Periodic Reporting for period 2 - FLASH (Flexible Approaches to Support Health through financing)
Período documentado: 2024-07-01 hasta 2025-12-31
The FLASH project (Flexible Approaches to Support Health through Financing - https://flash-project.com/(se abrirá en una nueva ventana)) aims to analyze the European financing of health systems and their adaptability. In response to evolving health challenges, including those highlighted by the COVID-19 pandemic, FLASH seeks to enhance the sustainability and resilience of healthcare systems. The project explores new financing models, evaluates their impact on health system performance, and develops policy recommendations to help EU member states improve their financial management and resource allocation in healthcare.
FLASH addresses the gap between dynamic health challenges (such as population aging, technological advancements, and varying health needs) and the often static financing mechanisms adopted by member states. By focusing on flexible approaches, the project aims to equip health systems with the tools to efficiently and equitably tackle current and future health challenges. This includes improving care quality, ensuring equitable access to services, and strengthening financial protection for citizens across the European Union.
FLASH addresses the gap between dynamic health challenges (such as population aging, technological advancements, and varying health needs) and the often static financing mechanisms adopted by member states. By focusing on flexible approaches, the project aims to equip health systems with the tools to efficiently and equitably tackle current and future health challenges. This includes improving care quality, ensuring equitable access to services, and strengthening financial protection for citizens across the European Union.
A significant amount of evidence has been produced regarding the ability of monetary and information-based incentives to improve the quality of both primary and hospital care, demonstrating that substantial progress can be made even without financial incentives and that context is a key factor. Furthermore, selecting the right incentives is crucial to ensuring that efforts translate into better patient outcomes. Maintaining adequate quantitative and qualitative standards of care can be particularly challenging in emergency situations, such as a pandemic. A resilience index has been developed and applied retrospectively to data on hospital activity in four EU countries. This analysis was combined with a collection of information on factors that can contribute to improving the resilience of the health system.
New technologies with significant potential benefits are constantly becoming available to patients. However, innovation is increasing pressure on healthcare budgets. We have studied the complex process that leads from the development of a new health technology to its adoption at two critical stages: before it reaches the market, and at the time when payers have to decide on adoption. For the early phase, a novel participatory approach has been developed for the early evaluation of new technologies. For the adoption phase, a tool has been developed that allows payers to forecast with greater precision the budget impact of innovations over time, even in complex settings, where patients can receive multiple treatments over time.
Digital health is one of the innovations that is likely to affect large numbers of patients in the near future. However, much remains to be learned about the efficiency and equity implications of widespread use of digital technologies. An in-depth analysis of data on the use of a digital health app made available to the population of Catalonia enabled us to identify its impact on various outcomes and healthcare utilisation. Furthermore, we identified groups within the population who require support to adopt new digital technologies, as there is a risk of their exclusion from the benefits they offer. Ongoing work will enable us to extend the analysis to the impact of new technologies in other geographic areas.
Contributing to defining policies to improve equity in healthcare is an essential goal of the FLASH project. Work Package 3 (WP3) examined whether health financing systems across Europe are aligned with people’s health needs and how out-of-pocket (OOP) payments affect access to care. A detailed comparison of funding allocation rules in nine EU countries was completed, showing wide differences in how population characteristics—such as age, socio-economic conditions and health status—are taken into account. An original dataset covering European regions over more than a decade was developed to assess whether areas with greater health needs receive proportionally more resources. The results indicate that funding generally responds to need, but only to a limited extent, with marked differences across countries. Additional analyses show that cost-related unmet needs remain concentrated among vulnerable groups and that private spending plays a complex role, partly compensating for gaps in public provision while raising equity concerns.
One way to improve equity of access is to allow patients to seek care where they can get the best service for their health needs. In some cases, this may involve cross-border patient mobility. After identifying the key barriers to cross-country patient mobility, the project made fundamental progress in establishing legal and financial arrangements that could help remove geographical barriers to patients accessing high-quality healthcare.
