EU excess capacity management through member states-driven patient mobility: economic and legal aspects

Abstract

Capacity management plays an increasingly important role in healthcare delivery, both at national and supranational level, in increasing value for money. In this paper, we propose using cross-border patient mobility across European Union (EU) countries to pool demand and reduce excess capacity. In a setting where the number of patients requiring a specific treatment is fixed but the facility requires a fixed capacity that cannot be adapted to demand, we show that cross-border patient mobility may improve welfare. From a legal perspective, we demonstrate that such mobility is compatible with existing EU law (comprising both EU primary and secondary law, namely the Patient Mobility Directive and the Social Security Coordination Regulation) and the case law of the European Court of Justice. These judgments confirm that planning and cost control objectives may justify not only restricting but also encouraging patient mobility, provided non-discrimination and proportionality are respected. In conclusion, this paper offers interdisciplinary solutions for reconciling patients’ preferences with member states’ planning goals, showing that cross-border healthcare cooperation can enhance efficiency, equity, and solidarity within the current EU legal framework.