Call: Better financing models for health systems

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Programme

Horizon Europe - Cluster 1 - Destination 4: Ensuring access to innovative, sustainable and high-quality health care

Acronym

HORIZON-HLTH-CARE

Type of Fund

Direct Management

Description of programme
"Horizon Europe - Cluster 1 - Destination 4: Ensuring access to innovative, sustainable and high-quality health care"

Calls for proposals under this destination are directed towards the Key Strategic Orientation KSO-D ‘Creating a more resilient, inclusive and democratic European society’ of Horizon Europe’s Strategic Plan 2021-2024. Research and innovation supported under this destination should contribute to the impact areas ‘Good health and high-quality accessible health care’ and ‘A resilient EU prepared for emerging threats’, and in particular to the following expected impact, set out in the Strategic Plan for the health cluster: ‘Health care systems provide equal access to innovative, sustainable and high-quality health care thanks to the development and uptake of safe, cost-effective and people-centred solutions, with a focus on population health, health systems resilience, as well as improved evidence-based health policies’. In addition, research and innovation supported under this destination could also contribute to the following impact areas: ‘Climate change mitigation and adaptation’, ‘High quality digital services for all’ and ‘A Competitive and secure data economy’.

Health systems are affected by limitations in sustainability and resilience, challenges which have been reinforced by the COVID-19 crisis that has also revealed inequalities in access to high-quality health care services. Our health systems need to become more effective, efficient, accessible, fiscally and environmentally sustainable, and resilient in order to cope with public health emergencies, to adapt to environmental challenges like climate change and to contribute to social justice and cohesion. Therefore, the transformation and modernisation of our health systems will be one of the biggest challenges in the economic recovery-bound future, but it will also be a time of opportunity for generating evidence, taking advantage of digital and data-driven innovation and developing more flexible and equitable health systems.

Under this destination, research and innovation aims at supporting health care systems in their transformation to ensure fair access to sustainable health care services of high quality for all citizens. Funded activities should support the development of innovative, feasible, implementable, financially sound and scalable solutions in the various dimensions of health care systems (e.g. governance, financing, human and physical resources, health service provision, and patient empowerment). Ultimately, these activities should provide decision-makers with new evidence, methods, tools and technologies for uptake into their health care systems and, consequently, allow improving governance of the European health care systems, supporting health care professionals and providers and allocating resources according to citizens’ health needs and preferences, while ensuring fiscal and environmental sustainability to assure those needs can be met on the long-term. Funded activities should adopt a patient-centred approach that empowers patients, promotes a culture of dialogue and openness between citizens, patients, caregivers, health care providers and other relevant stakeholders, and unleashes the potential for social innovation.

In this work programme, destination 4 will focus on the following issues:

Modernising health care systems in the EU, especially through a European public-public partnership on transforming health and care systems;
Improving the quality of health care along the entire health care continuum and being people-centred;
Supporting evidence-based health care decisions both for health care providers and policy-makers, fostering improved foresight and enabling sound planning of health care resources;
Enhancing development and uptake of innovative health care services and solutions, including environmentally sustainable ones that contribute to the European Green Deal.

In view of increasing the impact of EU investments under Horizon Europe, the European Commission welcomes and supports cooperation between EU-funded projects to enable cross-fertilisation and other synergies. This could range from networking to joint activities such as the participation in joint workshops, the exchange of knowledge, the development and adoption of best practices, or joint communication activities. Opportunities for potential synergies exist between projects funded under the same topic but also between other projects funded under another topic, cluster or pillar of Horizon Europe (but also with ongoing projects funded under Horizon 2020). In particular, this could involve projects related to European health research infrastructures (under pillar I of Horizon Europe), the EIC strategic challenges on health and EIT-KIC Health (under pillar III of Horizon Europe), or in areas cutting across the health and other clusters (under pillar II of Horizon Europe). For instance, with cluster 2 “Culture, Creativity and Inclusive Society” such as on health economics and economic models, on cost-effectiveness, fiscal sustainability and accessibility of health care, or on adaptation of public health systems to societal challenges (climate change, environmental degradation, migration, demographic change, emerging epidemics and One Health AMR) thereby contributing to building resilience; with cluster 3 “Civil Security for Society” such as on security of health care infrastructures, incl. digital health infrastructures, health systems preparedness and response to disasters and other emergencies, and quality and safety of medicine (counterfeit and substandard medicine, illicit drugs, One Health AMR); with cluster 4 “Digital, Industry and Space” such as on cybersecurity of (public) health systems, products and infrastructures of digitalised health and care, or on health impact assessment (e.g. related to consumer products, working place innovation).

