EU instruments for practical support
to health system reforms
Dr Loukianos GatzoulisUnit "Performance of national health systems"
Directorate-General for Health and Food SafetyEuropean Commission
What is available?
• Guidance material
• Good Practices
• Tools
• Technical assistance
• Financing instruments
3
HSPA group report –Integrated care
I. Introduction
II. What do we mean by integrated care: theory, concepts and definitions
III. Building blocks, design principles and system levers for integrated care
IV. Measuring the performance of integrated care
V. Conclusions
https://ec.europa.eu/health/sites/health/files/systems_performance_assessment/docs/2017_blocks_en_0.pdf
Guidance material
Analysis of >60 experiences, from >30 regions, with description of:
Intervention and target groupsSuccess factors
Transferable elements
4
Example:
HSPA group report –Integrated care
5
III. Building blocks, design principles and system levers for integrated care
HSPA group report –Integrated care
▪ For each building block: ➢ Tips and suggestions ➢ Pointing to real examples
Guidance material
6
Several proposals of frameworks, domains, and indicators to assessintegrated care, with experiences from
USA
New Zealand
WHO
IV. Measuring the performance of integrated care
HSPA group report –Integrated care
Guidance material
• From the EIP AHA
– Repository of practices: https://ec.europa.eu/eip/ageing/repository_en
– "How To" Guide of the Reference Sites: https://ec.europa.eu/research/innovation-union/pdf/active-healthy-ageing/how_to.pdf
– Action Group B3 on Integrated Care: https://ec.europa.eu/research/innovation-union/pdf/active-healthy-ageing/gp_b3.pdf
• Case studies on integrated care: http://is.jrc.ec.europa.eu/pages/TFS/SIMPHS3cases.html
• In the HSPA integrated care report (Annex 1 + links)
• From the Joint Action CHRODIS: http://platform.chrodis.eu/
• DG SANTE – MS Steering Group on “Health Promotion, Disease Prevention and Management of Non-Communicable Diseases” for implementation of good practices
Good practices
Tool for Integrated care assessment
• A contract under the Third Health Programme
• Timeline: January 2017 – March 2018
• Contractor: Optimity Advisors
• Main deliverables:
➢ Mapping of strategies and models of IC across the EU health systems
➢ Proposal of assessment framework for integrated care (tool) 8
Tools
The Maturity Model
(from the EIP AHA Action Group B3 onIntegrated Care)
• Assessing Readiness/Maturity to adopt Integrated Care
• Assessing Maturity Requirements of Good Practices
• Supporting Twinningand Coaching to transfer good practices
Tools
Using the B3 Maturity Model
Tools
Comparing "readiness" and "requirements" for a good practice
Tools
12
Seminars How to design and implement integrated care:
Lessons from early adopters in Europe@ ICIC17, 8-10 May, Dublin
• Each seminar focused on a successful example of integrated care in a European region➢ Northern Ireland, Northern Netherlands, Catalonia, Scotland,
the Basque Country, Norrbotten
Technical Assistance
Knowledge transfer
“Twinning” for good practice transfer
13
• Started within the EIP AHA context
• Small financial support to regions to kick-off bilateral actions for transfer of knowledge and (elements of) good practices
• Example: Basque Country
Technical Assistance
Risk stratification
Patient empowerment
• Three twinnings as originator Region:
1. New Aquitaine
2. Scotland
3. Liguria Region
• One twinning as adopter Region :
4. Scotland
Twinning
First lessons: Twinning plan
14
Technical Assistance
Creation of a Twinning Implementation Group between the transferring and the adopting organisations
Identificationand involvement interested actors in the adopter and originator region
Study visit: Involving actors, Agenda, Visit, documentation
Create working groups Implement possible improvements
Analysis of and potential adaptation of the innovative practice
Provide further information, organize webinars and training sessions
Twinning
First lessons: requisites for adopters
15
Technical Assistance
Awareness of the good practice: Basque Country’s whole population risk stratification through the EIP AHA.
