Examples of e-health and disease management reimbursement in France
22 Jan 2019

Next week (31st of January) we have a webinar that will provide insights in how to establish reimbursement for e-health and disease management in France. This is a brief update about the two programs that exist, what they entail and the disease areas where they have been utilized.

e-health experimentation (Art 54 / ETAPES Program)

The French E-health experimentation has been initiated in 2014, including the following e-health programs:

  • Remote consultation & expertise
  • Tele-monitoring (also called “ETAPES” Program)
  • Tele-assistance

Remote consultation & expertise experimentation started in 2014 and became a regular act within the French Reimbursement scheme September 2018.

The Tele-monitoring program ETAPES started in 2016 & 2017, in the following area:

  • Diabetes (14 programs)
  • Heart failure (20 Programs)  
  • Cardiology implants (5 programs)
  • COPD (36 Programs)
  • Renal Failure (32 programs)

Article 51 – Funding for organizational methods with or without support of disease management tools

The Article 51 Experiment has been implemented in 2018, for innovative healthcare organizations with a new derogative financing scheme for the next 5 years.

The main objective of Article 51 is to use new financing and organizational methods allowing to decompartmentalize the French healthcare system and encourage cooperation between stakeholders. The program is focused on changes that impact the organization by care, with or without technical solutions such as software, algorithms, Artificial intelligence, connected health etc.

The main priority in 2018 has been the selection of 54 projects (180 candidates):

  • 25 Health care organization for the EDS program (payment per episode for surgery management)
  • 18 groups for IPEP program (incentive for shared care)
  • 11 projects for PEPS (lump-sum payment to HCP’s for homecare treatment)

The following fields have been selected in these 3 groups of experimentation:

  • Cancer treatment
  • Diabetes
  • Elderly
  • Obesity
  • Pain treatment
  • Psychiatry
  • Renal therapy
  • Surgery (Orthopedy / digestive surgery)

The project has received another 10 million € in funding for 2019.