"Small hospitals are fine, but appearances are misleading"

Smaller hospitals started to improve in 2017 and overall, all general hospitals performed slightly better than the previous year. But "appearances are misleading" because two small hospitals – MC Slotervaart and Amstelland Hospital – have not yet filed their annual figures for 2017 and their results could well bring down the averages.

This is the conclusion reached by the BDO accounting and consulting firm on the basis of its annual comparison of the financial situation of general hospitals, in which hospitals receive a grade. Fourteen of sixty-six hospitals scored poorly in 2017, compared with fifteen in 2016. Amstelland and MC Slotervaart are not counted; MC Slotervaart became clear on Tuesday that a bankruptcy was threatening. The IJsselmeer hospitals, like MC Slotervaart, in the MC group and in the same difficult situation, are in second place on the lowest list on the BDO list and score 2. Limburg's fusion hospital, Zuyderland, is even weaker. Twente, Medisch Spectrum Twente, Lange Land and the Meander Medical Center all score 3. Treant Hospital, Maas Hospital, Zaans Medical Center, Haga and Alrijne Hospitals are rated 4. The most Tergooi, who lost thirty-eight places in a year, is fast. from 10 in 2016 to 6 in 2017. Fourteen hospitals scored 10 in 2017, compared with 11 in 2016. The OLVG made the fastest leap, from 7 in 2016 to 10 in 2017.

BDO stresses that efficiency of all hospitals in 2017 is 1.2%, compared to 1.6% in 2016. Again, the small hospitals do an apparently better job with a return of 2.4%. The profit margins of all hospitals taken together increased from 2.7 to 1.2% in 2017 since 2013. According to BDO, this "evaporation" is not a surprise, as the growth opportunities agreed in the agreements frameworks in recent years are limited. And the pressure on the return will be even greater because an even more limited growth space has been agreed in the framework agreements for 2019-2022. This will only make the bankruptcy scenarios even more realistic for hospitals already in financial difficulty.

According to BDO, hospitals need to take a different approach, for example by strengthening their cooperation with the front line and a line and a half and senior care organizations. Innovation is also needed, with the help of the business world. According to BDO, more and more private investors are interested in the healthcare chain, while banks are less and less willing to issue loans. But BDO is also interested in a return-based market-based commercial remuneration, while "the current regulations present serious imbalances with regard to the payment of returns," according to BDO.

On the other hand, independent medical specialists have decreased on average. in 2017. The average compensation of an independent medical specialist in 2016 was still 305,000 euros, compared to 295,000 euros in 2017. No information is included in the annual accounts of employees in 2017.

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