Similar problems and policy strategies: Chronic Care Model, patient empowerment
Previous experience: Risk prediction tools, used as part of clinical decision-making, active patients, patient centered programs,…
Existing capacities: Availability of rich individual level datasets and established expertise in modelling techniques and linkage of health and care information.
Benchmarking: Need to evaluate/develop existing initiatives: Sparra (Scotland), Multidimensional Prognostic Indices (Liguria)
Ongoing or planned projects: Extend SPARRA, model Osakidetza´s “OsasunEskola” website,...
Desire to collaborate: Opportunity to stimulate further knowledge transfer to inform and improve how we design and deliver person-centred integrated care services.
Twinning
SRSS
Structural Reform Support Service
• A service of the European Commission with a mandate to:
• Support the preparation, design and implementation of growth-enhancing reforms
• Direct provision of support and coordination of the support provided by the Commission
• Special assignments: Support for the management of migration in Greece and support for Cyprus settlement
• Focus on implementation and support on the ground - covering all reform stages and challenges
• Focus on country-specific perspective; tailor-made support
Technical Assistance SRSS/SRSP
Economic governance processes
• European Semester• Union Law• EU policy priorities • Better use of EU funds
SRSS Technical support to Member States
MS reforms at their own initiative
• Other growth-enhancing reforms to achieve sustainable investment, growth and job creation
Adjustment programmes • Conditionalities
• Ownership of the reforms remains with MS
• Support provided upon request from the MS
INTR
OD
UC
ING
THE
STR
UC
TUR
AL
REFO
RM
SU
PP
OR
TS
ERV
ICE
STRUCTURAL REFORM SUPPORT SERVICE (SRSS)
THE STRUCTURAL REFORM SUPPORT SERVICE, SRSS, IS A SERVICE OF THE EUROPEAN COMMISSION WITH A MANDATE TO:
• SUPPORT MEMBER STATES WITH THE PREPARATION, DESIGN AND IMPLEMENTATION OF REFORMS IN THE HEALTH
SECTOR, AND MANY OTHER POLICY AREAS
• FOCUS ON TAILOR-MADE SUPPORT, ON THE GROUND
• STEER AND COORDINATE TECHNICAL SUPPORT PROVIDED BY THE COMMISSION
• WITH A PROPOSED BUDGET OF EUR 142.8MN (2017-2020), THE SRSP WILL BE A SIGNIFICANT FACTOR FOR FUTURE
SRSS ENGAGEMENTS WITH MEMBER STATES.
SRSS FACTS
• CREATED IN JULY 2015;
• OFFICES IN BRUSSELS, ATHENS AND NICOSIA;
• 130+ STAFF.
18
HOW IT WORKS
AT THE REQUEST OF A MEMBER STATE, SRSS:
1) ENGAGES IN A DIALOGUE TO DISCUSS TECHNICAL SUPPORT NEEDS;
2) PUTS IN PLACE A SPECIFIC TECHNICAL SUPPORT PLAN TOGETHER WITH THE
MEMBER STATE; AND
3) SRSS PROVIDES FINANCING FOR THE TECHNICAL SUPPORT AND
COORDINATES THE NECESSARY EXPERTISE.
STUDIES & DIAGNOSTIC
ANALYSES
STUDY VISITS
SEMINARS, CONFERENCES &
WORKSHOPSEXPERT & SCOPING
MISSIONS
EMBEDDED
EXPERTS
TRAINING
REFORM
PARTNERSHIPS
TYPES AND PROVIDERS OF TECHNICAL SUPPORT
SRSS WORKS WITH TA PROVIDERS, SUCH AS
EXPERTS FROM MEMBER
STATES ADMINISTRATIONS; INTERNATIONAL
ORGANISATIONS; PRIVATE
FIRMS, INCLUDING
CONSULTANCY FIRMS; AND
INDIVIDUAL EXPERTS.
