Identifying and addressing low-value care in health and care systems
HORIZON Research and Innovation Actions
Basic Information
- Identifier
- HORIZON-HLTH-2026-01-CARE-03
- Programme
- Cluster 1 - Health (Single stage - 2026)
- Programme Period
- 2021 - 2027
- Status
- Forthcoming (31094501)
- Opening Date
- February 10, 2026
- Deadline
- April 16, 2026
- Deadline Model
- single-stage
- Budget
- €9,800,000
- Min Grant Amount
- €3,000,000
- Max Grant Amount
- €4,000,000
- Expected Number of Grants
- 3
- Keywords
- HORIZON-HLTH-2026-01-CARE-03HORIZON-HLTH-2026-01Comparative effectiveness researchHealth management systemsHealth services, health care researchHealthcare systemQuality of health care
Description
This topic aims at supporting activities that are enabling or contributing to one or several expected impacts of destination “Ensuring equal access to innovative, sustainable, and high-quality healthcare”. To that end, proposals under this topic should aim to deliver results that are directed at, tailored towards and contributing to all the following expected outcomes:
- Healthcare providers and policymakers make use of evidence-based indicators and methodologies to identify low-value care[1] practices, as well as opportunities for improvement and tools to monitor such improvements.
- Healthcare professionals are equipped with the knowledge and tools to implement guidelines for reducing or discontinuing low-value care activities and maintaining effective and patient-centred practices that ensure quality of care.
- Patients and citizens benefit from more effective healthcare, by understanding and endorsing measures that reduce low-value care, recognising the potential to achieve higher-quality healthcare and better health outcomes overall.
- Health and care systems benefit from a reduction of low-value care practices, which enables enhanced patient safety and quality of care, while contributing to their efficiency as well as fiscal and environmental sustainability.
- Healthcare organisations can, by identifying low-value care practices, reallocate valuable healthcare resources to other areas of need.
Low-value care, as defined in the footnote, can have widespread negative consequences for patients, caregivers, healthcare professionals, the health and care system, and the broader environment. A 2017 OECD report[2] estimated that “wasteful healthcare spending is common” and that “up to one-fifth of healthcare spending could be redirected towards better uses”. Low-value care represents a significant challenge, contributing to waste, costs, misuse of resources, and inefficiencies. Addressing low-value care can free up and allow reallocation of valuable healthcare resources to other areas of need, thereby maximising health outcomes, improving health and care systems resilience, and reducing their environmental impact. In this context, a recent report[3] by the Expert Group on Health Systems Performance Assessment (HSPA)[4] establishes the methodological basis and metrics to identify, measure and reduce low-value care.
Research activities under this topic should adopt a patient-centred approach that considers the needs and preferences of patients and citizens. They should promote socially acceptable solutions, taking into account relevant ethical, social and legal aspects and foster dialogue and collaboration between policymakers, healthcare providers, healthcare professionals, and patients/citizens. Proposals should engage citizens and civil society organisations in the development of their actions to ensure acceptability of solutions. By doing so the projects will contribute to better use of healthcare resources -including time and personnel- in ways that significantly improve patient outcomes and alleviate the increasing burden on healthcare professionals and health systems. Implementation research and multidisciplinary approaches should be considered to foster adoption and ensure effective interventions and long-term sustainability.
Proposed activities may[5] include clinical studies[6] to provide evidence on the value of any interventions or processes and, therefore, facilitate justified removal of any type of low value care. Proposed activities may also include data models, digital and artificial intelligence-based analysis, models and/or tools to identify and/or address low-value care. Proposed activities may examine the design and impact of healthcare payment systems, that could unintentionally incentivise low-value care and evaluate alternative financing models that better align incentives with patient outcomes and high-value care. Proposed activities may also facilitate or implement collaboration among registries (disease registries such as cancer registries, primary healthcare visits registries, prescription and drug purchase registries, reimbursement and medical devices registries, screening databases, socio-economic and census databases, etc.) across regions or countries, to enable or improve the assessment and comparison of different levels of care and their value to patients. Additionally, activities that facilitate learning and best practice transfers between countries or regions may also be considered as element of the proposal (for instance, to leverage best practice-sharing initiatives from international platforms such as the Knowledge Hub of the co-funded European Partnership on Transforming Health and Care Systems[7] or any other relevant European or global initiatives). Additionally, proposals may include or support international comparisons of low-value care practices and strategies for their reduction across countries, if and where deemed valuable.
Research actions should address all the following objectives:
- Develop a deeper understanding of how low-value care can be identified and measured throughout the healthcare process, including testing related indicators and producing evidence-based methodologies that enable the pursuit of improved efficiency and quality of care.
