Tino Martí Aguasca is a health economist and an associate researcher at the Centre for Research in Health and Economics (CRES) at Pompeu Fabra University. His professional and research career focuses on the analysis of health systems, health policy, primary care, and digital health, with particular attention to improving health service delivery. He is currently an eHealth Project Manager at the European Health Telematics Association (EHTEL), where he takes part in European projects on digital transformation in health. Throughout his career, he has held technical and managerial positions in institutions such as the World Health Organization (Regional Office for Europe), the Catalan Institute of Health, the Department of Health of the Government of Catalonia, TicSalut, and CASAP. He holds a degree in Economics from the University of Barcelona and a master’s degree in Health Economics and Health Care Management from Pompeu Fabra University.

Abstract: 

This session presents CAIROS, Catalonia’s recent health system reform initiative, as a response to a long-standing implementation gap between repeated diagnoses of system weaknesses and the limited capacity to translate them into structural change. Drawing on more than three decades of analyses and stakeholder consultations, CAIROS reframes reform as an operational challenge: how to align governance, incentives, professional roles and organizational models to address demographic ageing, workforce strain, fragmentation of care and declining accessibility without relying exclusively on additional funding.

From a health economics perspective, the presentation focuses on how CAIROS seeks to modify incentives and decision-making structures through prioritized measures. Particular attention is given to the Centres de Salut Integral de Referència (CSIR) as real-world laboratories for reform, where payment mechanisms, greater managerial autonomy, integrated care purchasing and systematic evaluation are tested in practice. The talk discusses expected impacts on efficiency, value creation and sustainability, and reflects on how CAIROS positions Catalonia within broader European trends toward value-based, integrated and learning health systems.