Many healthcare systems have witnessed the rise of commercially-oriented healthcare providers in recent decades. Inspired by the ideology of New Public Management (NPM), policymakers have embraced market-based incentives to enhance the efficiency of healthcare systems. The NPM prescribed a more commercially-oriented role for healthcare providers. This project examines how Dutch healthcare providers took on this "new" role and how they have carved out from the traditional sector certain niche markets. The aim of this research project is to assess whether these providers contribute to a financially sustainable healthcare system.

The nursing home and medical care providers in the Dutch healthcare system provide an interesting case study because these healthcare providers are incentivised to act as commercial entities, but are simultaneously restricted by a for-profit ban on the distribution of dividends. This project focuses on three types of providers: for-profit hospitals, for-profit nursing homes and independent treatment centres (ITCs).

In order to study these care providers, this project examines three research questions: (1) What market trends explain the growth and/or performance of commercially-oriented providers? (2) How do commercially-oriented (niche) providers perform in terms of costs, quality and accessibility in relation to the "traditional" sector? (3) What ethical issues arise from the provision of healthcare services by commercial niche organisations?