Jun30

Update 30 June 2026

Update 30 June 2026

As in most of Europe, summer has arrived with a vengeance. A key activity in the last few weeks has been to keep cool and stay out of the sun. This has not stopped the appearance of news related to the Dutch healthcare sector. Unfortunately, most of this news might be seen as negative for the respective sub-sectors. In this update we cover:

  • Objections from dental sector regarding lowered 2026 tariffs rejected. What are possible consequences?
  • Salary costs in elderly care sector to increase in the coming two years. What will this mean for profitability of nursing homes?
  • Physiotherapy sector goes to court to force healthcare insurance companies to increase tariffs. What is the background?

Objections regarding lower dental tariffs for 2026 dismissed

In the Dutch healthcare system, tariffs for most healthcare services are set in a two-step process. The first step is that the NZA (Dutch Healthcare Authority) calculates maximum tariffs based on regular extensive cost analytics in the sector. The NZA tariffs are based on the average costs of all providers in the sector and should guarantee an average provider to break even (including appropriate costs of capital). The second step in tariff setting is the negotiations between healthcare insurance companies and healthcare service providers. These take the NZA-set maximum tariffs as a starting point and typically end up between 3-15 percentage points  lower than the max NZA tariffs.

The NZA typically conducts the actual calculation of the maximum tariffs every five years. In the following years tariffs are adjusted by relevant inflationary numbers. In 2025 the NZA conducted a major cost calculation for the relevant services provided by the dental sector. On average, the new tariffs were 1,12% lower than the 2025 tariffs. Orthodontic-related services were particularly hard hit with an average decline of 11,18% in tariffs. The main driver for the reduced tariffs is the normative value that the NZA sets on the input of a dentist or orthodontist owning his/her own practice. The calculated tariffs are for all types of providers in the market, so also for commercial chains owned by international chains and/or PE-companies.

The lower tariffs are clearly not good news for the sector as a whole and commercial dental-care chains specifically. The sector has therefore complained to the NZA concerning the calculation methodology. The NZA has recently replied that the costs calculations have been “thorough and reproducible” and therefore are not willing to change the tariffs. The next step for the sector will be to go to court.

Salary costs in elderly care sector to increase in the next two years

A few days ago new agreements were reached between the main union for employees in the elderly care sector and ActiZ (the trade association for long-term care providers). The new agreement dramatically improves the salaries and other working conditions for the relevant staff. In the existing agreement salaries were increased by 3.5% from 1 July 2025 and another 3.5% from 1 July 2026. In the new agreement employees will get  a total of 7.4% further increase in salaries over the next two years (with half-yearly increases of 1.8%). In addition, other benefits related to travel costs will also be improved.

As explained in the previous piece, NZA-calculated tariffs tend to increase in line with changes to costs. However, there is typically a time lag, and the new collective bargaining results will have negative consequences for the profitability of (commercial) nursing home operators. On the positive side, it might make the sector more attractive, making it easier to find staff.

Physiotherapy sector goes to court to increase tariffs

We have recently written quite often about the physiotherapy sector and how it is trying but not succeeding  to improve its position in the overall healthcare market. In May last year we described how it was decided that physiotherapy would not become part of the compulsory basic insurance package. In January we described how the sector was not able to convince the regulator to set minimum tariffs for the sector.

The most recent development in this process is that the sector (represented by 1.600 physiotherapists) is trying to get the court to force healthcare insurance companies to increase the current (non-regulated) tariffs by more than 45%. The lawyers for the physiotherapists claim that the insurance companies have known for many years that the tariffs are too low, but have refused to do anything about this. The increased tariffs will be used to improve salary levels in the sector and thereby increase the overall attractiveness of working as a front-line physiotherapist.

Physiotherapists are playing an increasingly significant role in improving healthcare and controlling healthcare costs and it is therefore important that tariffs are realistic and support attractive wages. Physiotherapy has always been a “commercial” sector, and national chains (such as TopZorg and FGN) are playing an increasing significant role. If the sector as a whole finally gets a “win” in the ongoing discussions with the insurance companies this would clearly have a significant impact on these companies as well.