Le contrat d'amélioration des pratiques individuelles (CAPI) à la lumière de l'expérience anglaise

Bras, Pierre-Louis

doi:10.3917/jgem.115.0216

Cited by 7 publications

(5 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Unlike British fundholding physicians who works as brokers or holders of funds, playing one provider against another to extract better contracting terms and NHS managers who were able to internalize market principles and became more apt at navigating the marketplace and at cooperating in the commissioning of health services (Osipovič et al, ), French health care professionals are neither trained nor equipped to compare providers' costs and services and are often unwilling to play that role, preferring routine habits and structured networks over a marketplace of practitioners and care providers. French General Practitioners also lack the data collection and management skills of their British counterparts (Bras, ). Moreover, pay‐for‐performance (P4P) compensation mechanisms such as quality outcome framework or QOF and P4P are more advanced in the United Kingdom (Allen, Mason, & Whittaker, ) than in France where balanced scorecards contain fewer indicators and where there is little emphasis on long‐term quality improvement.…”

Section: Discussionmentioning

confidence: 99%

The quest for a better performing health system: Public expertise and corporate management recipes in France

Simonet

2019

Journal of Public Affairs

View full text Add to dashboard Cite

Though the government pledged to cut the public deficit from 7.7% of the gross domestic product in 2010 to 3% by 2013, thereby responding to EU Normative power, health expenditures continue to rise, because public demands are higher and more social problems are handled in the health care setting. With French budget deficit threatening France's credit rating, novel instruments were needed. These included corporate management recipes (e.g., pay for performance contracts, patient volume targets, and management by objectives), new compensation mechanisms (e.g., activity‐based accounting and a nationwide scale of health care costs) and far‐reaching laws (e.g., the 2009 HPST bill). Our approach investigates some critical elements of the French health care system. We focus on primary (e.g., family physicians and General Practitioners) and secondary (e.g., hospital and specialty) care. We explore how policies such as the standardization of health services, the regrouping of health policy decisions within the larger Regional Health Agencies, affected citizens' engagement and physicians' autonomy. A French welfare elite pursued a hybrid strategy, regulating quasi‐markets of care providers in a postcompetitive government, while creating supportive conditions for a vibrant private hospital sector. Reforms also emphasized evidenced‐based policy, outputs‐rather than outcome‐measurement, and performance evaluation in a bid to streamline the delivery of health services.

show abstract

Section: Discussionmentioning

confidence: 99%

The quest for a better performing health system: Public expertise and corporate management recipes in France

Simonet

2019

Journal of Public Affairs

View full text Add to dashboard Cite

show abstract

“…MG France, the major left-wing union of GPs, was not completely hostile to the objectives of CAPI, but they were concerned that such results-based contracting might encourage patient selection. The Confederation of Medical Unions in France (CSMF), the right wing union, was opposed to the principle of controlling “medical practice” implied by CAPI and called on their members to refuse to sign CAPI (Chevreul et al , 2010) on the basis that CAPI meant “ the end of the freedom of prescription ” (Bras, 2011). The emblematic former CSMF leader Michel Chassang interpreted CAPI as a “ proper SHI initiative backed by government ”.…”

Section: P4p In France and Germany: Similar But Differentmentioning

confidence: 99%

“…With respect to such an independent approach, another SHI actor said that it was necessary to “ force ” CAPI, while noting that since CAPI was transformed into ROSP in 2012 SHI has worked systematically with doctors. Likewise, an analysis by one of the authors of the IGAS report on P4P concludes that SHI used CAPI to “ force ” the evolution of payment modes in France (Bras, 2011). As one SHI actor stated, the isolated development was a source of resistance but allowed it to be quite prepared from the start.…”

Section: P4p In France and Germany: Similar But Differentmentioning

confidence: 99%

“…At the time of the introduction of CAPI, these representatives with a workforce of around 1,000 were also backed by SHI-employed physicians, with a workforce of about 2000. The high impact of this targeted approach is illustrated by the fact that, in 2009, 89% of GPs subscribing to CAPI stated that their signature followed a visit by a SHI representative (Bras, 2011). An SHI actor described CAPI as a vast and resource-intensive project with statisticians, lawyers and marketing experts, and the SHI team celebrated the milestones of 5,000 and 10,000 signatures.…”

Section: P4p In France and Germany: Similar But Differentmentioning

confidence: 99%

See 1 more Smart Citation

Tools of power: pay-for-performance in French and German health reforms

Brunn

2020

JHOM

View full text Add to dashboard Cite

PurposePay-for-performance (P4P) as an innovation for improved health care has been introduced in many health systems worldwide. The aim of this article is to apply and refine a specific theoretical angle for the analysis of these reforms, the theoretical frameworks of public policy instruments and programmatic actors, in order to highlight differences between countries.Design/methodology/approachThis analysis is based on a comparative case study of the introduction of P4P in France and Germany in the ambulatory sector for the period from 2007 until 2017. This included a literature review and semi-structured interviews with 23 actors between 2013 and 2015.FindingsThe introduction of a supposedly clear-cut policy instrument – P4P in health care – is distinctly shaped by the intertwined configuration of institutional architecture and the policy programme of key system actors. This can be understood as a continuation of long-term transformations, most importantly the increasingly direct influence of the state and a weakening of the representation of the medical profession, as well as an internal fragmentation of the latter.Originality/valueThis analysis illustrates the applicability of the policy instrument approach to the heath sector. In addition, the authors have applied the dual perspective of policy instruments and programmatic actors. Both proved complementary and appropriate for the study of a highly technical instrument such as P4P.

show abstract

“…La réticence plus virulente des médecins français au P4P peut ainsi s'expliquer par la justification et la construction institutionnelle de l'outil. Les objectifs initiaux et la relation entretenue entre médecins et tutelle sont en effet bien différents dans les deux cas [Bras, 2011]. Alors que le QOF avait pour objectif d'augmenter le budget du National Health Service, le CAPI s'inscrit dans le contexte d'une réduction des dépenses socialisées de santé.…”

Section: De L'intérêt à La Motivationunclassified

Faut-il intéresser les médecins pour les motiver ? Une analyse critique du paiement à la performance médicale

Silva¹

2013

Revue Du MAUSS

View full text Add to dashboard Cite

Distribution électronique Cairn.info pour La Découverte. © La Découverte. Tous droits réservés pour tous pays.La reproduction ou représentation de cet article, notamment par photocopie, n'est autorisée que dans les limites des conditions générales d'utilisation du site ou, le cas échéant, des conditions générales de la licence souscrite par votre établissement. Toute autre reproduction ou représentation, en tout ou partie, sous quelque forme et de quelque manière que ce soit, est interdite sauf accord préalable et écrit de l'éditeur, en dehors des cas prévus par la législation en vigueur en France. Il est précisé que son stockage dans une base de données est également interdit.

show abstract

Le contrat d'amélioration des pratiques individuelles (CAPI) à la lumière de l'expérience anglaise

Cited by 7 publications

References 2 publications

The quest for a better performing health system: Public expertise and corporate management recipes in France

The quest for a better performing health system: Public expertise and corporate management recipes in France

Tools of power: pay-for-performance in French and German health reforms

Faut-il intéresser les médecins pour les motiver ? Une analyse critique du paiement à la performance médicale

Contact Info

Product

Resources

About