From patient mobility to integration: cross-border healthcare in transition

The European framework on cross-border healthcare, rooted in Directive 2011/24/EU, was established to advance two main

objectives

enabling patients to exercise their rights to seek care abroad and strengthening cooperation between national health systems. Over the past decade, the EU health policy landscape has evolved significantly, raising questions about whether existing arrangements remain aligned with emerging system realities. This presentation draws on recent EU-level studies and evaluations examining the implementation and evolution of cross-border healthcare in the EU. It explores how the framework’s two foundational pillars, patient mobility rights and system-level cooperation, have developed along different trajectories. Particular attention is given to the expansion of collaborative initiatives such as European Reference Networks (ERNs), the growing role of interoperability and digital health services, and the emergence of the European Health Data Space (EHDS). Findings indicate that coordination mechanisms have expanded substantially, supporting new models of specialised care and cross-border knowledge exchange. However, the effective use of patient mobility rights continues to face persistent administrative procedures, prior authorisation requirements, financial barriers and uneven implementation. These dynamics are contributing to hybrid models of cross-border healthcare that combine individual patient travel with structured collaboration and digitally enabled services. These developments suggest that cross-border healthcare in the EU is undergoing a transition from a predominant focus on patient mobility rights towards more cooperative health ecosystems, particularly through emerging initiatives such as the EHDS. Recognising this transition has important policy implications for aligning legal frameworks, digital infrastructures and coordination mechanisms to support equitable access and sustainable integration across EU health systems.

Key messages

• EU cross-border healthcare is shifting from a primarily mobility-based model towards increasingly coordinated and digitally supported health ecosystems.

• While cooperation mechanisms such as ERNs and digital infrastructures are expanding, persistent administrative and financial barriers continue to limit the exercise of patient mobility rights.