The okamers open a room for consultations with the liberals

A new playing field is opening up between complementary organizations and liberal health professionals.

France Assureurs, Mutualité Française and CTIP sign a collaboration agreement with Les Libéraux de Santé (LDS). Together they will try to improve the advance tax exemption and prevention systems.

Opening a new page on the collaboration between complementary organizations and health professionals? Their relationship has been seriously damaged in recent years by the establishment of care networks and full third-party payment mechanisms.

The 11 unions of health professionals* united within the Liberals of Health (LDS) signed an unprecedented cooperation agreement with the three federations of complementary organizations on 6 September. Ocam and Liberals aim to open ” space for dialogue “and of” joint construction », as a supplement to the conventional relationships piloted by health insurance.

The purpose of the agreement is to provide concrete solutions for making the health system more efficient. Insurance companies and independent traders have identified two areas of cooperation: prepayment exemption and prevention.

That is what the signatories want preserve their freedom of exchange and action and prevent a strengthened legislative framework from limiting their capacity for initiative “. The agreement remains open to other representative organizations of healthcare personnel as well as to representatives of users of the healthcare system.

A sustainable consultation room

Together they want to perpetuate a space for consultation between health liberals and the AMC which will be structured in the autumn. The objective is ” to organize the 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 practice for relationships and contractualization between health professionals and ocams “, the text specifies.

On the construction site for advance fee waivers, the agreement nowhere repeats the phrase ” third party payment “. The distribution of third-party payments has been difficult to advance with health professionals in recent years. The public authorities have tried to legislate the absence of advances for 100% health legislation within the framework of the previous PLFSS in order to establish a technical solution. The agreement of September 6 between liberal professionals and complementary organizations aims to avoid the public authorities’ supervision of such a solution.

The text specifies that the fee exemption ” is experienced as a limitation for health professionals “. The parties have planned a consultation “to define”a target solution” which will take into account the needs of the players and the latest technological innovations. ” This solution will gradually be imposed on all the 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 two parties wish to consult with Cnam about the part reimbursed by AMO for ” develop technical specifications “.

The use of data in the service of prevention

In the field of prevention, insurance companies and health professionals agree on the importance of carrying out targeted actions, building suitable pathways and promoting them to those furthest away from healthcare. The agreement highlights the importance of digital health and data to offer personalized solutions. In accordance with the current standards, LDS and complementary organizations wish to define “ a common reference framework for the use of data useful for more effective support and prevention and to ensure its promotion among health professionals and users “.

This agreement between healthcare professionals and complementary insurance players is a strong signal that we are ready to work together. We are pleased that this space for exchange has been created to allow us to simplify the management of care with no residuals and no upfront payments to patients. Denis Laplane and Dominique Bertrand, president and vice-president of CTIP, Eric Chenut, president of Mutualité Française, and Florence Lustman, president of France Assureurs, declare in a press release.

Without denying the independence of the unions representing liberal health professionals, we wanted to establish a space for dialogue and projects. The urgent situation in the health system requires action and getting out of positions to build together and with the public authorities on issues as essential as prevention ” states Sébastien Guérard, chairman of the Health Liberals.

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

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