The hospital funding reform promised by Emmanuel Macron in January will begin to be implemented in the Social Security budget for 2024, Health Minister François Braun said on Thursday.
The first milestones will be in the 2024 social security financing bill, the Minister of Health told the Senate Social Affairs Committee.
In January, Emmanuel Macron announced a reform of the remuneration of players in the healthcare system, to move away from activity-based pricing and move towards remuneration based on public health objectives.
Mr. Braun then explained that we had to turn our backs on accounting logic, which could have led to a certain form of rationing of care.
Activity-based pricing was introduced in 2003, to replace the block grants in effect hitherto in public hospitals – at the time, clinics already had partial activity-based pricing.
She is accused in particular of having favored a certain form of competition between health establishments, and an overconsumption of care.
According to the explanations provided Thursday by Mr. Braun to the senators, it will not be a question of completely getting out of activity pricing (T2A), but of getting out of T2A at all.
Health establishments would receive an envelope in three compartments, one of which would remain linked to the activity, in particular for activities which are extremely expensive and require specific funding.
A second component would provide for specific funding, calculated according to the characteristics of the surrounding population, for certain missions such as intensive care units and maternity wards.
When you know how many births you will have in a sector, you might as well give the corresponding funding to these births rather than going back to funding strictly at the hospital passage, justified Franois Braun.
A third level would be linked to public health objectives, and would include in particular the sharing of permanent care, that is to say night and weekend call, between the public and the private sector.
According to the French Hospital Federation (FHF), which brings together public hospitals, activity pricing represents on average 60% of the revenue of public establishments, but this proportion tends to be higher in small hospitals.