Med in default because they were unable to provide crucial information on, among other things, practice occupancy. For this reason, not only them, but also all other health insurers have taken the step of suspending their agreement, CZ reported in a statement. “This also allows payments to Co-Med to be suspended.”
About the Author
Michiel van der Geest is the health reporter for by Volkskrant. Willem Feenstra is an investigative journalist at De Volkskrant. He wrote, among other things, about transgressive behavior in The World Turns Around and in Defense.
Never before have so many patients been left without a family doctor at the same time. In recent weeks, insurers and regional GP organizations have drawn up plans behind the scenes to deal with the chain’s collapse.
According to insurers, general medical care remains guaranteed for all Co-Med patients. ‘To this end, contact has been established with regional organizations of general practitioners and with Arene (an online clinic, ed.).’ ‘It is a priority to offer a solution to vulnerable patients and patients with (urgent) care needs. But in the coming period we will also work on a structural solution for all patients registered in Co-Med surgeries.’
Co-Med has been under fire for years, in fact since its founding in 2020. Inaccessible practices, absent doctors, emergency patient care that was not in order: patients complained strongly to the Health and Youth Inspectorate and the health insurers.
However, Co-Med was able to continue acquiring practices for years and continue to provide substandard care. The most important supervisors, the Dutch Health Authority (NZa) and the Health and Youth Inspectorate (IGJ), say they do not have sufficient options to effectively monitor this relatively new form of GP care.
Occupation in order
In June 2023, the IGJ tried to put a stop to it, but the intention to intervene failed in court. It was only in April this year that the IGJ received permission from the judge to impose an ‘instruction’, a supervisory measure requiring Co-Med to comply with all national guidelines within four weeks. The company also had to submit lists showing that staffing levels were in order.
The IGJ cannot and will not reveal whether Co-Med has met those requirements in recent weeks, a spokesperson said. There is a great fear of judicial proceedings in the event of a decision that is not sufficiently substantiated.
As a result, it is not the regulator that must control the quality of care that is now taking the most advanced steps, but rather the health insurers that are doing so.
They have a legal obligation to acquire high-quality care for their policyholders. In recent weeks they received new signs that care at Co-Med was not in order. But last weekend events accelerated due to a publication in by Volkskrant, which made it clear that unauthorized personnel had to provide care to patients against their will and that extremely risky situations for patients occur at Co-Med. Possibly even resulting in the death of a patient.
Health insurers work together
The four largest health insurers have been working together in recent days. On Monday they ordered Co-Med to submit “current staffing and schedules for the next four weeks, emergency protocol and afternoon, weekend and overnight observation.” When that information became concerning, an official “notice of non-compliance” followed.
On Thursday, the most serious intervention that health insurers have at their disposal took place: they canceled the contract and immediately decided not to pay more.
