197 General Discussion In conclusion, continuous evaluation of the role, impact, and effectiveness of financial arrangements on the quality of care in collaborative networks is important now that healthcare policy is moving towards more collaboration between and across sectors. Change in practice: future perspectives Moving towards VBHC requires deliberate action at the policy, management, health professional, and client levels. To put VBHC into practice, an implementation plan has been developed for the Netherlands, called “Right Care at the Right Place”, followed by the implementation of the Integrated Care Agreement in September 2022.39 This agreement stipulates the need for integrated and task-shifting care, through intensive collaboration between professionals across organizations and regions to ensure continuity of care for patients across the life course. However, the concrete steps or ‘how to’ remain vague. There is no clear plan for financial support to develop collaborations. Intensive collaboration is recommended without guidance on how organizations should approach this process. According to Porter, one way to achieve the desired outcomes of integrated care may be through the development of integrated practice units. Professionals from different backgrounds set up a unit and collaborate to provide all the care that a group of patients with the same condition may need, thereby increasing the continuity and quality of care. Value is based on the patient’s experience and is measured by the outcomes relative to the cost of the full cycle of care for the patient. This means that everything (personnel, equipment, drugs, etc.) involved in the care of the patient should be counted and measured. Measuring outcomes is easier when these units are integrated, which is why value-based healthcare researchers argue for integrated practice units. Developments in maternity care follow this trend. Although integrated maternity care is complex, regional maternity care networks are working to establish a care system to achieve the abovementioned healthcare goals. No definitive organizational form has yet been established, but the following form of organization is being developed in some regions. The idea is to set up an autonomous integrated maternity care organization that 1) Stimulates quality, 2) Organises the financing of care, and 3) Purchases facilities at the hospital. Youth health care, maternity care assistance, primary care midwives, hospital-based midwives, and obstetricians will all be subcontractors of the integrated maternity care organization. Obstetric nurses, pediatricians, and neonatologists are collaborators who work closely with the integrated maternity care organization, but whose care is purchased by hospital facilities. Service users play a prominent role in quality stimulation. Healthcare providers continue to work autonomously in their own organizations while having contracts with the integrated maternity care organization about reimbursement for their work. This gives the organization the important responsibility to agree on 7
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