TOGETHER WITH IN-HOUSE COMMISSION EXPERTISE, THESE PROVIDERS
ENSURE THE RIGHT ASSISTANCE IS DELIVERED WHERE IT IS NEEDED.
Financial envelope: two layers
SRSP "dedicated" envelope: EUR 142.8 million (to be split by annual allocations)
"Additional" budget: voluntary contribution from MS – transfer of resources under Article 25 ESIF
• extended to all MS (programme countries or not)
• follows ESIF rules (both procedure and eligibility)
NOTA BENE: NO CO-FINANCING BY MS (COM DIRECT MGMT)
SRSP budget
Request for support (this year two budget cycles:
30 April for 2017; and 31 October for 2018)
• One request encompassing all MS support needs
• Template + instructions for MS (guidance)
• Purpose: to enable MS to prioritise and to provide information relevant for the assessment by COM of the request for support
COM decisional process• General principles: transparency, equal treatment, sound financial
management
• Criteria for analysis: urgency, breadth and depth of problems identified, support needs in relevant policy areas, socio economic indicators, general administrative capacity of MS
CONTACTS: SRSS LABOUR MARKET, HEALTH AND SOCIAL SERVICES UNIT:
GÉRALDINE MAHIEU, HEAD OF UNIT, [email protected], TEL: +32 2 29 63796 / CHRISTOPH SCHWIERZ, DEPUTY HEAD OF UNIT, [email protected], TEL: +32-2-296.07.52
SRSP process
EU Health Programme 2014-2020
➢ financial instrument for policy coordination in the area of health
➢ supporting collaborative actions between
• 28 EU Member States
• Iceland, Norway
• Serbia & Moldova
➢ to find solutions to common health concerns
Financing Instruments
The objectives
1) Promote health, prevent diseaseand foster supportive environmentsfor healthy lifestyles
2) Protect citizens from seriouscross-border health threats
3) Contribute to innovative, efficientand sustainable health systems
4) Facilitate access to better andsafer healthcare for Union citizens
Address in particular the
key risk factors with a focus on the Union added
value.
Coherent approaches
integrated into MS
preparedness plans
Innovative tools and
mechanisms in health and
health prevention
Increase access to medical
expertise and information for
specific conditions
Health Programme 2014-2020
HealthProgramme
Joint Action CHRODIS http://www.chrodis.eu/
Repository of Good practices
Examples of outputs
HealthProgramme
Project ACT
http://www.act-programme.eu/
Guidance material
Examples of outputs
HealthProgramme
Project SCIROCCO http://www.scirocco-project.eu/
Maturity Model Tool
Examples of outputs
SRSS
ESIF Thematic Objectives
Research and InnovationClimate change adaptation,
risk prevention
ICT, incl.e-health
Competitiveness of SMEs
Low carbon economy
Environmental protection
and resource efficiency
Sustainable transport
Better public
administration
Education, training
and LLL
Social Inclusion,
incl.access to healthcare
Employment and mobility,
incl. AHA
26
Structural Funds
SRSS
One of the guiding principles:
Moderating the use of hospital care in favour of primary and out-patient care, operating a transition from institutional- to community-based services
Investment possibilities in primary care:
➢ As part of the transition from hospital-based to more community-based care, support reorientation of specialist to general practitioners, to strengthen healthcare in primary care settings;
➢ Increase pool of primary care human resources within education and training programmes;
➢ Strengthen and support primary and secondary prevention to reduce the development and onset of major preventable chronic diseases;
➢ Promote innovative integration of care, based on improved communication and coordination, across the levels of health care (incl. primary);
➢ Strengthen ambulatory services and primary care, via prevention and monitoring, including telemedicine and telecare solutions.
