Please note: The algorithm descriptions in English have been automatically translated. Errors may have been introduced in this process. For the original descriptions, go to the Dutch version of the Algorithm Register.

Cost prices and maximum rates msz

We conduct annual cost price surveys in medical specialist care (MSF). Based on the data we receive, we calculate weighted average cost prices and then recalibrate the maximum rates for the regulated segment.

Last change on 10th of December 2025, at 14:42 (CET) | Publication Standard 1.0
Publication category
Other algorithms
Impact assessment
Privacy Quickscan
Status
In use

General information

Theme

Health and Healthcare

Begin date

Field not filled in.

Contact information

https://www.nza.nl/service/contact

Responsible use

Goal and impact

These cost-price studies only concern medical-specialist care for which the NZa sets maximum rates: the so-called A-segment. This is only a small part of medical-specialist care. It includes, for example, oral surgery, 'other care products' and vaccination packages. The vast majority of medical-specialist care treatments have freely negotiable rates between hospitals and health insurers: we call this the B-segment.


The NZa sets maximum rates to ensure that the rates cover the costs of treatments, but are also not unnecessarily high. The aim of this is to keep healthcare, which we jointly finance through taxes and healthcare premiums, affordable for those who need it.

Considerations

Certain institutions are exempt from submitting cost data. These are:

Institutions providing only a small share (less than 10%) of care in the regulated segment are exempt from the provision of cost price data. However, we also examine whether there are institutions below this limit that specialise in providing certain regulated care, and are therefore still relevant for the cost price survey, so that reliable rates can be calculated. Therefore, in addition to the share of regulated vs free segment, we also look at provider shares within a healthcare product from the regulated segment.

As a first step in the process, policy officers assess the institutions' submissions. A checklist is available for this purpose.

The calculation of the weighted average cost prices per product is accompanied by an assessment of the validity of the cost prices. This is done in a number of steps, starting with assessing a healthcare product on the basis of the complete delivery in terms of the ratio between average cost price and rate (KO ratio) and the spread of the deliveries (CV value). In case of deviating KO-ratio and/or CV-value, an explanation is sought for this deviation in the delivered cost prices, e.g. whether this is possibly due to the calculation method, a change in the care input, or a change compared to the historical cost price data. Based on the possible explanations, it is then decided whether individual submissions can be approved or cleaned, or whether more information is required from the provider for further assessment.

Human intervention

An institution will be contacted if consideration is being given to completely excluding an institution from the costing calculations. Institutions are then given the opportunity to adjust their cost prices or make a completely new submission if necessary.

If there is then any doubt about whether or not to include the cost price of a product, the institution will be contacted by e-mail.

In addition, all institutions receive institution-specific feedback. This also includes an Excel file containing an overview per cost price, including the validity assessment.

Risk management

The risks in terms of technology, legislation, costs, ethics, explainability and other issues are very limited. The algorithm is not critical, no direct decisions follow from it and the technique is understandable and explainable.

Legal basis

The following policy rule and further rule relate to the submission of cost prices:

-Policy rule Cost model care products medical-specialist care (BR/REG-23152)

-Regulation on registration and submission of cost prices of medical-specialist care products (NR/REG-2320)

Links to legal bases

  • NR/REG-2320: https://puc.overheid.nl/nza/doc/PUC_739805_22/
  • BR/REG-23152: https://puc.overheid.nl/nza/doc/PUC_739810_22/

Elaboration on impact assessments

A legitimacy assessment has been done on the processes in which this algorithm plays a role according to our standard procedure. The impact on privacy of this algorithm is negligible.

Impact assessment

Privacy Quickscan

Operations

Data

It concerns cost price data of (other) care products supplied by MSF institutions.

Similar algorithm descriptions

  • The algorithm 'Ex officio refund of healthcare insurance contributions (mass)' selects the required data of individuals who will receive a refund or have to make an additional payment via the mass process. In a mass process, the Tax Administration handles tax cases of very many people at the same time. By ex officio, we mean that the Tax Administration does this itself, without an application or request.

    Last change on 30th of October 2025, at 15:44 (CET) | Publication Standard 1.0
    Publication category
    Impactful algorithms
    Impact assessment
    Field not filled in.
    Status
    In use
  • This algorithm automatically selects cost lines from partner declarations in Interreg Meuse-Rhine projects for sample verification. The sample selection is based on the principle of risk-based management verification (RBMV). The algorithm combines selection of the highest amounts with monetary unit sampling (MUS) to include both risk-based and random cost lines in the sample.

    Last change on 13th of November 2025, at 14:35 (CET) | Publication Standard 1.0
    Publication category
    Other algorithms
    Impact assessment
    Field not filled in.
    Status
    In use
  • An algorithm calculates how much premium you have to pay for voluntary AOW and Anw insurance.

    Last change on 28th of October 2024, at 10:31 (CET) | Publication Standard 1.0
    Publication category
    Other algorithms
    Impact assessment
    Field not filled in.
    Status
    In use
  • Calculation of financial indicator and dimension scores for the Visibility of Care Providers dashboard

    Last change on 10th of December 2025, at 13:11 (CET) | Publication Standard 1.0
    Publication category
    Impactful algorithms
    Impact assessment
    Privacy Quickscan
    Status
    In use
  • This page contains information about the algorithm 'Ex officio refund of Healthcare Insurance Act (treaty beneficiaries)'. This algorithm is designed to retrieve tax payroll data for calculating the refund of the wrongly deducted income-related Healthcare Insurance Act contribution to treaty beneficiaries.

    Last change on 30th of October 2025, at 15:44 (CET) | Publication Standard 1.0
    Publication category
    Impactful algorithms
    Impact assessment
    Field not filled in.
    Status
    In use