While the Minister of Health Agnès Buzyn is due to present the Health Bill on February 13, one of the proposals provides for a vast change in the remuneration of doctors and hospitals: this would be partly based on the satisfaction of patients.
How to ensure better patient follow-up and avoid costly, redundant and unnecessary procedures? Jean-Marc Aubert, director of the “task force” dedicated to the reform of the financing of the health system, created with the Minister of Solidarity and Health, has his idea: to provide doctors with remuneration not at each appointment you medical with his patient, but a “global payment for his care”.
This major change in the method of financing hospitals and city doctors will certainly be part of the health bill that Agnès Buzyn will present on February 13 in the Council of Ministers. Jean-Marc Aubert, head of the Department of Research, Studies, Evaluation and Statistics (Drees) gave him his proposals on Tuesday.
The end of fee-for-service?
But will they be well received by health professionals? While for months, the Minister of Health has had to deal with the growing discomfort of hospital staff, not sure that this new method of remuneration will satisfy them. The latter should however, if we are to believe the report of the “task force”, make it possible to put an end to the 30% of unnecessary acts which weigh on the budget of healthcare establishments, while ensuring better monitoring of patients.
According to the report submitted by the head of the DREES, it is not one, but five different payment methods that could complement each other. Among these, remuneration of the practitioner no longer at each medical appointment but a “global payment” which will ensure better management of chronic pathologies. If the follow-up is done correctly, the professional or the establishment will receive a financial envelope, explains Le Figaro.
Compensation based on satisfaction
Another suggested mode of remuneration: that “for quality and relevance”, which should make it possible to better take into account the opinions of patients. Their satisfaction after a treatment or an operation will count just as much as their biological constants.
The Aubert report also drew inspiration from across the Atlantic by advocating “bundled payment”, that is to say a grouped payment “for the sequence of care”, that a group of health professionals distributes. The goal? Better coordinate medical teams and encourage them to work together. Already tested for hip prostheses, this financing method has notably made it possible to limit patient rehospitalizations.
To allow certain services to be maintained, in particular emergencies, and to encourage them to take charge of severe or urgent cases, the Aubert report is also betting on a payment “for the restructuring of the service”.
However, fee-for-service will remain relevant for health professionals since it remains, according to the task force, the most appropriate for a one-off intervention. Its activity-based pricing (T2A) should however change, going from 63% today to 50% by 2022 in order to favor other methods of financing when possible.
.