- Identify instances of overuse, misuse, underuse and unwarranted variation in specific healthcare contexts across different stages of the healthcare process. This analysis should provide actionable insights for policymakers, healthcare providers and healthcare professionals to evaluate the potential of possible strategies for reducing low-value care, allowing for more informed decision-making and improved care practices.
- Develop and/or pilot innovative strategies for effective reduction of low-value care in specific settings across the care pathway. These pilots should demonstrate scalability and transferability across diverse health and care systems in Europe.
Proposals should consider how gender norms and roles influence utilisation patterns, ensuring that strategies to reduce low-value care do not inadvertently exacerbate existing gender and social inequalities in healthcare access and outcomes. In addition, attention should be paid to intersectional factors that may further affect healthcare access and outcomes. If handling data and indicators, sex- and gender-disaggregated data should be collected and analysed, incorporating intersectional factors where feasible.
Proposals should consider the work and output of any EU level initiatives (e.g. the Expert Group on Health Systems Performance Assessment, the co-funded European Partnership on Transforming Health and Care Systems, relevant projects or Joint Actions funded under the EU4Health Programme (2021-2027)[8] and under EU Research & Innovation Framework Programmes, etc.) or other international initiatives (e.g. the 2017 OECD report mentioned above) in this area.
Applicants envisaging[5] to include clinical studies[6] should provide details of their clinical studies in the dedicated annex using the template provided in the submission system.
[1] Definition of low-value care from the Report by the Expert Group on Health Systems Performance Assessment: “From a health system perspective, low-value care encompasses overuse, misuse and underuse of healthcare services (for example, prevention, diagnostics, treatment, medication). Overuse and/or misuse comprise the delivery of harmful, ineffective, inappropriate, or not cost-effective healthcare services. Underuse refers to healthcare services not provided or used despite being necessary. Low-value care can lead to negative consequences for patients, their caregivers, the healthcare workforce, the health system as a whole and the wider environment.”
[2] OECD (2017), Tackling Wasteful Spending on Health, OECD Publishing, Paris. http://dx.doi.org/10.1787/9789264266414-en
[3] Report by the Expert Group on Health Systems Performance Assessment: “Identifying, Measuring And Reducing Low-Value Care In The Context Of Health System Performance Assessment”. https://health.ec.europa.eu/publications/identifying-measuring-and-reducing-low-value-care-context-health-system-performance-assessment_en
[4] https://health.ec.europa.eu/health-systems-performance-assessment_en
[5] Some proposals may not need to conduct clinical studies to achieve the objectives.
[6] Please note that the definition of clinical studies (see introduction to this Work Programme part) is broad and it is recommended that you review it thoroughly before submitting your application.
[7] https://cordis.europa.eu/project/id/101095654, https://www.thcspartnership.eu
[8] https://commission.europa.eu/funding-tenders/find-funding/eu-funding-programmes/eu4health_en
[9] Some proposals may not need to conduct clinical studies to achieve the objectives.
[10] Please note that the definition of clinical studies (see introduction to this Work Programme part) is broad and it is recommended that you review it thoroughly before submitting your application.
Destination & Scope
Topics under this destination are directed towards the Key Strategic Orientation 2 “The Digital transition” and Key Strategic Orientation 3 “A more resilient, competitive, inclusive, and democratic Europe” of Horizon Europe’s strategic plan 2025-2027[1].
Research and Innovation supported under this destination should contribute to the following expected impact, set out in the strategic plan impact summary for the Health Cluster: “healthcare systems provide equal access to innovative, sustainable and high-quality healthcare thanks to the development and uptake of safe, cost-effective and people-centred solutions. This is to be accompanied by management models focusing on population health, health systems resilience, and health equity and patient safety, and also improved evidence-informed health policies”.
Health systems are affected by limitations in sustainability and resilience, and face inequalities in access to high-quality and acceptable healthcare services. Health systems need to become more effective, efficient, accessible, fiscally and environmentally sustainable, and resilient in order to cope with public health emergencies, support healthcare workforce, adapt to environmental challenges like climate change, and contribute to social justice and cohesion. The transformation and modernisation of health systems will remain an important challenge for many years to come, but it also holds a significant opportunity to generate evidence, leverage existing and emerging solutions, implement digital and data-driven innovation and develop more accessible, cost-effective, flexible and equitable health systems.
