In a recent study, the EU Commission analysed the strengths and opportunities for future cross-border cooperation in healthcare.

AD – 04/2018

What is CBHC?

The concept of Cross Border Healthcare (CBHC) is enshrined by law in Article 168 of the Treaty on the Functioning of the European Union (TFEU). It aims to improve cooperation between Member States and improve the complementarity of their health services in border regions, without disturbing the principle of healthcare as a national competence. 


The broader framework for CBHC is stipulated in Directive 2011/24/EU on patients’ rights and Regulation (EC) No 883/2004 on the coordination of social security systems. The Directive defines CBHC as ‘healthcare provided or prescribed in a Member State other than the Member State of affiliation.’ 

Overview of the study

The study, published in March 2018, provides an overview over more than 250 pages of EU-funded collaborative initiatives in the period 2007-2016. Based on current agreements, it analyses strengths and opportunities for future cross-border cooperation in healthcare. The main objectives of the study were: 


  • to present a comprehensive picture of CBHC in the EU (based on Chapter IV of Directive 2011/24/EU); 
  • to provide insight into potential future opportunities and challenges for cross-border cooperation in CBHC by identifying current driving factors, possible future scenarios at European level, and policy recommendations for the period up to 2030; 
  • to provide documented support for stakeholders interested in starting a cross-border collaboration project in healthcare, 
  • to provide an overview of fraud and fraud mitigation strategies in CBHC in the EU, and 
  • to assess take-up of the Joint Action on Patient Safety and Quality of Care (PaSQ) at national, regional and/or local levels in the EU Member States. 

Insights gained

The study’s findings provide an in-depth look into CBHC collaborations with various objectives and new insights into a range of CBHC research. 


The most likely of the potential future scenarios is the one where regional networks are built. These provide a cost-effective form of cross-border healthcare; however, they tend to be small-scale and do not benefit all regions equally. 


The complete study and the annexes can be read online. 


The executive summary is also available online.