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Investing in Health: examples - PowerPoint Presentation

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Investing in Health: examples - PPT Presentation

relevant to Cyprus Dr Dimitrios Florinis Unit Performance of national health systems DirectorateGeneral for Health and Food Safety European Commission 2 New Opportunities for investments in health in Cyprus ID: 744430

care health investments investment health care investment investments http project efsi europa primary models plan amp services european centres

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Slide1

Investing in Health: examples relevant to Cyprus

Dr

Dimitrios Florinis

Unit "Performance of national health systems"

Directorate-General for Health and Food Safety

European CommissionSlide2

2

New Opportunities for investments in health in Cyprus

Coming from

recent health system reforms, Acts adopted in June 2017

Build and improve the

know-how

&

capacity

of care authorities to implement reforms/new care models

Mobilising

investments

for implementation of innovative forms of care necessary part of reforms

Use

ALL opportunities

and financing tools for the new models and new services.Slide3

3Slide4

Now in the EU…

Infrastructure

(hospitals)

Medical innovations

(medicines, imaging,

diagnostics, devices…)

New care models

& services

Investments in

Healthcare (old school)Slide5

The investment triangle in health

The future

Infrastructure

(primary care & community care centres)

Medical innovations

(diagnostics, data analytics,

decision support systems,

eHealth/mHealth)

investment

triangle

New care models & services

(patient pathways; workforce skills and roles; governance, financing and reimbursement models, …)Slide6

Where to find further information about concrete project possibilities?

Use previous experience in the EU (ESIF):

-> Read previous guidance and reports.

-> Contact authorities responsible for a given OP implementationContact details under the link:http://ec.europa.eu/regional_policy/en/atlas/managing-authorities/Or in the Mapping:http://esifforhealth.eu/pdf/Mapping_Report_Final.pdf

Getting ideas from

Other toolsSlide7

Organ donation and transplantation:

Increase availability, and strengthen safety and quality, of organs, tissues and cells for transplantation, and of blood for transfusion, including via the promotion of programmes for altruistic donation programmes, among the public and health professionals, and set up a transplant/donor coordinator in every health facility with potential for organ donation.

Promote the use of centres of reference and the exchange of organs between EU MS, develop common methodology and definitions, and use a common accreditation system for organ donation and transplantation programmes.

Develop registers for living donors and organ recipients to evaluate and ensure their health and safety.Available at: http://ec.europa.eu/health/health_structural_funds/docs/esif_guide_en.pdfCommission guide

on

health

investments

through

ESIF

7

Getting ideas from

Other toolsSlide8

"Effective use of European Structural and Investment Funds for health investments in the programming period 2014-2020"

http://esifforhealth.eu/Mapping_report.htm

8

Getting ideas from

Other toolsSlide9

Mapping ICT investments in Operational Programmes

http://s3platform.jrc.ec.europa.eu/

9Slide10

Mapping ICT investments in Operational Programmes

http://s3platform.jrc.ec.europa.eu/

10Slide11

Where to find further practical information for health investments?

-> Information in EC/ DG SANTE website on health.

-> Material from Strategic Investments in Health workshop.

Further details under the link:http://ec.europa.eu/health/investment_plan/events/ev_20170227_en

Looking for Investments

With real valueSlide12

Need for an enabling and encouraging regulatory environment

for investments.

Broad scope

of health investments, not just infrastructure but e-health, service provision and reorganisationLong-term thinking and strategy required, with dual aim (a conditioning b): Reform and delivery of transformed health servicesInvestment planningThere is an opportunity for

smart

investments

to

transform

your

health

systems

for

the better

– the time is now

Strategic Investments for the future of healthcare

27 February 2017 - Main MessagesFurther information:

http://ec.europa.eu/health/investment_plan/events/ev_20170227_en

S

eminar on "Strategic investments for the future of healthcare"Slide13

European Fund for Strategic Investment (EFSI)

The main channel to deliver on the

Investment Plan for Europe

New EU financial instrument (loan-based) – EFSI is a guarantee on lending granted by the European Investment Bank (EIB) and the European Investment Fund (EIF – for SMEs) - addressing market failures and sub-optimal market situations

Budget

(all

fields

,

accross

the EU):

21

bn EUR, now proposed extension to 33,5bn (EFSI II) to mobilise private financing up to 500bn up to 2020;

225bn investment already committed

(August 2017)

Priorities in health:

New models of infrastructure (e.g. primary care)

R&D (incl. medical devices & products)

eHealth and new technologies

Health workforce

SMEs and social enterprises

> 10 major health projects granted EFSI support > 500mEUR

Primary care centres (IE)

Medical equipment & care provision

(IT)

Medical

research

(ES, UK, IE, DE)

Healthcare infrastructure facilities reconfiguration (UK, AT, PL, RO)