Available at:
http://ec.europa.eu/health/health_structural_funds/docs/esif_guide_en.pdf
Commission guide on health investmentsthrough ESIF
27
SRSS
"Effective use of European Structural and Investment Funds for health investments in the programming period 2014-2020"
http://esifforhealth.eu/Mapping_report.htm
28
SRSS
ESIF Mapping Report
What information you will find:
➢ Overall assessment – summary of the mapping results
➢ Main health-related areas of investment (direct and indirect) per MS and OP, for programming periods 2007-13 and 2014-20
➢ ESIF health-related specific objectives in all MS
➢ Source of funding (the list of all OPs)
➢ Financial allocations as regards some types of health-related investments (4 "categories of intervention")
➢ Contact data for relevant national/regional Authorities
29
SRSS
Scope of investments 2007-2013:
- Health infrastructure
- Health promotion and disease prevention
- Education of medical staff
- E-health
- Medical R&D
- Public administration and health services
- Workplace health & safety
- Health tourism
Overview of the Mapping results
30
Scope of investments 2014-2020:
- Deinstitutionalisation and community-based care
- Active and Healthy Ageing
- Improving access & quality of health care services
- Health promotion and disease prevention
- Education of medical staff
- E-health
- Medical R&D
- Public administration and health services
- Workplace health & safety
- Health tourism
- Risk prevention and disaster preparedness
SRSS
SRSS
SRSS
Examples of actionsidentified within the "Mappingexercise"
33
SRSS
➢ (Estonia) Improving access to primary health care
- Investments in modern, regionally accessible and optimal primary health care and acute
care networks offering high quality and sustainable health care services
- Development of competency centres (pathology, psychiatry, children's clinic, ear clinic),
- Early detection of alcohol abuse, counselling, alcohol addiction treatment and internet-
based counselling will be provided to alcohol abusers and their relatives.
➢ (Greece) E-health investments
- To support operation of the Primary Health Care Information System, development of
Electronic Patient File
ESIF Investments in primary care
examples
34
SRSS
➢ (Croatia) Improving access to primary and emergency health
care
- Investments in primary health care infrastructure and equipment, improving emergency health care services, with focus on isolated and deprived areas
- Acquiring the medical equipment and vehicles necessary to provide primary health care.
➢ (Hungary) Improving health services
- Modernization of local government’s primary health care services
- Education and training programmes aimed at providing the health sector with qualified
professionals including primary and specialized care workers, family doctors and physicians
ESIF Investments in primary care
examples
35
SRSS
➢ (Latvia) Improving access to primary health care- Development of infrastructure; Development of planning, including access to health
services and infrastructures, patient flow planning, health promotion planning, health care level selection criteria and guidelines for clinical health care
➢ (Malta) Primary care strengthening- Investment in infrastructure for primary health care services
- Optimisation of capacity in the provision of health services and establishment of a more sustainable primary health care system
- Development and / or modernisation of primary health care infrastructure, improvement of the regional health facilities in Gozo (aimed at providing services to ageing population)
ESIF Investments in primary care
examples
36
SRSS
Conclusions from the Mapping
➢ Health is a relevant issue both for ERDF and ESF (though no health-OP)
➢ While all MS invest in health through ESIF, such investments prevail in the"new" Member States
➢ Less investment in health infrastructure in 2014-2020 as compared to 2007-13, but more focus on community-based care, access to care, active andhealthy ageing.
➢ Overall combined investment 2014-2020 in health infrastructure, eHealth,access to health and social services, AHA: more than ~9 billion EUR
➢ Figures for investment in other areas that include investment in health(health R&I, health SMEs, health workforce training, institutional capacitybuilding for health authorities, etc.) cannot be given at this stage (for laterevaluations)
37
SRSS
Mapping ICT investments in Operational Programmes
http://s3platform.jrc.ec.europa.eu/
38
SRSS
Mapping ICT investments in Operational Programmes
http://s3platform.jrc.ec.europa.eu/
39
SRSS
Where to find information about concrete project possibilities?
