Jacob was trained as an Economist at the Rijks Universiteit Groningen (1974). In May 1974 he started his career in Health Care at the University Hospital Leiden with BAZIS. In 1979 he managed the DRG project in the Netherlands. With Prof JM. Rodrigues he started the International Network for Patient Classification Systems (PCSE), and acts now as emeritus secretary of PCSI. In 2005 he left HISCOM to become active in the world of Casemix, as partner in Casemix, and as consultant at the Ministry of health and special advisor at the Dutch Casemix Office. Since 2006 he is as founding partner in Casemix heavily involved in the introduction of integrated care concepts. The new funding methodology in Chronic Care and Perinatal care is based on the concept of condition based Care Standards. These introductions require a paradigm shift in healthcare shifting from institutional care to connected and integrated care. As “serial silo killer” he has been involved in several of these changes processes from the national to the regional and local levels. Since 2014 Jacob is chair of the Association of Specialised Childcare Nurses, which are also involved in the introduction of Integrated Childcare for children with somatic conditions and/or mental or physical disabilities. Since 2016 Jacob has been involved in population management applying the ACG system in different regional settings. Together with the Jan van Es Institute he is involved in a project to assess the ACG system for a broad implementation in the Netherlands.