The role of insurance providers in the Dutch health care system is changing. With the system overhaul, a role has been marked out for insurers in the market of health care purchasing. They should not just take costs into account, but quality as well. One insurer could distinguish itself from others by good purchasing, and consequently attract more clients. Apart from this, insurers appear to react differently, sometimes purely strategically, to the changes to the system; for instance by forming closer alliances with care providers than just through their links in purchasing care. An example is setting up and financing a health care centre. NIVEL is closely monitoring the effects of the system overhaul on insurers. NIVEL also does systematic research into how insured consumers rate their insurer. The results of this research are published on www.kiesBeter.nl (Dutch only).