OREANDA-NEWS. Fitch Ratings has published a report on the background of the Dutch hospitals sector, giving a summary of its rating approach and covering areas that are important when providing credit ratings for individual hospitals.

Hospital care in the Netherlands is provided through university medical centres (UMCs), top clinical hospitals and general hospitals through 85 healthcare facilities and about 255 independent treatment centres. Fitch classifies Dutch hospitals as public-sector entities that are non-credit linked to the Dutch government. The government monitors the healthcare system at a national rather than individual level. As such, Fitch does not consider extraordinary support to be particularly likely or to be provided in a timely manner.

Fitch uses a "bottom up" approach to rate Dutch hospitals assessing first the credit profile of Dutch hospitals on a standalone basis, factoring in the strong quality of their cash flow, through funding from insurance companies. Then, a credit enhancement of up to three notches is added to the standalone rating, reflecting an assessment on substitution, relativity, borrowing options and moral hazard.

The Ministry of Health and the hospital sector aim to divert basic care away from the expensive top clinical hospitals and UMCs to the general hospitals, and from hospitals to primary care. Increasing efficiencies is key for the sector, both for hospitals and insurers. Nevertheless, the Netherlands again topped the 2015 Euro Health Consumer Index (ECHI) ranking for 35 countries and has been in the top three in each report published since 2005. ]