The Occam opens a space for consultation with the liberals

The Occam opens a space for consultation with the liberals

It opens up a new field of play between complementary organizations and liberal health professionals.

France Assureurs, Mutualité Française and CTIP have signed a cooperation agreement with Les Libéraux de Santé (LDS). Together, they will try to improve advance exemption from fees and prevention systems.

Is it opening a new page for cooperation between complementary organizations and health professionals? Their relations have been seriously damaged in recent years due to the establishment of sponsorship networks and complete third-party payment mechanisms.

The eleven unions of health professionals* united within the Liberal Health Organization (LDS) signed an unprecedented cooperation agreement with the three unions of complementary organizations on September 6. Occam and liberals aim for openness spaces for dialogue “Based on” co-construction Complementary to the traditional relationships led by health insurance.

The agreement aims to provide tangible solutions to improve the efficiency of the health system. Insurance companies and independent professionals have identified two areas of cooperation: prepayment waiver and prevention.

The signatories wish Preserve freedom of exchange and action and prevent the enhanced regulatory framework from limiting their ability to take initiative The Agreement remains open to other representative organizations of health care professionals as well as to representatives of users of the health care system.

sustainable consulting space

Together, they wish to perpetuate A space for consultation between health liberals and AMC to be organized in the fall. The goal is To organize dialogue between the two parties on a permanent basis According to the terms of the agreement.

Within the framework of complementary exchanges, the two parties will also be able to discuss ” Good practices for relationships and contracting between health professionals and OCAMS “, Text.

On a construction site where the advance fee has been waived, the agreement does not repeat the term anywhere.” Payment through an intermediary The distribution of third-party payments has had difficulty making progress with health professionals in recent years. Public authorities have attempted to legislate the lack of advances in health procedures at 100%, under the former PLFSS in order to develop a technical solution. The September 6 agreement between liberal professionals and organizations aims Complementary to avoid the supervision of public authorities on such a solution.

The text specifies that exemption in advance from fees ” It is considered as a limitation for health professionals I have planned the parties consultation “in order to determine”targeted solutionWhich will take into account the needs of the actors and the latest technological innovations. ” This solution will be gradually imposed on all health professions represented in the health liberals According to the terms of the agreement. On the other hand, health professionals and OCAMS will be able to freely choose the solutions offered. Finally, the parties wish to consult with the KNAM Council on the portion to be reimbursed by the AMO for ” Develop technical specifications “.

Use of data in the prevention service

In prevention, insurers and healthcare professionals agree on the importance of implementing targeted actions, and building and promoting appropriate pathways for those furthest from the healthcare system. The agreement highlights the importance of digital health and data to deliver customized solutions. In compliance with applicable standards, Stah and complementary organizations wish to define “ A common frame of reference on the use of useful data to increase the efficiency of support and prevention, and to ensure its promotion among health professionals and users “.

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This agreement between healthcare professionals and supplemental insurance professionals is a strong signal, showing that we are ready to work together. We are pleased that this exchange space has been created to allow us to simplify the management of care without paying any residual amount and without prepaying patients. Denis Lablin and Dominique Bertrand, President and Vice President of CTIP, Eric Chenot, President of Mutualité Française and Florence Lustman, President of France Assureurs, announced in a press release.

Without denying the independence of the trade unions representing liberal health professionals, we wanted to create a space for dialogue and projects. The urgency of setting up the health system requires taking action and getting out of situations to build together, and with public authorities, around such essential topics as prevention. Refers to Sebastien Girard, president of Liberals Health.

* The Liberal Health Organization (LDS) brings together 11 major labor unions representing liberal health professionals: CDF, CSMF, FFMKR, FNI, FNO, FNP, FSPF, SDA, SDB, SML, and The SNAO.

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