Belgian hospital managers sound alarm: “Our healthcare system requires fundamental reform”

Belgium’s healthcare system is at a crossroads. The system, which has long been valued for its accessibility and quality, can no longer manage the increasing challenges it faces. Growing demand, acute staff shortages and financial pressure are pushing the system closer to an existential crisis. The Belgian Association of Hospital Managers (BAHM) warns in a report published today* that the affordability, efficiency and accessibility of healthcare will be jeopardised if there is no structural reform. They are therefore calling for a fundamental transformation to value-based healthcare (VBHC) to enable the provision of healthcare solutions at manageable costs. At the same time, they highlight the responsibility of the government, which, as the primary funder of the system, not only provides the resources but also has the task of facilitating change and innovation among all stakeholders.

The healthcare system in Belgium has traditionally focused on treating and controlling acute pathologies with mainly performance-based reimbursement. However, the sector is facing increasing demand, financial pressures and permanent staff shortages, all of which increase pressure on the quality and availability of care. According to the country’s hospital managers, there is an urgent need for a new approach to reforming the organisation and financing of the system that puts patients and the highest quality of care at its core. This requires transparency, accelerated digitisation, robust data infrastructure and close cooperation between all parties.

“Our current approach lacks an integrated, coherent vision and is insufficiently attuned to what we expect and the needs of the future. We are on the brink of a healthcare crisis, and key actors must be convinced of the urgency of a fundamentally different approach,” says the BAHM.

VBHC offers a clear approach to decisively address the shortcomings of the existing model. It organises care integrated around patients’ needs, with a focus on prevention, and aims to improve quality and cost-effectiveness. By using resources more efficiently and adopting a more effective approach, care provision becomes more sustainable and remains accessible and affordable for all.

Government must take control

A successful transition to VBHC requires a nationally coordinated approach. This is a considerable challenge given the complex structure of the Belgian healthcare system. The fragmentation of powers within the state model leads to overlapping responsibilities and delays systemic reforms. Despite significant spending – more than €55 billion, or 11% of GDP – the system’s performance falls short of expectations*.

The BAHM is calling for the establishment of a federal coordinating body to oversee the transition. This body should systematically implement VBHC with political support and the involvement of all stakeholders, with a joint strategy and clear roadmap. This will make a phased shift to a more prevention-oriented system feasible. Political support, financial resources and a change in attitudes are essential to enable this shift to a future-proof healthcare system.

Belgium lags internationally

While several countries are making progress in modernising their healthcare systems by adopting VBHC, Belgium lags behind. The government does not encourage enough innovation and digitisation to enable data-driven healthcare. This not only hinders the integration of new technologies, it also delays the implementation of sustainable care models. Without a clear strategy, Belgium remains stuck in a reactive system rather than adopting a proactive and forward-looking approach.

“The transition to a future-proof healthcare system will not be easy. It requires leadership, financial resources and the courage to make structural choices. Yet with the right approach, Belgium has the opportunity to become an example within Europe. It is time to be ambitious and disruptive in the interests of patients, healthcare providers and society,” says the BAHM.

* A New Era in Belgian Healthcare: Key Findings and Collaborative Insights towards Implementation of Value-Based Healthcare

Full report:

About value-based healthcare

VBHC was introduced in 2006 by Michael Porter and Elizabeth Teisberg as a solution to the rising costs and increasing pressure on the quality and accessibility of healthcare around the world. Its objective is to sustainably improve outcomes in relation to costs by organising care around individuals with a specific condition. This is achieved by standardising measurements of outcomes and costs and using this data to monitor and compare performance within and across organisations. VBHC defines value as the measured improvement in a person’s health outcomes relative to the cost of achieving that improvement. Within this approach, healthcare providers are encouraged to help patients and the population at large improve their health, prevent chronic diseases and adopt evidence-based practices.

About the Belgian Association of Hospital Managers

The Belgian Association of Hospital Managers (BAHM) brings together the directors, CEOs, executive committee members, directors and active board members of Belgian hospitals, regardless of the legal status of their hospital, their language regime and the community or region to which they belong. The association was founded on 1 February 2002 and counts among its members 94 affiliated general managers and CEOs of hospitals and university hospitals. Between them they represent more than 95% of Belgian general and university hospitals.

Belgian Association of Hospital Managers

More information:

Erik Struys
​+32 4 95 51 83 58 ​
​erik@upragency.com