While Health Minister Agnès Buzyn is due to submit the Health Bill on February 13, one of the proposals calls for a major change in the remuneration of doctors and hospitals: this would be partly based on the satisfaction of patients.
How to ensure better follow-up of patients and avoid costly, redundant and unnecessary acts? Jean-Marc Aubert, director of the "task force" dedicated to the reform of the financing of the health system, created with the Minister of Solidarities and Health, has his idea: to provide for the doctors a remuneration not at each appointment you medical with his patient, but a "global payment for his care".
This major change in the funding of hospitals and city doctors will certainly be part of the Health Bill that will present Agnès Buzyn February 13 in the Council of Ministers. Jean-Marc Aubert, head of the Directorate of Research, Studies, Evaluation and Statistics (Drees) gave him this Tuesday his proposals.
The end of the fee-for-service payment?
But will they be welcomed by health professionals? While for months, the Minister of Health has to deal with the growing unease of hospital staff, not sure that this new method of remuneration satisfies them. The latter should, however, according to the report of the "task force", make it possible to put an end to the 30% of useless acts that weigh on the budgets of the healthcare establishments, while ensuring a better follow-up of patients.
According to the report submitted by the head of the Drees, it is not one, but five different payment terms that could complement each other. Among these, a remuneration of the practitioner no longer at each medical appointment but a "global payment" that will ensure better management of chronic diseases. If the follow-up is done correctly, the professional or the establishment will receive a financial envelope, explains Le Figaro.
Compensation according to satisfaction
Another form of remuneration suggested is that of "quality and relevance", which should make it easier to take into account the opinions of patients. Their satisfaction after a treatment or an operation will count as much as their biological constants.
The Aubert report also drew its inspiration across the Atlantic by advocating "bundled payment", that is to say a group payment "to the sequence of care", a group of health professionals is distributed. The goal? Better coordinate medical teams and encourage them to work together. Already experienced for hip prostheses, funding method has allowed to limit the readmissions of patients.
To enable certain services to be maintained, especially emergencies, and to encourage them to take charge of severe or urgent cases, the Aubert report also calls for a payment "for the restructuring of the service".
The fee-for-service payment, however, will remain topical for health professionals since, according to the task force, it remains the most appropriate for a specific intervention. However, its activity-based pricing (T2A) should evolve from 63% today to 50% by 2022 in order to favor other financing methods whenever possible.