Evaluation of the cross-border healthcare Directive

On 28 May, the Commission released an evaluative study on the cross‐border healthcare Directive (2011/24/EU).

The deadline for transposition into Member States’ legislation of the Directive 2011/24/EU on the application of patients’ rights in cross‐border healthcare was 25 October 2013. Article 20 of the Directive requests a report to be submitted to the European Parliament and to the Council including information on related processes in place and the overall operation of the Directive in the first years of its implementation.

The Commission’s evaluative study focused on three main aspects of the Directive’s implementation:

  • reimbursement;
  • quality and safety of care;
  • undue delay.

Concerning reimbursement, the report points out that some progress has been made regarding dissemination of information about the Directive and the role of National Contact Points. However, there is still a lack of patients’ awareness about their rights to reimbursement and new possibilities offered under the Directive.

The evaluative study also reports that many different practices were observed among Member States in terms of prior authorization.

As far as quality and safety of care is concerned, the report calls on National Contact Points to provide patients with more comprehensive information on the quality and safety of the care delivered by healthcare providers in their respective countries. However the report notices that, while the administrative burden caused by prior authorisation and reimbursement procedures could prevent the effective use of the Directive, quality of care did not appear as a major obstacle to patients’ mobility.

Finally, with regards to undue delay, the study shows a large difference in Member States’ practices. The report also points out that undue delay is most often evaluated on an individual basis and that only two countries (The Netherlands and Denmark) have specific rules in place to determine the maximum waiting time for all treatments.

Conclusions highlight the fact that the Directive is still at an early stage of its implementation. Therefore, more evaluative efforts have to be conducted in the future to monitor implementation and impact produced. The study also reveals that demand for cross‐border healthcare has the potential to grow if better and more target information is provided to patients. In this regard, the report recommends National Contact Points to provide additional information not only on citizens’ rights but also on the specific steps to be taken to benefit from cross‐border healthcare.

Furthermore, it recommends enhancing usefulness of information contained on National Contact Points’ websites and close collaboration with patients’ organisation to review this information.

The evaluative study on the cross-border healthcare directive (2011/24/EU) is available at: http://ec.europa.eu/health/cross_border_care/docs/2015_evaluative_study_frep_en.pdf