Research and Innovation under this destination should aim to support the transformation of healthcare systems ensuring fair and inclusive access to high-quality, acceptable, sustainable healthcare for all. Funded activities will focus on developing innovative, practical, scalable and financially sound solutions, that improve governance, provide decision-makers with new evidence, tools, and technologies, and ensure long-term fiscal, environmental and climate sustainability. A patient-centred approach should be adopted, improving patients’ health outcomes, empowering patients, fostering active dialogue among stakeholders (e.g. citizens, patients, caregivers, healthcare providers), and encouraging social innovation. Research and Innovation actions should prioritise supporting healthcare professionals and providers, ensuring they have the resources and tools needed to meet the diverse needs and preferences of citizens. Research and Innovation should facilitate scalable and transferable solutions that can be applied across different healthcare systems and national, regional, and local contexts. This should include generating knowledge that supports the transfer of solutions between countries, including measures to address health inequalities. Research and Innovation activities under this destination will contribute to, among other things, the European Care Strategy[2], the digital transformation of health and care in the EU[3], the European Pillar of Social Rights[4], [5], the EU strategy on adaptation to climate[6], the Pharmaceutical Strategy for Europe[7], the European Health Data Space (EHDS)[8], the Strategy for European Life Sciences[9] and the European Green Deal[10]. They align with the Commission's Political Guidelines for 2024-2029[11], which include efforts to complete the European Health Union by promoting access for all to high-quality and affordable healthcare, fostering a resilient and innovative health ecosystem, and strengthening the competitiveness of the European Union[12].
In this Work Programme part, the focus of this destination will be on public procurement of innovative solutions for integrated or personalised care, aiming to develop and test solutions that improve access to and provision of healthcare. It will also support personalised medicine approaches to reduce adverse drug reactions due to the administration of multiple medication, and research to identify and address low-value care in health and care systems, improving healthcare outcomes, efficiency, and fiscal sustainability.
To increase the impact of EU investments under Horizon Europe, the Commission encourages and supports cooperation among EU-funded projects to foster cross-fertilisation and synergies. This includes networking, joint activities such as workshops, knowledge exchange, best practices development, and joint communication activities. Synergies can be explored not only between projects funded under the same topic, but also between projects funded under other topics, Clusters or Pillars of Horizon Europe. For instance, collaborations may arise between projects related to European health research infrastructures (under Pillar I), the EIC[13] strategic challenges on health (under Pillar III), or across the Clusters of Pillar II such as Cluster “Culture, Creativity and Inclusive Society” focusing e.g. on the long-term sustainability of public health systems (e.g. economic and organisational models and measures for cost effectiveness and fiscal sustainability), or Cluster “Digital, Industry and Space” focusing on the digitalisation of the health sector, including the use of Artificial Intelligence (AI).
The Commission aims to foster synergies between Horizon Europe and other EU programmes. To this end, applicants are encouraged to explore the funding opportunities available through the EU4Health Programme (2021-2027)[14], the EU's public health programme, as a means of capitalising on potential collaborations and maximising impact.
Expected impacts:
Proposals for topics under this destination should set out a credible pathway to contributing to ensuring access to innovative, sustainable, inclusive and high-quality healthcare, and more specifically to one or several of the following impacts:
- Health and social care services and systems have improved governance mechanisms, making them more effective, efficient, accessible, resilient, trusted and sustainable, from fiscal, organisational and environmental perspectives. This includes shifting from hospital-centred to community-based, people-centred and integrated healthcare structures, embedding technological innovations and prioritising health promotion and disease prevention and management.
- Healthcare providers are trained and equipped with the skills and competences needed for future healthcare systems that are modernised, digitally transformed and equipped with safe innovative tools, technologies and digital solutions for healthcare. This will involve better patient management, improved patient engagement and health outcomes, reorganised workflows, and improved resource management.
- Citizens play a key role in managing their own healthcare, informal carers (including unpaid carers) are fully supported (e.g. by preventing overburdening and economic stress) and the specific needs of groups in a vulnerable situation are recognised and addressed. This includes improved access to healthcare services, financial risk protection, timely access to quality healthcare services including essential medicines and vaccines.
- Health policy and systems adopt a holistic approach -considering individuals, communities, organisations, society- in evaluating health outcomes, public health interventions, healthcare organisation, and decision-making. They benefit from evidence based, scalable and transferable healthcare solutions (e.g. between countries and healthcare settings) including for addressing health inequalities and ensuring environmental and climate sustainability in the health sector.
The actions resulting from the topics under this destination will also create strong opportunities for synergies with actions stemming from the EU4Health programme, in particular contributing to the goals under the general objective “protecting people in the Union from serious cross-border threats to health” and specific objective 4 “to strengthen health systems, their resilience and resource efficiency”.
Legal entities established in China are not eligible to participate in both Research and Innovation Actions (RIAs) and Innovation Actions (IAs) falling under this destination. For additional information please see “Restrictions on the participation of legal entities established in China” found in the Annex B of the General Annexes of this Work Programme.
The protection of European communication networks has been identified as an important security interest of the Union and its Member States. Entities that are assessed as high-risk suppliers[15] of mobile network communication equipment (and any entities they own or control) are not eligible to participate as beneficiaries, affiliated entities and associated partners to topics identified as “subject to restrictions for the protection of European communication networks”. Please refer to the Annex B of the General Annexes of this Work Programme for further details.
