PNRR Health Mission: 5 out of 14 targets are behind schedule and 82% of funds remain unspent.

In addition to increasing the number of intensive and semi-intensive care beds, the most critical objective is the reorganization of community care. Indeed, Agenas Monitoring data, updated to December 20, 2024, document substantial delays in fully activating Community Homes and Hospitals.

Community Homes. The target is for at least 1,038 Community Homes to be fully operational by June 30, 2026, equipped with services and healthcare personnel. However, as of December 2024, only 164 facilities (15.8%) had activated all planned services, and of these, just 46 (4.4%) had medical and nursing staff. Only one service was active in 485 facilities (46.7%), while the remaining 389 Community Homes (37.5%) had not activated any services. "Beyond the delays in structural and technological completion," warns Cartabellotta, "the serious shortage of nurses and the lack of agreement with family doctors to work in Community Homes are of concern. Thus, the great challenge of territorial reform risks remaining a colossal healthcare construction project or being outsourced to private providers."

Community Hospitals. By June 2026, at least 307 community hospitals, the intermediate facilities for patients discharged from acute care hospitals, should be fully operational. However, as of December 20, 2024, only 124 facilities (40.4%) reported at least one active service, and no information on healthcare personnel was reported. "It is clear," comments Gimbe President, "that the activation of community hospitals is even further delayed, and the goal of strengthening intermediate care risks being undermined."

Intensive and semi-intensive care beds. The National Recovery and Resilience Plan (NRRP) calls for the activation of 2,692 intensive care beds and 3,230 semi-intensive care beds by June 2026. However, as of March 21, 2025, only 890 intensive care beds (33.1%) and 1,199 semi-intensive care beds (37.1%) have been activated. "It is surreal," the President commented, "that, despite the drastic downward revision of the initial targets, five years after the pandemic, Italy has still not managed to complete an essential infrastructure to address future health emergencies."

Despite progress, two other targets are behind schedule.

Anti-seismic interventions. To secure at least 84 hospitals, the PNRR funded anti-seismic interventions across the country. As of February 2025, 86 construction sites were active or completed, but actual spending remained at 11% of the total, with an even lower average in Southern Italy (6%).

Adoption of the EHR in all regions. By June 2026, all regions are expected to adopt and use the EHR. However, as of March 2025, only six out of 16 documents are available in all regions (hospital discharge letters, laboratory and radiology reports, pharmaceutical and specialist prescriptions, and emergency room reports). Furthermore, only 42% of citizens have consented to accessing their data. "Without informing citizens about the usefulness of the EHR," warns Cartabellotta, "and reassuring them about data security, despite reaching the PNRR target, the potential of this tool risks being undermined by citizens' lack of consent."

Four targets are at an advanced stage of implementation or have been completed ahead of schedule.

Hospital renovation and modernization projects (pursuant to Article 20) : disbursement of at least 90% of €250 million. As of March 21, 2025, 127 projects have been funded for a total of €458.1 million. "Exceeding the theoretical funding threshold would certify the target has been reached," Cartabellotta emphasizes, "but a review is underway because it is unclear how many projects fall within the scope of the PNRR."

Integrated home care (ADI) for those over 65. The goal is to increase the number of patients receiving ADI by at least 842,000 compared to 2019. The end-2024 data confirms that the target has been exceeded a full 18 months ahead of schedule, with 900,853 more patients taken care of.

Large healthcare equipment. Of the 3,223 planned machines, as of January 31, 2025, 3,126 (97%) had been ordered, 2,578 (80%) delivered, and 2,482 (77%) tested. The target for testing the equipment is therefore close to completion.

Specialist training contracts. Starting in the 2020-21 academic year, €538 million has been allocated for the 4,200 specialist medical training contracts envisaged by the objective. The target has been formally met.

For some targets, no publicly available, updated sources have been identified, making it impossible to assess their implementation status. "We believe it is essential," Cartabellotta comments, "that all data relating to the progress of PNRR projects be made publicly available. In a democratic country, transparency is not a technical detail, but the primary tool for public accountability and trust between institutions and citizens."

At least 300,000 people will be treated with telemedicine tools. The deadline is December 31, 2025, but to date, no official data is available on the number of patients treated with telemedicine tools. Data collection through the National Telemedicine Platform began in the first quarter of 2025, and tenders for infrastructure and workstations were completed.

Digitization of 280 hospital facilities hosting emergency departments (A&E). This target also expires on December 31, 2025. There is no public data on the hospitals already digitized, but as of February 25, 2025, all contracts have been awarded. However, the amount invoiced at the national level stands at just 21% of the total.

General Practitioners' Electronic Health Record (EHR) updates. By December 31, 2025, 85% of GPs should be regularly updating the EHR. However, there is no public data to assess compliance with this objective. The only information available is that 95% of GPs and Pediatricians accessed the EHR at least once in the last quarter monitored. "Without accurate data on EHR updates," Cartabellotta observes, "it is impossible to assess the active role of family doctors. This is particularly true with respect to the Patient Summary, the document where GPs summarize and update the patient's medical history to promote continuity of care."

Electronic health card and EHR interoperability. The system must be fully operational by June 2026. The technical infrastructure for interoperability of health data between regions was activated in early 2025, and the decree establishing the new health data ecosystem was published in the Official Journal in March.

Training in management and digital skills and abilities for 4,500 healthcare professionals. For this goal, too, to be achieved by June 2026, there is no public data available on the number of professionals who have already completed the training. "The final sprint of the Health Mission," Cartabellotta comments, "cannot become a political battleground because everyone is responsible: the Conte government, which, due to the limited time available and the ongoing pandemic, failed to implement more rigorous and close monitoring of various targets; and the Meloni government, which initially wavered on the actual usefulness of certain measures (e.g., Community Houses) and then simply celebrated the receipt of the installments, without exerting sustained pressure on the Regions and Local Health Authorities (ASLs), the "implementing bodies" tasked with completing the projects. The responsibility for the final sprint is collective and requires a concerted effort, with no room for blame game."