+ 2

multi-sector infrastructure

projects incl.

health

Investment Plan

Examples in HealthcareSlide14

EFSI and the Health Sector (I)

14

This is where EFSI can play

an important facilitating role

. With EFSI acting as a

guarantee

against first losses, the Investment Plan for Europe offers an opportunity for

the public and private sectors to join together in health investments that are deemed

high-risk

. Slide15

EFSI and the Health Sector (II)New facilities, such as primary care and community care centres that will constitute the "hubs" for transformed care services – "infrastructure" investment

ICT systems

that can support the back-end organisation, as well as the implementation of integrated care pathways and decision support systems -

"infrastructure and medical technology" investmentNew service models and new technologies, such as ICT devices and apps (eHealth and mHealth), which can facilitate remote management of chronic patients at their homes, as well as empowering them to engage in self-care – investment on "soft" elements with medical technologies embeddedCapacity-building and "system re-organisation": education of the care workforce in new roles and associated skills (for example, new roles of "care coordinators"), new care pathways, new governance models, new financing and reimbursement models (more linked to performance, quality and coordination) – investment on "soft" elements of organisational change.15Slide16

Case Study:Irish Primary Care Centres PPP

The project

comprises the design, build, finance, maintenance and facilities management of 14 Primary Care Centres located throughout Ireland.

The project is in line with the Irish Government Health Reform to reduce reliance on acute sector and is part of the national programme of establishing around 300 primary care centres, 14 of which are procured as a PPP (the project).16AmountUp to EUR 70 millionMaturity

Up to 27

years

Location

14

different locations throughout

Ireland

Timeline

2016-2018Slide17

The PromoterIreland, represented by the Minister for Health, acting by its agent, the National Treasury Management Agency (NTMA) during the construction phase

As of the service commencement, the agent for the Minister for Health will be the Health Service Executive (HSE)

HSE

defined the Project scope, the output specifications and the budget for the ProjectNTMA is the statutory financial advisor to State authorities for all public investments and it has full responsibility for delivery of most of Ireland’s PPPs (except transport sector)17Case Study:Irish Primary Care Centres PPPSlide18

Conclusions / SummaryThe Project will have a strong demonstration effect for future heath care projects to be financed in the country, but also potentially for primary health care projects to be financed across Europe.

The Irish government specifically requested the Bank to support the project.

The improved project funding costs due to EIB presence will be passed through to the public sector by lowering the availability payment due by the public sector to private operators. The project will facilitate the delivery of accessible, high-quality integrated primary care services aimed at improving the health and well-being of the local population. There is a clear economic benefit because patients can return to the workforce and be more productive as a result of better clinical outcomes and shorter waiting times for treatment. 18

Case Study:

Irish Primary Care

Centres

PPPSlide19

EIAH health sector requests – a case study

MOH request

via the local Jaspers team

EIB general consultant supporting MOH to fulfil EC country conditionalities for accessing ESI funds (8 regional masterplans for health services reorganisation based on the national strategy)EIAH Advisory Services Agreement with the MOH, to support the preparation of three regional hospitals plans and submission of applications for the ESI fundsPotential support for the implementation (through the

EIB Advisory Services

)

Potential loan

to cover the difference between

the available funds and total final costs

19Slide20

Partnerships among payers and providers of care services are needed:

Various models are possible – the local context must be considered

Partnerships preferably

driven by local communitiesRole for a lead provider / service integratorBasic principle of trust and sharing responsibility, risks and benefitsIncentives: payment-for-results, outcome-based payments, value-based contracting etc.Develop new

contractual models for healthcare: no specific "new model" is evidently superior to others - results depend hugely on

relationships

,

financial incentives

,

cultures

and

leadership.

Now is the

opportunity

for

smart

health investments in Cyprus!

Investing in

the

New GESY 2020Slide21

ACCESSIBLE

RESILIENT

DG SANTE Public

Health

:

http://ec.europa.eu/health

Seminar

"Strategic investments for the future of healthcare":

http://ec.europa.eu/health/investment_plan/events/ev_20170227_en

Investment

Plan

for

Europe

http://ec.europa.eu/priorities/jobs-growth-and-investment/investment-plan_en

 

 

 

&  

Investment Plan for Europe & health

 

http://ec.europa.eu/health/investment_plan/policy/index_en.htm

European Fund for Strategic Investments (EFSI)

via the EIB

https

://www.eib.org/efsi & via the EIF http://www.eif.org/what_we_do/efsi/

European Investment Project Portal (EIPP) - project promoters can publicise their projects to European and global investors https://ec.europa.eu/priorities/european-investment-project-portal-eipp_enEuropean Investment Advisory Hub (EIAH) – project promoters can get advice

http://www.eib.org/eiah/about/index