A public establishment of the State, the National health Insurance Fund manages the risks of the health insurance and work accident-occupational illness (AT-MP) branches. It is both the pilot of the network which implements these schemes and one of the organizations of the general health insurance scheme. The Court examined the functioning of this establishment which is at the heart of health regulation. The analysis reveals insufficient strategic management which is seen in particular in governance, but also in the two transversal functions analyzed (human resources and purchasing) and in the two operational services examined (the studies strategy department and statistics, as well as the regional directorates of the medical service, decentralized services of the CNAM whose membership, decided in 2015, has not fully entered the culture of the public establishment). The Court considers it necessary to have more assertive strategic management of the establishment which strengthens its cohesion and performance.