Expected impacts:

Proposals for topics under this destination should set out a credible pathway to contributing to ensuring access to innovative, sustainable and high-quality health care, and more specifically to one or several of the following impacts:

Health and social care services and systems have improved governance mechanisms and are more effective, efficient, accessible, resilient, trusted and sustainable, both fiscally and environmentally. Health promotion and disease prevention will be at their heart, by shifting from hospital-centred to community-based, people-centred and integrated health care structures and successfully embedding technological innovations that meet public health needs, while patient safety and quality of services is increased.
Health care providers are trained and equipped with the skills and competences suited for the future needs of health care systems that are modernised, digitally transformed and equipped with innovative tools, technologies and digital solutions for health care. They save time and resources by integrating and applying innovative technologies, which better involve patients in their own care, by reorganising workflows and redistributing tasks and responsibilities throughout the health care system, and by monitoring and analysing corresponding health care activities.
Citizens are supported to play a key role in managing their own health care, informal carers (including unpaid carers) are fully supported (e.g. by preventing overburdening and economic stress) and specific needs of more vulnerable groups are recognised and addressed. They benefit from improved access to health care services, including financial risk protection, timely access to quality essential health care services, including safe, effective, and affordable essential medicines and vaccines.
Health policy and systems adopt a holistic approach (individuals, communities, organisations, society) for the evaluation of health outcomes and value of public health interventions, the organisation of health care, and decision-making.
The actions resulting from the calls under this destination will also create strong opportunities for synergies with the EU4Health programme and in particular to contribute to the goals under general objectives 1a “protecting people in the Union from serious cross-border threats to health and strengthening the responsiveness of health systems and coordination among the Member States to cope with those threats” and 3 “strengthening health systems by improving their resilience and resource efficiency, in particular through: i) supporting integrated and coordinated work between Member States; ii) promoting the implementation of best practices on data sharing; iii) reinforcing the healthcare workforce; iv) tackling the implications of demographic challenges; and v) advancing digital transformation”.

Link

Link to Programme

Call

Better financing models for health systems

Description of call
"Better financing models for health systems"

Expected Outcome

Health and social care services and systems have improved governance mechanisms and are more effective, efficient, accessible, resilient, trusted and sustainable, both fiscally and environmentally. Health promotion and disease prevention will be at their heart, by shifting from hospital-centred to community-based, people-centred and integrated health care structures and successfully embedding technological innovations that meet public health needs, while patient safety and quality of services is increased.
Health policy and systems adopt a holistic approach (individuals, communities, organisations, society) for the evaluation of health outcomes and value of public health interventions, the organisation of health care, and decision-making.

To that end, proposals under this topic should aim for delivering results that are directed, tailored towards and contributing to some of the following expected outcomes:

Decision and policymakers in the field of health care avail of new approaches to financial planning and financing mechanisms that provide flexibility to stretched health budgets, including alternative procurement and contractual methods;
Decision and policymakers in the field of health care apply cost-effective spending strategies based on the optimisation of the use of resources, while maintaining or improving health outcomes in an equitable way;
Decision and policymakers in the field of health care access tools that enable them to better remunerate, contract and incentivise health care professionals and providers;
Decision and policymakers in the field of health care take evidence-based and socially equitable health care financial decisions.

Scope:

In 2017, spending on health care in the EU stood at 9.6% of gross domestic product, ranging from over 11% in France and Germany to less than 6% in Romania. In most countries, in-patient care services made up the bulk of health spending, while spending on pharmaceuticals also accounted for a large share of health expenditure in some countries.

Due to demographic changes in the EU with a population projected to continue ageing and higher expectations regarding provision of health care services, public health threats with relevant repercussions for society and the introduction of innovative and digital solutions to improve health care systems’ functioning, the demand for health care services as well as the budgetary pressures on health care systems are and will keep increasing.

Future models of care delivery will have to take into account both the systemic and multi-dimensional performance perspective and to look at relevant outcome and quality indicators, structure of care delivery, and knowledge base regarding optimal care delivery systems,

Therefore, research and innovation should tackle the challenges of financing health care services in the EU by addressing one or more of the following:

Financing of health care – development of new cost-effective models for financing and reimbursement, including incentive mechanisms and outcome-based financing in order to promote good performance of the health care systems.
Financing of preventive health care – novel models and appropriate structure of financial incentives for effective health promotion and disease prevention, financial incentives for stronger co-operation between primary care and public health services, long-term sustainable financing mechanism for local- and municipality-run promotion programmes and the assessment of personal health risk behaviour and its potential impact on health costs.
Innovative purchasing and contract methods – new strategies for contracting provision of health care services (public sector hired services) as well as solutions to better assess provision capacity and quality, to assess markets, and cost-effectiveness as well as equal access of contracting-out services. This can help align the incentives of providers with those of patients and the public good.
New and improved tools for better design of incentives for health care professionals – incentives that minimise differentiation between services and “cream-skimming” by patients, fostering better health care planning, optimized use of health care services and avoidance of resources’ overconsumption and -waste.

Value-based pricing- and payment models for health technologies are not in the scope of this topic; such models are covered by topic “New pricing and payment models for cost-effective and affordable health innovation” (HORIZON-HLTH-2022-IND-13-03) under destination 6.

Research and innovation in these areas should take into account the potential impact of public health emergencies and threats on the sustainability, financing, as well as the effective and efficient functioning of EU health care systems.

