Experiments under Article 51 initiated in the fourth quarter of 2020 in France

The French Ministry of Solidarity and Health constantly announces the new experiments initiated under Article 51 of the Social Security Financing Act. These experiments are focused on various topics concerning medical technologies and organization of care.

Article 51 of the Social Security Financing Act allows for the financing of innovative technologies and organizational schemes in the health sector. In order to receive financing via this framework, the experiments proposed must improve healthcare access, system efficiency, the relevance of prescription and patient pathway. With this approach, the experimentations can bypass one or more of the 63 regulations of social security financing laws, if it is on the coordination of medical pathway, relevance and quality of health, social or medico-social services, structuration of ambulatory cares and healthcare access.

The experiments initiated by stakeholders in the fourth quarter of 2020 are the following:

• DRAD - reinforced support for the elderly people. The experiment offers a solution to elderly people with loss of autonomy who wish to stay at home, for whom "classic" support from home services is not more sufficient. The experiment is organized for three years, with a total budget of €21,381,820
• PRIMORDIAL - experiment on the new fixed-price financing model resulting from the PEPS experiment to newly created health centers for primary care. The experiment is authorized for a period of five years, the financing requirement is estimated at €12,000,000
• PASCIA`MANS - innovative coordinated accompanied health course adapted for precarious patients with a low level of literacy in the Southern Quarters of Le Mans, authorized for a period of five years with the funding estimated at €3,180,914
• DNUT - home care pathway for undernourished people over 60, which sets up a home care pathway for the undernourished patient by a multi-professional team including dietetic and physical care, coordinated and monitored by the registered nurses in support of the doctor treating the patient. The experiment is authorized for three years with funding estimated at €1,047,000 (not including the financing of project engineering estimated at €263,440 and paid separately)
• Parcours Nutri'Age - prevention, screening, and management of undernutrition and risky situations in a multi-professional city hospital team in Haut de France, authorized for four years with funding estimated at €352,595 (not including the financing of project engineering estimated at €120,000 and paid separately)
• LENA - the implementation of a coordinated course of preparation for discharge from hospitalization and return home with the possibility of accommodation in assisted transitional accommodation in an independent residence. The financing via the health system innovation fund (FISS) is estimated at €146,160 for the total duration of the experiment. To this amount, funding by the FISS of €41,000 for project engineering is added
• THÉRAPIES ORALES (ORAL THERAPIES) experiment with the focus on home monitoring of patients on oral cancer drugs. The experiment is planned for a period of 33 months, starting from the inclusion of the first patient during the pilot phase. Financing is complex, as it is subdivided into pilot and experimentation phases and is only preliminary estimated
• PAP DOP experiment provides financial incentives for healthcare professionals and organizations to prevent and take charge of undernutrition before and after the patient's hospitalization to improve the results of surgical interventions. The duration of the experiment is two years from the date of inclusion of the 1st patient. The financing via the health system innovation fund (FISS) is estimated between €224,000 (minimum hypothesis) and €1M (maximum hypothesis) for the total duration of the experiment, excluding engineering costs (ca. €400,000)
• BARIA UP - Support path for obese patients after bariatric surgery in the areas of Lille, Lyon, and Toulouse, which sets up a coordinated, standardized, and reproducible educational course for the obese patients after operation. The experiment is planned for the period of five years, with the total financing estimated at €4,277,753
• FNMF Prediabetes - implementation of a package for the management of prediabetes by a multidisciplinary team within mutual health care structures. The experiment is planned for a period of three years, with the total financing estimated at €124,897.

Only one experiment was initiated by the French Ministry of Health in the fourth quarter of 2020. It is the CSSAC project - Community-based sexual health centers that aim to facilitate screening for sexually transmitted infections (STIs) and to treat the most spread infections. The experiment is planned for two years. Financing is complex and is only preliminary estimated.

The full details in French can be found here.

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