Coheur Alain : Mutualités Socialistes de Belgique

Common Challenges for Health and Care

Facing the challenges : cross-border experiments

WORKSHOP

Guidelines for operational cross-border care, practical dimension

- introduction- the global level- the local level- conclusions

INTRODUCTION

aim of cross-border experiments is to get all hospitals, practionars and insurers working together

To allow European citizens to move around more easily

Do the Euroregions have any real autonomy in the field of health ?

THE GLOBAL LEVEL 1992, first community initiative = Interreg

General principle = the national borders should not be an obstacle to balanced development or to integration of the European territory

Three elements characterise and constitute the added value of the Interreg Initiative

Support for development Method of partnership Grassroots visibility

The most significant results and progress achieved as regards cross-border accessibility to health care have been under the Interreg programme

Our complementary projects have given rise to four results :

An easing in the administrative procedure Parternships Bilateral agreements exchanges

THE LOCAL LEVELChoosing the most relevant projects

for the insurers and for the hospitalsHighlight the gaps in the health cover, Highlight the needs of the populationHow to set up and implement the

actual possibilities for cross-border care ?

How can we ensure that health managers are able to cohabit ?

Do we need to set up official bodies ?

How the project is organized

Team health-care insu. pro ject

Subprojects Subprojects

Subprojects

Subprojects

Subprojects

C oordinators H ospita ls pro ject team

Executive Bureau

Steering C om m ittee

M onitoring C om m ittee

Decision making process relating to the Decision making process relating to the subprojectssubprojects

•  • External "researchers"•  •

(3) (3)• 10 10• Coordinators Member organizations Project teams• 4• 5 10 9•  •

8• Executive Bureau 1 2• 6 11• 12 13• Steering Committee Monitoring Committee European Commission • 7• = project proposal = project (proposal) approved• = (sub)project completed

Selection criteriaSelection criteria• The award of the subprojects always takes place following a

check on their appropriateness in relation to the overall objectives of the project

• The projects selected are then classified according to priority

• The projects are choosen on the basis of very precise criteria• What specific know-how is necessary• Preference is always given to what meets the real needs of

the insured persons/patients

With figures by way of example Example of subproject grade

Subproject grade

high High low

1. Target group for large population group 4 0 1 2 3 4 small group 3 0 1 2 3 4

2. Necessity, in Region 1 1 0 1 2 3 4 in Region 2 2 0 1 2 3 4 in Region 3 3 0 1 2 3 4 in Region 4 4 0 1 2 3 4

3. Hospital care 2 0 1 2 3 4 Outpatient care 2 0 1 2 3 4 Combination of both 4 0 1 2 3 4 Health insurance 4 0 1 2 3 4

4. Limited provision in relation to needs 2 0 1 2 3 4

3. Favourable/adverse financial consequences for health-care, insurance bodies and patients

2 0 1 2 3 4

6. Distance in relation to patients/families 4 0 1 2 3 4

7. Skills (need for centres of excellence) 2 0 1 2 3 4

8. Involvement of the 4 regions 4-3-3-1 0 1 2 3 4

9. Project objective scientific approach 2 0 1 2 3 4 possibilities as regards practical application 4 0 1 2 3 4