'Plus Practices' (Dutch: Pluspraktijken) in the pioneer site of MyCare (Dutch: MijnZorg); an evaluation study

‘Plus Practices’ (in Dutch: Pluspraktijken) are general practices who will start with innovation

projects. Besides this, they will work according to the new concept of positive health of Machteld

Huber.

To change the health care system the Dutch ministry of Health designated nine regions across

the Netherlands in April 2013 which have been labelled as pioneer sites. The ministry will

actively monitor these innovative regions. One of those regions is Eastern South Limburg

located in the southern part of the Netherlands with pioneer site ‘My Care’ (in Dutch ‘Mijn Zorg’).

This initiative is a partnership between the only primary care organization in the region ‘GPs

Eastern South Limburg (in Dutch ‘Huisartsen Oostelijk Zuid Limburg (HOZL)), the regional

hospital Zuyderland Medical Centre, the patient representative foundation House of Care (in

Dutch ‘Huis voor de Zorg’) and the most dominant (62%) health care insurance company in the

region CZ. The pioneer site consists of several interventions that will be implemented in the

upcoming three years; initiative ‘Plus Practices’ is one of them. The basic premise is to improve

the quality of care by organizing it closer to the patient and to encourage better cooperation

between health care organizations and professionals, without increasing of the healthcare costs.

The My Care pioneer site aims to achieve more sustainable care by initiating different

interventions according to the Triple Aim principle of Berwick, Nolan and Whittington. They state

that to achieve high quality improvements of care three aims should be linked; reduced care

costs per capita should go along with improved population health and patient experiences.



In the ‘Plus Practices’ GPs and nurse practitioners will work according to the vision of positive

health. The nurse practitioners will focus more on patients with chronic diseases. GPs will focus

on patients who often visit the clinic with unexplained complaints. In their consultations with

patients they will not just talk about the physical domain, but also discuss the other domains.



The profile of ‘Plus Practices’ are in line with the general practice of the future. Which is a

practice where patients themselves have control, patients are treated effectively and the GP is

the director of the community health. The aim of the ‘Plus Practices’ is achieving the triple aim

targets: improved general health and better care at lower costs.

The aim is that Pluspraktijken result in lower health care costs compared with usual care, while maintaining or enhancing the health status and experience with care of the patients.

For the qualitative study: The first interviews will be carried out in approximately six months from the start of the project. The follow-up measurements take place every six months until the end of the project.

For the quantitative study: has seven measuring moments. The first measurement takes place during the start of the study. The purpose of this measurement is to identify the current situation. Next, measurement take place after every six months.

Plus Practices organize care in a different way. This happens on three levels: the content of care, the care organization and financing of care. Plus Practices start with a set of interventions in three areas: Patient empowerment, effective care and care in the neighborhood. Next, we closely monitor what works and what does not.