Contact authorities responsible for a given OP implementation
Contact details under the link:
http://ec.europa.eu/regional_policy/en/atlas/managing-authorities/
Or in the Mapping:
http://esifforhealth.eu/pdf/Mapping_Report_Final.pdf
SRSS
"Thematic blocks":
1. Improving access to healthcare (with emphasis on primary and preventive care, especially for vulnerable groups);
2. Support to reform processes towards effective and resilient health systems:
2a) Deinstitutionalisation measures for people with disabilities, mental health problems, older people and children deprived of parental care;
2b) transition from hospital to community-based care i.e. primary/integrated care;
2c) investments in healthcare facilities efficiency and sustainability, in particular in hospitals.
3. Uptake of e-health/digital solutions, in particular related to the Digital Single Market and the interoperability of these solutions within and across Member States;
4. Research and innovation in health and lifesciences.
5. Active and healthy ageing, healthy workforce, health promotion and disease prevention;
6. Health workforce (including i.a. training, lifelong learning, workforce planning, retention).
NEXT STEP: DG SANTE (B1) tender project: ESIF support in the area of health: building knowledge and capacities for monitoring and implementation, supporting innovation and effectiveness
SRSS
More information
ESIF:
http://ec.europa.eu/health/health_structural_funds/policy/index_en.htm
http://esifforhealth.eu/pdf/Mapping_Report_Final.pdf
http://ec.europa.eu/regional_policy/en/policy/what/investment-policy
https://cohesiondata.ec.europa.eu
Contact: [email protected]
42
The Investment Plan for Europe & the European Fund for Strategic Investments (EFSI)
43
Aim: to mobilise at least €315 billion in investment across the EU
Give investment advice • European Investment
Advisory Hub (EIAH)• European Investment
Project Portal
Mobilise finance for investment• European Fund for
Strategic Investments (EFSI)
• Cooperation with National Promotional Banks
Investment Plan for Europe
Create an investment friendly environment• Improving the
regulatory environment
• Structural reforms
SRSS
European Fund for Strategic Investment (EFSI)
The main channel to deliver on the Investment Plan for Europe
New EU financial instrument (loan-based) – EFSI is a guarantee on lending granted by the European Investment Bank (EIB) and the EuropeanInvestment Fund (EIF – for SMEs) - addressing market failures and sub-optimal
market situations
Budget (all fields, accross the EU): 21bn EUR, now proposed extension to 33,5bn (EFSI II) to mobilise private financing up to 500bn up to 2020; 183bn investment already committed (May 2017)
Priorities in health:
• New models of infrastructure (e.g. primary care)
• R&D (incl. medical devices & products)
• eHealth and new technologies
• Health workforce
• SMEs and social enterprises
> 10 major health projects granted EFSI support > 500mEUR• Primary care centres (IE)• Medical equipment & care provision(IT)• Medical research (ES, UK, IE, DE)• Healthcare infrastructure facilities
reconfiguration (UK, AT, PL, RO)
+ 2 multi-sector infrastructure projectsincl. health
EFSI and the Health Sector (I)
45
• This is where EFSI can play an important facilitating role.With EFSI acting as a guarantee against first losses, theInvestment Plan for Europe offers an opportunity for thepublic and private sectors to join together in healthinvestments that are deemed high-risk.
EFSI and the Health Sector (II)
• New facilities, such as primary care and community carecentres that will constitute the "hubs" for transformed careservices – "infrastructure" investment
• ICT systems that can support the back-end organisation, aswell as the implementation of integrated care pathways anddecision support systems - "infrastructure and medicaltechnology" investment
• New service models and new technologies, such as ICTdevices and apps (eHealth and mHealth), which can facilitateremote management of chronic patients at their homes, aswell as empowering them to engage in self-care – investmenton "soft" elements with medical technologies embedded
• Capacity-building and "system re-organisation":education of the care workforce in new roles and associatedskills (for example, new roles of "care coordinators"), new carepathways, new governance models, new financing andreimbursement models (more linked to performance, qualityand coordination) – investment on "soft" elements oforganisational change
46
Case Study:Irish Primary Care Centres PPP
● The project comprises the design, build, finance, maintenanceand facilities management of 14 Primary Care Centres locatedthroughout Ireland.
