Competition policy for health care provision in France

•More than two thousand public and private hospitals operate in France.•Government reports argue that activity-based payment and competition impede synergies between hospitals.•An important reform coming into effect in January 2016 mandates close cooperation between public hospitals.•GP fees are set...

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Bibliographic Details
Published in:Health policy (Amsterdam) Vol. 121; no. 2; pp. 111 - 118
Main Author: Choné, Philippe
Format: Journal Article
Language:English
Published: Ireland Elsevier B.V 01.02.2017
Elsevier Science Ltd
Subjects:
Acute services
Central government
Competition
Competition policy
Cooperation
Cooperation agreements
Cooperative Behavior
Diagnosis-Related Groups - economics
Economic Competition - economics
France
Government Regulation
Health care
Health care policy
Health Care Reform
Health Expenditures
Health Personnel - economics
Health Policy
Health services
Hospitals
Hospitals, Private - economics
Hospitals, Public - economics
Humans
Internal Medicine
Markets
Merger control
Ownership
Physician competition
Physicians
Prices
Private Practice - economics
Reforms
Regulation
Rules
Self control
Self employment
Tariffs
France
Merger control
Physician competition
Hospitals
Cooperation agreements
ISSN:0168-8510, 1872-6054, 1872-6054
Online Access:Get full text
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Summary:•More than two thousand public and private hospitals operate in France.•Government reports argue that activity-based payment and competition impede synergies between hospitals.•An important reform coming into effect in January 2016 mandates close cooperation between public hospitals.•GP fees are set nationally while many self-employed specialist physicians may overcharge.•Government regulation and centralized negotiations tend to be favoured over market mechanisms. There are more than two thousand hospitals in France, about equally divided between government-owned and privately-owned hospitals. Activity-based payment, which has been generalized in 2008 for acute care hospitals, has raised competition issues as DRG tariffs differ according to ownership status. Furthermore, the payment rule has been criticized for preventing the realization of potential hospital synergies, and as a result a recent reform has mandated close cooperation between public hospitals. The physician market is dual, with most GPs being subject to fee regulation and many self-employed, private-practice, specialist doctors being allowed to set their prices freely. Government regulation and centralized negotiations have traditionally been preferred to market mechanisms in this industry.
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ISSN:0168-8510
1872-6054
1872-6054
DOI:10.1016/j.healthpol.2016.11.015