[2] Communication from the European Commission on the European care strategy, COM(2022) 440, 7.9.2022
[3] Communication from the European Commission on enabling the digital transformation of health and care in the Digital Single Market; empowering citizens and building a healthier society, COM(2018) 233, 25.4.2018
[5] Commission Communication on Artificial Intelligence for Europe; COM(2018) 237 final: https://digital-strategy.ec.europa.eu/en/policies/european-approach-artificial-intelligence; https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=COM:2018:237:FIN
[6] https://climate.ec.europa.eu/eu-action/adaptation-climate-change/eu-adaptation-strategy_e
[7] https://health.ec.europa.eu/medicinal-products/pharmaceutical-strategy-europe_en
[9] https://research-and-innovation.ec.europa.eu/strategy/strategy-research-and-innovation/jobs-and-economy/towards-strategy-european-life-sciences_en; https://ec.europa.eu/commission/presscorner/detail/en/ip_25_1686
[10] https://commission.europa.eu/strategy-and-policy/priorities-2019-2024/european-green-deal_en
[11] https://commission.europa.eu/about/commission-2024-2029_en
[12] https://commission.europa.eu/topics/eu-competitiveness_en
[14] https://commission.europa.eu/funding-tenders/find-funding/eu-funding-programmes/eu4health_en
[15] Entities assessed as “high-risk suppliers”, are currently set out in the second report on Member States’ progress in implementing the EU toolbox on 5G cybersecurity of 2023 (NIS Cooperation Group, Second report on Member States’ progress in implementing the EU Toolbox on 5G Cybersecurity, June 2023) and the related Communication on the implementation of the 5G cybersecurity toolbox of 2023 (Communication from the Commission: Implementation of the 5G cybersecurity Toolbox, Brussels, 15.6.2023 C(2023) 4049 final).
Eligibility & Conditions
General conditions
1. Admissibility Conditions, proposal page limit and layout
2. Eligible Countries
Eligible countries are described in Annex B of the Work Programme General Annexes.
A number of non-EU/non-Associated Countries that are not automatically eligible for funding have made specific provisions for making funding available for their participants in Horizon Europe projects. See the information in the Horizon Europe Programme Guide.
3. Other Eligibility Conditions
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.
If projects use satellite-based earth observation, positioning, navigation and/or related timing data and services, beneficiaries must make use of Copernicus and/or Galileo/EGNOS (other data and services may additionally be used).
Subject to restrictions for the protection of European communication networks.
Other eligibility conditions are described in Annex B of the Work Programme General Annexes.
4. Financial and operational capacity and exclusion
Financial and operational capacity and exclusion are described in Annex C of the Work Programme General Annexes.
5a. Evaluation and award: Award criteria, scoring and thresholds
Award criteria, scoring and thresholds are described in Annex D of the Work Programme General Annexes.
5b. Evaluation and award: Submission and evaluation processes
The thresholds for each criterion will be 4 (Excellence), 4 (Impact) and 4 (Implementation). The cumulative threshold will be 12.
Submission and evaluation processes are described in Annex F of the Work Programme General Annexes and the Online Manual.
5c. Evaluation and award: Indicative timeline for evaluation and grant agreement
Indicative timeline for evaluation and grant agreement are described in Annex F of the Work Programme General Annexes.
6. Legal and financial set-up of the grants
The granting authority may, up to 4 years after the end of the action, object to a transfer of ownership or to the exclusive licensing of results, as set out in the specific provision of Annex 5.
Legal and financial set-up of the grants are described in Annex G of the Work Programme General Annexes.
Specific conditions
Specific conditions are described in the specific topic of the Work Programme.
Application and evaluation forms and additional documents:
Application and evaluation form templates
Standard application form (HE RIA, IA) - the application form specific to this call is available in the Submission System
Standard evaluation form (HE RIA, IA) - will be used with the necessary adaptations
Guidance
Model Grant Agreement (MGA)
Call-specific instructions
Additional documents
HE Main Work Programme 2026-2027 – 1. General Introduction
HE Main Work Programme 2026-2027 – 4. Health
HE Main Work Programme 2026-2027 – 15. General Annexes
HE Framework Programme 2021/695
HE Specific Programme Decision 2021/764
EU Financial Regulation 2024/2509
Decision authorising the use of lump sum contributions under the Horizon Europe Programme
Rules for Legal Entity Validation, LEAR Appointment and Financial Capacity Assessment
EU Grants AGA — Annotated Model Grant Agreement
Funding & Tenders Portal Online Manual
Support & Resources
Online Manual is your guide on the procedures from proposal submission to managing your grant.
Horizon Europe Programme Guide contains the detailed guidance to the structure, budget and political priorities of Horizon Europe.
Funding & Tenders Portal FAQ – find the answers to most frequently asked questions on submission of proposals, evaluation and grant management.
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