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Background: The sustainability of many healthcare systems in Western countries is of serious concern due to rising expenditures. In the Netherlands for example, the expenditures on medical specialist care increased with more than 55% during the past decade to more than 27 billion euros in 2016. Therefore, redesigning healthcare delivery models is high on the Dutch political agenda. In two Dutch pioneer sites, various stakeholders started experimenting with a new healthcare delivery model called Primary Care Plus (PC+). In PC+, various medical specialists perform consultations in the primary care setting in order to achieve substitution of specialised hospital care with less expensive primary care to control for rising costs. Additionally, stakeholders aim to achieve better integration between primary care and specialised hospital care by enhancing collaboration and communication between GPs and medical specialists. This should ultimately prevent unnecessary referrals to (outpatient) hospital care and consequently improve Quadruple aim outcomes. Aims and Objectives: The aim is to present and discuss the evaluation and results of the PC+ interventions in two Dutch pioneer sites measured according to the Quadruple Aim outcomes (experiences of patients and healthcare providers, population health and costs). The results are based on the evaluation, which started in 2013 and will be finished in 2018. At the ICIC 2016 in Barcelona, results of a PC+ pilot and preliminary results of the implementation of the PC+ centres were presented and during this workshop we will present the final results and lessons learned. Format: The workshop, which will be chaired by professor Dirk Ruwaard as leader of the Living Lab on Sustainable Care at Maastricht UMC+/Maastricht University, will be structured according to the Quadruple Aim outcomes in the pioneer sites for PC+ and will end with the lessons learned including recommendations for policy, practice and research. Several researchers of the Living Lab will present their work and there will be ample time to discuss the outcomes and share thoughts and experiences. Speakers: Dirk Ruwaard, Tessa Quanjel, Esther van den Bogaart, Daan Westra, Niels Hameleers and Marielle Kroese. Timing: 65 minutes presentation and 25 minutes discussion Proposed Structure 10 min: Opening: Integrated care through Primary Care Plus by Dirk Ruwaard 45 min: Quadruple aim outcomes: 10 min: Quality of care as experienced by patients by Tessa Quanjel 10 min: Experiences and satisfaction of healthcare providers by Esther van den Bogaart 10 min: Health of the population measured with health related quality of life outcomes by Marielle Kroese 15 min: Effects of PC+ on the healthcare costs by Niels Hameleers  10 min: Lessons learned by Daan Westra 25 min: Discussion (led by Dirk Ruwaard) Target audience: researchers, healthcare providers, healthcare insurers and policy makers Learnings/Take away: We will share our experiences with the audience regarding the evaluation of PC+ on Quadruple Aim outcomes and the do’s and don’ts for all stakeholders on how to start and implement new healthcare delivery models, such as PC+.

Evaluating Primary Care Plus interventions in the Netherlands: discussion of methods and results regarding the Quadruple Aim