A major Dutch health insurer recently published its hospital rankings on breast cancer surgery. The list includes four hospitals (down from six, previously) with whom the insurer, Central Zorgverzekeraar (Central Health Insurer, CZ), will no longer contract because of their low rank. The rankings are primarily based on the volume of operations performed each year. CZ determined that at least 70 operations must be performed annually to ensure quality of care.
In response to CZ’s announcement that it would not contract with poorly ranking hospitals (which CZ made prior to the publication of the list), the Dutch Health Inspectorate reaffirmed that all breast cancer treatment in the Netherlands must meet standards of care, and the Dutch Association of Surgeons accused CZ of using standards that the insurer had set independently and arbitrarily. The Dutch Hospital Association, claiming the rankings to be misleading and damaging, filed suit in court to block publication of the list; the judges barred CZ from publishing its list until hospitals had been given the right of reply.