Unexpected Experimenters and Promoters: The Implementation, Effects, and Applications of the PEPS Pilot Programme in 16 Health Centres

QES n° 285
2024/01

ABSTRACT
The national pilot programme based on a collective lump sum payment scheme for primary care teams for GPs and nurses (PEPS, Paiement en équipe de professionnels de santé en ville) is one of the new collective remuneration methods, an alternative to fee-for-service remuneration, enabled by Statement 51 of the 2018 French Social Security Funding Act (Article 51, Loi de Financement de la Sécurité Sociale, LFSS). This scheme was designed to reinforce coordination between healthcare professionals. Amongst the primary healthcare teams, 16 health centres (Centres de santé, CDS) took part in the national pilot programme, which initially targeted the Multiprofessional Group Practices (Maisons desanté pluriprofessionnelles, MSP).
The sociological survey, based on 57 interviews conducted with healthcare professionals and observations made in 6 CDS between 2021 and 2023, studied the conditions of the CDS' com-mitment to the pilot programme and the effects of this collective lump sum payment on the work carried out by primary healthcare teams. It highlighted a paradox: initially intended as an incentive to change aimed at self-employed healthcare professionals in coordinated prac¬tice, the lump sum payment emerged as an instrument of solvency and legitimisation of the practices of coordination and healthcare work developed by the CDS, which employ salaried healthcare professionals.

See also Questions d'économie de la santé n° 285 in French: Des expérimentateurs et promoteurs inattendus : mise en œuvre, effets et usages de l'expérimentation Peps dans 16 centres de santé.

See also Podcast n° 3 in French: Les soins pour tous, des dispensaires aux centres de santé.