For the first time of their history, French primary care practitioners will be paid for performance. Until now their remuneration was only of “fee for service” type. But the new contract with social security scheme of July 2011 introduces a dose of “pay for performance”. Goals that will have to be reached in order to receive bonuses will be fixed by the contract negotiated with the French national social security scheme.
Old time when practitioners only had an obligation of mean is from now on a past history. Bonuses are now also paid for the obtaining of results.
The risk of such a new remuneration is that it only add on to the previous one “fee for service” remuneration without address the problem of repetitive un-necessary medical cares.
Pay for performance should potentially show better results in a salaried context like in England than in a fee for service context like it is in France.
Furthermore patients with multiple chronic diseases often do not correspond to any guidelines available. But… wait and see.
All the more, results depend on how generous will be the financial incentive and how high will be set the performance thresholds. From now on bonuses costs are estimated between 360 and 380 million Euros.