Learning from Integrated Care in Belgium: Implementation Challenges and Opportunities

Belgium has a partially decentralized healthcare system and is characterized by fragmentation of responsibilities. This poses a challenge for care integration, which is still at an early stage, although it has been on the political agenda for more than a decade. During this period, there have been several initiatives at both federal and federated levels, which have developed at different speeds. This provides an opportunity to identify barriers and facilitators to the implementation and scale-up of integrated care in Belgium. This chapter provides a comprehensive description of the current situation of care integration in Belgium by presenting the dynamics of integrated care from different angles, levels, and perspectives. The analysis is based on stakeholder consultations and explores integrated care implementation in Belgium overall as well as the nature and progress of various integrated care policy initiatives at federal and federated levels. Findings show not only a strong will among many stakeholders to move toward more integrated care but also structural gaps and the need for system-wide solutions to enable the scale-up of integrated care. These solutions should focus on financing, regulatory legal frameworks for the healthcare professions, and support for the need-based approach.