Study on Enhancing Implementation of the Cross-Border Healthcare Directive 2011/24/EU to Ensure Patient Rights in the EU

Book excerpt: In this report, we present the methodology and results for the 'Study on Enhancing implementation of the Cross-Border Healthcare Directive 2011/24/EU to ensure patient rights in the EU'. The purpose of this study was to support the Commission's work to deepen analysis of the problem that it continues to be difficult for a number of patients to access healthcare in another Member State and many remained shortcomings in the practical application of the Directive, by: (1) identifying options and solutions for improving the consistency and transparency in the application of the Directive; (2) gathering, mapping and analysing information from the 27 Member States as well as EEA EFTA countries on specific areas of the Directive's practical implementation; and (3) developing an intervention logic and critical review of existing monitoring indicators for future evaluation of the Directive. In the light of these objectives different research methods were applied including, a literature review, interviews and written inquiries with NCP's, online questionnaires with patient organisations, healthcare insurers and healthcare providers, and workshops with NCP's and patient organisations. The core findings of this study are: The way Prior Authorisation procedures are implemented differs greatly across Member States and EEA EFTA countries. Guiding Principles were developed to provide recommendations to streamline and simplify Prior Authorisation procedures; Certain administrative procedures and requirements across Member States and EEA EFTA countries may be regarded as creating potentially unjustified obstacles for patients seeking cross-border healthcare under the Directive; The 2019-toolbox can still be helpful to further enhance the implementation of the Directive. Most Member States indicated that the Toolbox is implemented by their NCP. Patient organisations, healthcare insurers and healthcare providers do not appear to be familiar with the Toolbox; A limited number of Member States implement consultation arrangements between NCPs and relevant national stakeholders such as healthcare insurers, providers and patient organisations. To facilitate future monitoring and evaluation of the Directive, a shortlist of indicators has been developed and associated stakeholder views were provided.