The final report of the Evaluative Study on the Cross-Border Healthcare Directive (2011/24/EU), co-authored by empirica GmbH, KPMG Advisory Spa and Technopolis Group, has been officially published on the European Commission website on 28 May, 2015.
The Cross-Border Healthcare Directive clarified the rules on accessing (planned) healthcare by EU citizens in another EU country and stipulated legislative efforts in member states by setting a deadline (25 October 2011) for passing corresponding implementation laws. The study in question looked at the functioning of the Directive in the first years since its implementation. The evaluative directions undertaken focused on the reimbursement of cross-border healthcare, the information on quality and safety of cross-border healthcare as well as issues around undue delay (too long waiting times for patients justifying seeking healthcare in another country). The study was carried out at the EU-28 level, with a sample of 12 focus countries subject to a broader analysis. In order to obtain as much information as possible a wide range of stakeholders was involved.
A main hindrance encountered by the Evaluative Study was the scarcity of quantitative data at the member state level. The study was able to identify, however, the main trends and obstacles, and the analysis confirmed the advancements and growth potential of cross-border healthcare in spite of a still very low number of patients who accessed cross-border healthcare services. The major finding is that increased awareness at patient level may bring forth a higher demand for cross-border healthcare. The lack of awareness of the new opportunities available to European citizens under the Directive is the most likely reason for the low number of requests for information and the even lower number of interventions triggering a reimbursement request. Concerns about the quality and safety of healthcare received abroad do not play a key role in patient decision making, which is more often unfavourably swayed by the prospective cumbersome administrative process. The study recommends more targeted and regular communication activities about the opportunities offered by the Cross-Border Healthcare Directive, covering specifically the sometimes complex and difficult to comprehend procedural steps and administrative aspects. It also suggests improving the usefulness of the information provided by the dedicated National Contact Points through a broader involvement of patient organisations.