New technologies with significant potential benefits are constantly becoming available to patients. However, innovation is increasing pressure on healthcare budgets. We have studied the complex process that leads from the development of a new health technology to its adoption at two critical stages: before it reaches the market, and at the time when payers have to decide on adoption. For the early phase, a novel participatory approach has been developed for the early evaluation of new technologies. For the adoption phase, a tool has been developed that allows payers to forecast with greater precision the budget impact of innovations over time, even in complex settings, where patients can receive multiple treatments over time.
Digital health is one of the innovations that is likely to affect large numbers of patients in the near future. However, much remains to be learned about the efficiency and equity implications of widespread use of digital technologies. An in-depth analysis of data on the use of a digital health app made available to the population of Catalonia enabled us to identify its impact on various outcomes and healthcare utilisation. Furthermore, we identified groups within the population who require support to adopt new digital technologies, as there is a risk of their exclusion from the benefits they offer. Ongoing work will enable us to extend the analysis to the impact of new technologies in other geographic areas.
Contributing to defining policies to improve equity in healthcare is an essential goal of the FLASH project. Work Package 3 (WP3) examined whether health financing systems across Europe are aligned with people’s health needs and how out-of-pocket (OOP) payments affect access to care. A detailed comparison of funding allocation rules in nine EU countries was completed, showing wide differences in how population characteristics—such as age, socio-economic conditions and health status—are taken into account. An original dataset covering European regions over more than a decade was developed to assess whether areas with greater health needs receive proportionally more resources. The results indicate that funding generally responds to need, but only to a limited extent, with marked differences across countries. Additional analyses show that cost-related unmet needs remain concentrated among vulnerable groups and that private spending plays a complex role, partly compensating for gaps in public provision while raising equity concerns.
One way to improve equity of access is to allow patients to seek care where they can get the best service for their health needs. In some cases, this may involve cross-border patient mobility. After identifying the key barriers to cross-country patient mobility, the project made fundamental progress in establishing legal and financial arrangements that could help remove geographical barriers to patients accessing high-quality healthcare.
The FLASH project achieved the following key results between months 19 and 36:
- Development of a quantitative index to measure resilience in the provision of hospital care and its application, including the identification of factors contributing to increasing resilience
- Development and application of a quantitative measure of the flexibility of healthcare funding with respect to local health needs, including an analysis of the spatial heterogeneity in the prevalence of unmet health needs
- Extensive, comparative analysis of rules adopted in EU countries with significantly decentralised healthcare systems, as a complement to the result reported in the previous point
- Development of a flexible tool enabling more precise estimates of the dynamic budget impact of the adoption of new technologies (especially new pharmaceutical products) over time, in complex settings
- Identification of financial and legal solutions enhancing patients’ opportunities in terms of cross-border mobility
- Extensive evidence on the ability of monetary and information-based incentives to improve the quality of both primary and hospital care
- Large-scale analysis of the efficiency and equity impacts of the introduction of a new digital tool (app) within a public health system
- Development of a quantitative index to measure resilience in the provision of hospital care and its application, including the identification of factors contributing to increasing resilience
- Development and application of a quantitative measure of the flexibility of healthcare funding with respect to local health needs, including an analysis of the spatial heterogeneity in the prevalence of unmet health needs
- Extensive, comparative analysis of rules adopted in EU countries with significantly decentralised healthcare systems, as a complement to the result reported in the previous point
- Development of a flexible tool enabling more precise estimates of the dynamic budget impact of the adoption of new technologies (especially new pharmaceutical products) over time, in complex settings
- Identification of financial and legal solutions enhancing patients’ opportunities in terms of cross-border mobility
- Extensive evidence on the ability of monetary and information-based incentives to improve the quality of both primary and hospital care
- Large-scale analysis of the efficiency and equity impacts of the introduction of a new digital tool (app) within a public health system