Report WAEH Community of Practice – Finances | 25 June 2026

On Thursday 25 June 2026, the WAEH held its first Community of Practice on Finances, led by Mee Chee (Macy) Thong, Chief Financial Officer at Singapore National Eye Centre (Singapore), Jessica Dollé (Chief Financial Officer at Quinze-Vingts National Eye Hospital, France) and Urs Winkler (Chief Financial Officer at Hôpital Ophtalmique Jules-Gonin, Switzerland). The session brought together finance professionals from Indonesia, the Netherlands, Singapore, Saudi Arabia, Rwanda, France and Switzerland. 

The meeting was opened by Maaike van Zuilen, Global Lead of the WAEH, who welcomed participants and introduced the CoP leader Macy Thong and her co-leads Jessica Dollé and Urs Winkler. The primary objective of the meeting was to create a platform for finance professionals in eye hospitals to exchange experiences, discuss common challenges, and identify opportunities to improve financial sustainability while maintaining high-quality patient care.

Value-Based Healthcare and Financial Sustainability

Macy Thong provided an overview of the healthcare landscape in Singapore and the financial challenges facing eye care providers. The Singapore National Eye Centre (SNEC) currently serves approximately 390,000 patients annually, performs around 27,000 surgeries, and employs more than 1,300 staff members. Like many healthcare institutions worldwide, the centre is experiencing increasing demand for services due to population ageing, rising healthcare costs, workforce shortages, and growing concerns around staff wellbeing and burnout.

A central theme of the presentation was the transition towards value-based healthcare. Macy explained that healthcare systems can no longer focus solely on increasing activity and service volumes. Instead, healthcare providers must optimise resources while achieving the best possible outcomes for patients. Participants learned how Singapore has gradually shifted from traditional fee-for-service reimbursement models towards population-based funding. Under this approach, healthcare clusters receive a fixed budget to care for a defined population, encouraging providers to focus on prevention, efficiency, and outcomes rather than activity volumes.

Several practical examples were presented. SNEC has introduced streamlined assessment pathways that reduce unnecessary patient visits and diagnostic testing. Nurse-led services, including intravitreal injection clinics and pre-operative assessments, have helped address workforce constraints while reducing costs. The organisation has also reviewed long-standing protocols to eliminate low-value testing and improve efficiency. These initiatives have not only generated financial benefits but have also improved patient flow, reduced waiting times, and enhanced staff productivity.

An important message throughout the presentation was that value-based healthcare is not simply about cost reduction. Rather, it involves ensuring that resources are used appropriately and that patients receive care that aligns with their individual needs and expected outcomes. Achieving this requires robust data, strong leadership commitment, multidisciplinary collaboration, and significant cultural change across the organisation.

Discussion on Reimbursement Models

Following the presentation, participants exchanged experiences regarding reimbursement systems in their respective countries. Urs Winkler explained that Switzerland has also begun moving away from purely activity-based reimbursement towards bundled payments for episodes of care. This encourages providers to optimise care pathways and improve efficiency because reimbursement is linked to the overall service rather than individual activities.

Jessica Dollé shared that France continues to operate largely under an activity-based funding model, where hospitals are paid according to the services they deliver. While value-based approaches are increasingly discussed, implementation remains limited. She noted that financial considerations alone are insufficient to drive change, as value-based healthcare also requires a significant shift in mindset among clinicians, managers, and policymakers. The discussion highlighted that although healthcare systems differ considerably between countries, eye hospitals around the world face similar challenges in balancing financial sustainability with increasing demand and rising costs.

Financial Challenges for Specialised Eye Hospitals

A second topic was introduced by Mireille Wolleswinkel, CEO of the Rotterdam Eye Hospital, who highlighted the financial challenges facing the only specialised eye hospital in the Netherlands. Despite providing highly specialised care and contributing significantly to research, education, and innovation, the Rotterdam Eye Hospital is reimbursed largely at the same level as general hospitals, with limited funding for activities beyond clinical care and physician training. This creates ongoing pressure on the hospital’s financial sustainability. 

Mireille explained that increasing financial pressure and shrinking margins have raised concerns about long-term sustainability. To better demonstrate the hospital’s value to society, Rotterdam Eye Hospital has commissioned a cost-benefit analysis aimed at quantifying the broader impact of its activities beyond direct patient care. The findings are intended to support discussions with insurers and government stakeholders regarding future funding arrangements.

Several attendees recognised similar challenges in their own countries, particularly regarding the funding of specialised care, research infrastructure, education, and innovation activities. Participants from France, Singapore, and Switzerland shared their experiences with alternative funding mechanisms, including government grants, philanthropic funding, subsidies for training, and research grants. It was proposed to set up a think tank to discuss this further.

Do you have experience in addressing similar funding challenges, conducting cost-benefit analyses, or demonstrating the societal impact of specialised eye hospitals? Please share your insights and lessons learned with Mireille Wolleswinkel by sending an email.

Key Takeaways

All in all, this first Community of Practice on Finances marked an important step towards building a global network of finance professionals dedicated to ensuring the long-term sustainability of eye hospitals while continuing to deliver high-quality, accessible eye care. This CoP is particularly relevant, as financial sustainability is becoming a critical issue for eye hospitals globally due to ageing populations, workforce shortages, and escalating healthcare costs. Many WAEH members are already implementing initiatives that create value, such as nurse-led services, pathway redesign, task shifting, and reduction of low-value interventions are increasingly common and can deliver measurable benefits for both patients and providers. By coming together and sharing these best practices and initiatives, we will greatly improve eye care worldwide.

Watch the full recording on the Knowledge Hub (for members only)!

The Community of Practice for Finances will come together online again on site during the 20th WAEH Annual Meeting from 9-13 November 2026 in São Paulo (Brazil), and on 28 January 2026.

Read more about the Communities of Practice here.