Acceso al informe del seminario “Strategic investments for the future of healthcare” (27 Feb. 2017) http://ec.europa.eu/health/sites/health/files/investment_plan/docs/ev_20170227_mi_en.pdf
MAIN MESSAGES SUMMARY
• There is an urgency to start restructuring care delivery, fuelled by factors such as chronic diseases, ageing population and health workforce shortages. To tackle the challenges, new care models are needed and their implementation requires essential investments and investments strategies.
• Involvement of a broad range of public and private partners and investors is required, with a combination of bottom-up and top-down approaches to realise the new care models.
• Several communities have to talk to each other: investors, health providers, policy-makers, regulators, universities, SMEs, etc.
– The objective is to break barriers and end up talking the same language, and pursue common goals.
– There is a need to create eco-systems where all different players can work together: stakeholder platforms, hubs, etc.
• Partnerships among purchasers and providers of care services are a fundamental element: o Various models are possible – there is no “one size fits all”, 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., are possible mechanisms for building a sense of joint ownership and responsibility – everybody becomes a “shareholder”.
• Sustained financing is essential: for up-front investments and during a transitional period; long-term contracts also help with certainty until the benefits appear and bring the anticipated return-on-investment.
• Combination of funding from multiple sources is required: 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 financial instruments.
• Broad scope for health investments exists, not just for infrastructure but also for e-health, service provision and reorganisation.
• An integrated investment approach should be pursued: Infrastructure, 3 technology and service models to be considered together.
• There is need for an enabling and encouraging regulatory environment for investments.
• Long-term thinking and strategy is required, with dual aim:
a) Reform and delivery of transformed health services.
b) Investment planning.
A should condition B, not the other way around.
• Rethink contractual models for healthcare: no specific “new model” is evidently superior to others – results depend hugely on relationships, financial incentives and leadership.
• There is a need and an opportunity for smart investments to transform our health systems for the better – the time is now.