Typology of health policy reforms and framework for evaluating reform effects

The purpose of this report is to develop a typology of reforms and a template for screening health policy effects to support ex-ante and ex-post evaluation. Thus, it is proposed a typology of reforms that can be used to review impact and progress in areas such as coverage, equity, efficiency, quality, resources and sustainability. Moreover, the report discusses types of health reforms; stresses the need to address coherent reforms reinforcing the core values of universality, solidarity, equity and access to high quality services; analyses the factors influencing the reforms, and the various narratives and choices that are at the basis of reforms; and warns of the cost of inaction. Then, the influence of the institutions of the European Union in health reforms in recent years is analysed, showing how the European Semester and the Country Specific Recommendations are creating opportunities to orient reforms. The report also notes several factors that have to be taken into account when implementing reforms, in order to its feasibility. Finally some conclusions and recommendations regarding the reform processes and the design and implementation of the template are presented.