New price for consultations, “additional” package… What does the draft agreement submitted to doctors contain?

New price for consultations, “additional” package… What does the draft agreement submitted to doctors contain?
New price for consultations, “additional” package… What does the draft agreement submitted to doctors contain?

Liberal doctors and Health Insurance meet on Thursday for 48 hours of price negotiations presented as the concluding session, with the hope of reaching an agreement for the next five years. But for practitioners, the copy is “far from being finalized”.

Initiated in the fall after a failure last year, these difficult discussions aimed at upgrading doctors’ consultations in return for collective commitments for access to care were suspended at the beginning of April, after explosive government announcements on hospital prices. .

Various behind-the-scenes talks – with Health Insurance and the Ministry of Health – have since eased tensions.

A draft convention of 168 pages

The National Health Insurance Fund (Cnam), which wishes to succeed as quickly as possible, recently sent the unions a draft agreement of 168 pages.

It “is based on an unprecedented investment from Health Insurance, 50% higher than that of the previous agreement,” argues Cnam director Thomas Fatôme, in a letter to the unions on Wednesday.

In 2016, the financial effort for Health Insurance was estimated at 960 million euros per year in the long term, once all the measures were in force.

Revaluation of consultation

This time, Cnam is proposing to increase the price of general practitioner consultations to 30 euros, compared to 26.50 currently.

She wants to create a “long consultation” at 60 euros for certain patients over 80 years old (once a year, in very special cases).

A complementary “package”

To “support the role of the attending physician”, it combines this remuneration with an additional “package”, determined by the number of patients followed and their “complexity” (age, state of health, level of precariousness, etc.).

Medical consultations: general practitioner, specialists, extended visit… These prices which could increase

For specialist doctors, it plans to increase the one-off consultant opinion to 60 euros (APC, when the treating doctor requests the expertise of a colleague); to authorize the “cumulation” of certain acts with consultation and targeted upgrades towards specialties in difficulty (pediatricians, gynecologists, geriatricians, psychiatrists, etc.).

But for the unions “the account is not there”.

A “shock of attractiveness”

Main stumbling block: the timetable for revaluations does not appear in the text, sent “without its annexes”. The unions want an immediate “shock of attractiveness” but fear gradual increases over several years.

“We will negotiate with great determination but little hope.”

Philippe Cuq. (co-president of Avenir Spé-Le Bloc)

The specialists are demanding an envelope of 500 million euros for the upgrading of their technical actions, compared to 200 million proposed by the Cnam.

The main general practitioners’ union MG France, for its part, deplored “large gray areas” at the beginning of May, questioning “the possibility of an agreement”.

With AFP

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