To ensure wide uptake by user communities and scalability of the models and methods across health systems, actions should promote the highest standards of transparency and openness, going well beyond documentation and extending to aspects such as assumptions, architecture, code and any underlying data.

Applicants are highly encouraged to actively involve public authorities (i.e. ministries of finances and health, procurement agencies/procurers and agencies responsible for the management of health services contracts, public health and health-policy institutes, health administrations, among other) in the proposals.

Projects funded under this topic are strongly encouraged to participate in networking and joint activities, as appropriate, and in particular they are expected to liaise with successful applicants under topic “New pricing and payment models for cost-effective and affordable health innovation” (HORIZON-HLTH-2022-IND-13-03) and the consortium to be created under the planned “European Partnership on Transforming Health and Care Systems” (HORIZON-HLTH-CARE-2022-IND-10-01). These networking and joint activities could, for example, involve the participation in joint workshops, the exchange of knowledge, the development and adoption of best practices, or joint communication activities. This could also involve networking and joint activities with projects funded under other clusters and pillars of Horizon Europe, or other EU programmes, as appropriate. Therefore, proposals are expected to include a budget for the attendance to regular joint meetings and may consider to cover the costs of any other potential joint activity without the prerequisite to detail concrete joint activities at this stage. The details of these joint activities will be defined during the grant agreement preparation phase. In this regard, the Commission may take the role of facilitator for networking and exchanges, including with relevant stakeholders, if appropriate.

Link

Link to Call

Thematic Focus

Clustering, Development Cooperation, Economic Cooperation, Health, Social Affairs, Sports, Digitisation, ICT, Telecommunication, Capacity Building, Cooperation Networks, Institutional Cooperation

Funding area

EU Member States
Overseas Countries and Territories (OCTs)
United States of America

Origin of Applicant

EU Member States
Overseas Countries and Territories (OCTs)
United States of America

Eligible applicants

Education and Training Centres, Federal State / Region / City / Municipality / Local Authority, Research Institution, Lobby Group / Professional Association / Trade Union, International Organization, Small and Medium Sized Enterprises, SMEs (between 10 and 249 employees), Microenterprises (fewer than 10 employees), NGO / NPO, Public Services, National Government, Other, Start Up Company, University, Enterprise (more than 250 employees or not defined), Association

Applicant details

eligible non-EU countries:

countries associated to Horizon Europe

At the date of the publication of the work programme, there are no countries associated to Horizon Europe. Considering the Union’s interest to retain, in principle, relations with the countries associated to Horizon 2020, most third countries associated to Horizon 2020 are expected to be associated to Horizon Europe with an intention to secure uninterrupted continuity between Horizon 2020 and Horizon Europe. In addition, other third countries can also become associated to Horizon Europe during the programme. For the purposes of the eligibility conditions, applicants established in Horizon 2020 Associated Countries or in other third countries negotiating association to Horizon Europe will be treated as entities established in an Associated Country, if the Horizon Europe association agreement with the third country concerned applies at the time of signature of the grant agreement.

low-and middle-income countries

Legal entities which are established in countries not listed above will be eligible for funding if provided for in the specific call conditions, or if their participation is considered essential for implementing the action by the granting authority.

Specific cases:

Affiliated entities - Affiliated entities are eligible for funding if they are established in one of the countries listed above.
EU bodies - Legal entities created under EU law may also be eligible to receive funding, unless their basic act states otherwise.
International organisations - International European research organisations are eligible to receive funding. Unless their participation is considered essential for implementing the action by the granting authority, other international organisations are not eligible to receive funding. International organisations with headquarters in a Member State or Associated Country are eligible to receive funding for ‘Training and mobility’actions and when provided for in the specific call conditions.

Project Partner

Yes

Project Partner Details

Unless otherwise provided for in the specific call conditions , legal entities forming a consortium are eligible to participate in actions provided that the consortium includes:

at least one independent legal entity established in a Member State;and
at least two other independent legal entities, each established in different Member States or Associated Countries.

In recognition of the opening of the US National Institutes of Health’s programmes to European researchers, any legal entity established in the United States of America is eligible to receive Union funding to support its participation in projects funded under the Health cluster.

Further info

Proposal page limits and layout:

The application form will have two parts:

Part A to be filled in directly online (administrative information, summarised budget, call-specific questions, etc.)
Part B to be downloaded from the Portal submission system, completed and re-uploaded as a PDF in the system

Page limit - Part B: 45 pages

Type of Funding

Grants

Financial details

Expected EU contribution per project	The Commission estimates that an EU contribution of around EUR 5.00 million would allow these outcomes to be addressed appropriately. Nonetheless, this does not preclude submission and selection of a proposal requesting different amounts.
Indicative budget	The total indicative budget for the topic is EUR 30.00 million.
Typ of Action	Research and Innovation Actions (RIA)
Funding rate	100%

Submission

Proposals must be submitted electronically via the Funding & Tenders Portal Electronic Submission System. Paper submissions are NOTpossible.