Factsheet – Romania
Health system overview
Romania operates a mixed healthcare financing model: Mandatory public health insurance contributions to the National Health Insurance House (CNAS) account for approximately 65% of total healthcare expenditure. State and local government budgets contribute about 15.5%. Private sources, including out-of-pocket payments and voluntary health insurance, cover the remaining 19.5%.
Key-decision makers:
Ministry of Health (Ministerul Sănătății) – Sets national health policy and strategy, manages public health programs, and coordinates EU-funded healthcare reforms. It plays a central role in legislative and regulatory oversight.
National Health Insurance House – CNAS (Casa Națională de Asigurări de Sănătate) – Administers the public health insurance scheme, including contracting with providers and reimbursing healthcare services. CNAS is the main healthcare purchaser.
Public Health Directorates (Direcțiile de Sănătate Publică) – These are regional branches of the Ministry of Health responsible for implementing national policies at the local level, including disease control, inspections, and coordination with hospitals.
National Authority for Quality Management in Health – ANMCS (Autoritatea Națională de Management al Calității în Sănătate) – Oversees the accreditation of healthcare providers and monitors service quality to ensure compliance with national standards.
National Institute of Public Health – INSP (Institutul Național de Sănătate Publică) – Gathers and analyzes health data, supports health policy with evidence-based recommendations, and coordinates epidemiological surveillance and public health interventions.
Analysis of healthcare system in Romani: A brief Review
Analysis of the Healthcare System in Romania: A Brief Review – PMC
Country Health Profile 2023
Funding & budget allocation
Romania has committed significant funding to innovation and digital health through multiple public programs, most notably via the National Recovery and Resilience Plan (PNRR), but also through EU structural funds and national initiatives. 1. National Recovery and Resilience Plan (PNRR) €400+ million from the Ministry of Health for digitalizing the public healthcare system. €230 million from the Ministry of Investments and European Projects to modernize healthcare services and digital infrastructure. Key objectives include: System interoperability Electronic Health Records (EHRs) E-prescriptions Telemedicine expansion 2. EU Structural and Investment Funds (2021–2027 programming period) Romania’s Operational Programme for Health (POH) and Regional Development Programmes also allocate funding for: Digital infrastructure for hospitals and clinics Smart medical equipment Support for R&D in health tech and medtech startups Capacity building in data governance and cybersecurity in healthcare 3. National Health Strategy & Ministry of Research Programs The National Health Strategy 2023–2030 prioritizes innovation and digital transformation. The Ministry of Research, Innovation and Digitalization (MCID) supports health-tech projects through national RDI competitions and public-private partnerships
Innovation Romania Program Budget: €106.7 million Focus:
Supports startups and SMEs in innovation, including health tech. Grant Amounts: Micro-enterprises in Bucharest-Ilfov can receive grants ranging from €25,000 to €300,000.
Start-Up Nation 2025 Budget: €295.75 million Focus: Provides non-repayable grants to new businesses, including those in the health sector. Grant Amounts: Up to ~€50,000 per startup.
EIT Health and European Innovation Council (EIC): Grants Total Funding (2020–2024): Approximately €16.2 million Focus: Supports health tech startups through grants and accelerator programs.
PNRR – National Recovery and Resilience Plan. Total Health Digitalization Budget: €442 million Allocation for Startups: Specific amounts for startups are not detailed, but the plan includes funding for digital health initiatives, which startups can access.
LevelUP Health & Life Sciences Accelerator Focus: First Romanian accelerator dedicated to health and life sciences startups. Support: Provides mentorship and resources; specific funding amounts are not publicly disclosed
Care delivery & purchasing
In Romania, public hospitals possess legal and administrative autonomy, allowing them to conduct their own procurement processes. However, these institutions must adhere to strict public procurement regulations established by national and European Union legislation. The primary legal framework governing public procurement in Romania is Law No. 98/2016, which transposes EU Directive 2014/24/EU into national law. This law outlines the procedures and thresholds for various procurement methods, including open procedures, restricted procedures, and negotiated procedures. While hospitals can independently manage their procurement activities, certain thresholds dictate the procurement method: Direct procurement Formal procurement procedures: Required for contracts exceeding these thresholds, involving more rigorous processes such as open or restricted. Additionally, for procurements exceeding RON 50,000 (approximately €10,000), the hospital’s management board must endorse the annual procurement plan and any significant acquisitions. This measure aims to enhance transparency and accountability in the use of public funds.
Romania adheres to European Union (EU) public procurement regulations, which strictly prohibit discrimination based on the origin of suppliers. This means that contracting authorities in Romania are not permitted to favor local suppliers over foreign ones in public procurement processes.
Key Points: Non-Discrimination Principle: EU public procurement law mandates equal treatment and nondiscrimination, ensuring that all suppliers, regardless of their country of origin within the EU, have equal access to public contracts. European Union Romanian Legislation: Romania’s public procurement laws, including Law No. 98/2016, align with EU directives, reinforcing the commitment to non-discriminatory practices in awarding public contracts. ICLG Business Reports Third-Country Suppliers: While EU rules apply uniformly to member states, suppliers from non-EU countries that are not part of the World Trade Organization’s Government Procurement Agreement (GPA) or lack bilateral agreements with the EU may face restrictions. Romania, like other EU countries, is not obligated to grant these suppliers the same access to public procurement markets.
Digital health Infrastructure
Romania’s national EHR system is the Dosarul Electronic de Sănătate (DES), managed by the National Health Insurance House (CNAS). It stores patient data such as medical history, prescriptions, and lab results, accessible to both doctors and patients. Interoperability is a strategic goal. While not yet fully implemented, it is prioritized in the National Health Strategy 2023–2030 and supported by PNRR funding. The system is being integrated with other national health platforms to enable secure data exchange
Reimbursement for digital Service
Telemedicine: CNAS reimburses family / specialist consultations, chronic disease monitoring and some follow-ups, performed via video / phone and reported through national IT system.
Digital therapeutics: app-based treatments are not reimbursed under public insurance.
Key challenges & priorities
Romania’s healthcare system faces several persistent and structural challenges:
Key Pain Points:
Chronic underfunding – Despite EU support, public health spending remains low compared to EU averages, limiting service quality and innovation.
Rural–urban access gap – Rural areas face significant shortages in healthcare professionals, facilities, and infrastructure, reducing access to care.
Aging infrastructure – Many hospitals and clinics operate in outdated buildings with obsolete medical equipment and software systems.
Shortage of healthcare professionals – Romania suffers from a brain drain of doctors and nurses, many of whom emigrate for better conditions abroad.
Overreliance on hospitals – The system is heavily hospital-centric, with insufficient investment in primary care, prevention, and community services.
Limited access to reimbursed services – State-funded consultations are constrained by long waiting times and limited availability. Many providers restrict such services due to delayed payments from the National Health Insurance Fund (CNAS), reducing patient access.
National priorities:
National priorities:
Romania’s National Health Strategy 2023–2030 outlines several priorities aimed at modernizing the healthcare system and fostering the adoption of innovative solutions:
- Digital Transformation: Emphasizing the integration of digital tools to enhance healthcare delivery and system efficiency.
- Personalized Medicine: Focusing on tailoring medical treatments to individual patient characteristics, particularly in areas like oncology.
- Hospital Infrastructure Modernization: Investing in the upgrade and development of healthcare facilities to improve service quality and accessibility.
- Health Data Governance: Establishing frameworks for the secure and effective management of health data to support informed decision-making.
- Prevention and Early Screening: Prioritizing proactive health measures to detect and address health issues at early stages.
National Strategy
