Isabelle Durand-Zaleski Special thanks to Ms Dominique Polton, from the National health insurance fund for salaried workers
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1 Financial incentives in France: from CAPI to public health targets Isabelle Durand-Zaleski Special thanks to Ms Dominique Polton, from the National health insurance fund for salaried workers
2 CAPI: contract for the improvement of Individual practice 2009, financial incentives for GPs Contracted individually with the SHI Initial resistance from national stakeholders Physicians Unions (vs tradition of collective contracting) National Council of the Physicians Association Union of drug manufacturers National health authority
3 CAPI criteria Prevention Flu immunization Breast cancer screening Monitoring & risk factors control Diabetes Hypertension Outcome Hypertension Limit useless and potentially harmful prescriptions Vasodialtors Benzodiapzepines Control expenditues Generic prescription: PPI, statins, antidepressants, antihypertensives, antibiotics Choose the cheap statins, antihypertensives, anti platelet agregants
4 CAPI= Current practice and CAPI targets diabetes benzodiazepines vasodilators breast cancer screening flu immunization generic prescribing hypertension control current target
5 CAPI= KOL opinion and independent GP journal KOL Prescrire generic prescribing hypertension control diabetes benzodiazepines vasodilators breast cancer screening flu immunization
6 Despite opposition from their Unions, GPs enroled Évolution du nombre de signataires du CAPI ,067 (38% of eligible physicians) individually contracted CAPI.
7 Resultsfor them: 70% received a bonus Average bonus of for the first year Max 8,000
8 And for their patients (2009 vs2012) HbA1C x3 eye exam aspirin 2009 contracting 2010 contracting 2009 non contracting 2010 non contracting
9 At the macro level: Appropriate diabetes management by # enrolees Taux de patients diabétiques ayant eu 3 ou 4 dosages d'hba1c Effectif de signataires taux à fin juin 2009 taux à fin mars 2012 CNAMTS - DSES DEOS
10 Appropriate risk factor management by # enrolees Taux de patients diabétiques à haut risque cardio-vasculaire sous statines Effectif de signataires taux à fin juin 2009 taux à fin mars 2012 CNAMTS - DSES DEOS
11 Taux de patients diabétiques à haut risque cardio-vasculaire sous statines et sous aspirine à faible dose Effectif de signataires taux à fin juin 2009 taux à fin mars 2012 CNAMTS - DSES DEOS
12 Use of asprin vs other anti platelets Taux de patients sous AAP traités par aspirine à faible dose Effectif de signataires taux à fin juin 2009 taux à fin mars 2012 CNAMTS - DSES DEOS
13 2012 changes: Public Health targets Chronic diseases and prevention: 500 points Efficient prescribing (reduce overuse, misuse and increase generic prescribing): 400 points Office management, computerized records: 400 points For each indicator the SHI defines the current level, intermediate and final target levels Each point is worth 7 The maximum number of points is 1,300 The expected average bonus is 4,500 per physician per year The 2011 Act on social security has allowed the contract to be integrated in the new collective agreement to be negotiated in 2011.
14 Quality and efficiency of care Prevention / screening Follow up of chronic care patiens Efficiency of drug prescription + New target for flu immunisation, cervical cancer screening, antibiotic use, duration of prescription for benzodiazepines + Level of Hb1C & LDL cholesterol for diabetic patients Same indicators Organisation of the practice Use of EMR, use of a software labelled by HAS for prescribing, electronic exchanges with NHI, information for patients, annual synthesis of the medical record 29 indicators 1300 points 1 point = 7 for 800 patients registered (> 16 years old) Potential bonus = euros (for 800 patients)
15 Other agendas for the SHI P4P is now part of the basic remuneration of physicians (fee level frozen until 2016) SHI acquires legitimacy for guidelines implementation SHI has developed academic detailing vs pharma reps. New deal in the relationship with Unions
16 When financial incentives do more good than harm: a checklist BMJ 2012;345:e Does the desired clinical action improve patient outcomes? 2. Will undesirable clinical behaviour persist without intervention? 3. Are there valid, reliable, and practical measures of the desired clinical behaviour? 4. Have the barriers and enablers to improving clinical behaviour been assessed? 5. Will financial incentives work, and better than other interventions to change behaviour, and why? 6. Will benefits clearly outweigh any unintended harmful effects, and at an acceptable cost?
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