● The project is in line with the Irish Government Health Reformto reduce reliance on acute sector and is part of the nationalprogramme of establishing around 300 primary care centres,14 of which are procured as a PPP (the project).
47
Amount Up to EUR 70 million
Maturity Up to 27 years
Location 14 different locations throughout Ireland
Timeline 2016-2018
The Promoter
● Ireland, represented by the Minister for Health, acting by itsagent, the National Treasury Management Agency (NTMA)during the construction phase
● As of the service commencement, the agent for the Ministerfor Health will be the Health Service Executive (HSE)
● HSE defined the Project scope, the output specifications andthe budget for the Project
● NTMA is the statutory financial advisor to State authorities forall public investments and it has full responsibility for deliveryof most of Ireland’s PPPs (except transport sector)
48
Case Study:Irish Primary Care Centres PPP
Conclusions / Summary
● The Project will have a strongdemonstration effect for future heathcare projects to be financed in thecountry, but also potentially forprimary health care projects to befinanced across Europe.
● The Irish government specificallyrequested the Bank to support theproject.
● The improved project funding costs dueto EIB presence will be passed through tothe public sector by lowering theavailability payment due by the publicsector to private operators.
● The project will facilitate the delivery ofaccessible, high-quality integratedprimary care services aimed at improvingthe health and well-being of the localpopulation. There is a clear economicbenefit because patients can return tothe workforce and be more productive asa result of better clinical outcomes and
49
Case Study:Irish Primary Care CentresPPP
The European Investment Advisory Hub
Investment Plan for Europe
Support investment in the real economy
…through the European Investment Advisory Hub (EIAH) and the European Investment Project Portal
Mobilise EUR 315 bn of additional financing
…through the European Fund for Strategic Investments (EFSI)
Create an investment friendly environment
…through improvements in the European regulatory environment (SRSS, CMU)
5027 February 2017
The European Investment Advisory Hub
Launched in September 2015 as part of the Investment Plan for Europe, the
EIAH is a tool to strengthen Europe's investment environment and improve
the quality of investment projects
A cooperation platform to leverage and exchangeexpertise from EIAH partners(NPIs, Managing Authorities)
An instrument to assess and address unmet needsfor advisory support
A single access point to a comprehensive offer ofadvisory and technical assistance services
A joint initiative
51
The EIAH’s purpose
Support for projects and investments
Advisory and technical support in identification,
prioritisation, preparation, structuring and implementation of
investment projects
Enhance use of EU funds
Advisory and capacity
building support in the
implementation of ESIF
financial instruments
Improve access to finance
Enhancing financing
conditions and creating
bankable propositions
52
What is the Advisory
Hub?
A cooperation platform to deliver advisory services
locally
MoUs with National Promotional Institutions and other partnership agreements (LoIs, MoUs with Member States, other relevant parties)
3
An instrument to assess market gaps and unmet needs
4
An instrument to provide advisory
support to project promoters
Requests coming via the website
1
Requests coming from expert sources
2
• Process to handle all requests
• Key Performance Indicators for EIAH
• Build on/exploit the expertise of already existing advisory services and activities both within and external to EIB
4 stre
ams o
f activity
► Through consolidation of information on projects► Through assessments of policy implications► Through market studies
53
FAQs about the Advisory HubWhat is the geo scope of the Hub?The European Union
Is the Hub only linked to EFSI projects?
No, support will not be limited to projects to be financed by EFSI
(and/or the EIB)
Does the Hub provide financing?
The EIAH does not provide financing of any sort. Requests for financing addressed to the Hub are redirected to relevant resources as appropriate.
Who concretely delivers the advisory support
provided via the Hub?
Experts of the EIB, its partner institutions and/or appointed
external consultants
Is the support provided via the Hub free of charge?
In most cases, yes. A contribution may be requested from private sector beneficiaries in order to
align interests and ensure ownership of results
Does the Hub have local offices?Currently the Hub operates mainly via the EIB headquarters in Luxembourg and its local offices. A network of local partner Institutions is developing
€
€
54
EIAH health sector requests – a case study
● MOH request via the local Jaspers team
● EIB general consultant supporting MOH to fulfil EC countryconditionalities for accessing ESI funds (8 regionalmasterplans for health services reorganisation based on thenational strategy)
● EIAH Advisory Services Agreement with the MOH, to supportthe preparation of three regional hospitals plans andsubmission of applications for the ESI funds
● Potential support for the implementation (through the EIBAdvisory Services)
● Potential loan to cover the difference between
the available funds and total final costs
55
Would you like to know more about the EIAH?
Consult the Hub’sadvisory offer
www.eib.org/eiah
Contact the Hub for more info
Request support fromthe Hub
www.eib.org/eiah/contact
5627 February 2017
SRSS
57
Main considerations for the future
• How to support health system reforms
1. Build and improve the know-how & capacity of care authorities to implement reforms/new care models
2. Mobilising investments for implementation at scale
SRSS
Now…
Infrastructure(hospitals)
Medical innovations(medicines, imaging, diagnostics, devices…)
New care models & services
Investments in healthcare
SRSS
Main messages
▪ Sustained financing is essential: for up-front investments and during a transitional period; long-term contracts also help with certainty
▪ Combine funding from multiple sources EFSI and other EU-supported financial instruments managed by the EIB/EIF can be essential enablers▪ Plan how to access and blend financing components▪ Need to raise capacities at all levels to manage new instruments
▪ Broad scope of health investments, not just infrastructure but e-health, service provision and reorganisation
▪ Integrated investment: Infrastructure, technology and service models to be considered together
Seminar on "Strategic investments for the future of healthcare"
SRSS
The investment triangle in health
The future
Infrastructure (primary care &
community care centres)
Medical innovations(diagnostics, data analytics,decision support systems,
eHealth/mHealth)
investment triangle
New care models & services(patient pathways; workforce skills and roles;
governance, financing and reimbursement models, …)
SRSS
▪ Long-term thinking and strategy required, with dual aim: a) Reform and delivery of transformed health servicesb) Investment planning➢ with (a) conditioning (b), not the other way around
▪ Involvement of a broad range of public and private partners and investors& combination of bottom-up and top-down approaches
▪ Several communities have to talk to each other: investors, health providers, policy-makers, regulators, universities, SMEs▪ The objective is to break barriers and end up talking the same
language▪ Need to create eco-systems where all different players can work
together: platforms, hubs, etc.
Seminar on "Strategic investments for the future of healthcare"
SRSS
▪ Partnerships among payers and providers of care services:➢ Various models are possible – the local context must be considered➢ Partnerships preferably driven by local communities➢ Role for a lead provider / service integrator➢ Basic principle of trust and sharing responsibility, risks and benefits➢ Incentives: payment-for-results, outcome-based payments, value-based
contracting etc.
▪ Rethink contractual models for healthcare: no specific "new model" is evidently superior to others - results depend hugely on relationships, financial incentives, cultures and leadership
Seminar on "Strategic investments for the future of healthcare"
SRSS
ACCESSIBLE
RESILIENT
▪ DG SANTE Public Health: http://ec.europa.eu/health
▪ Seminar "Strategic investments for the future of healthcare": http://ec.europa.eu/health/investment_plan/events/ev_20170227_en
▪ Investment Plan for Europe http://ec.europa.eu/priorities/jobs-
growth-and-investment/investment-plan_en & Investment Plan
for Europe &
health http://ec.europa.eu/health/investment_plan/policy/index_en.htm
▪ European Fund for Strategic Investments (EFSI) via the EIB
https://www.eib.org/efsi & via the EIFhttp://www.eif.org/what_we_do/efsi/
▪ European Investment Project Portal (EIPP) - project promoters can publicise their projects to European and global investors https://ec.europa.eu/priorities/european-investment-project-
portal-eipp_en
▪ European Investment Advisory Hub (EIAH) – project promoters can get advice http://www.eib.org/eiah/about/index