France case study 2021

Overview

The French long-term care (LTC) sector is complex with multiple funders and care providers managed by different levels of government. While the statutory health insurance (SHI) system allows a unified and relatively good coverage of medical LTC needs, the type and funding of the personal and social LTC services vary depending on the local authority. This has resulted in large differences across French departments in prices of personal LTC services and out-of-pocket payments faced by the recipients. Prices and payment mechanisms used for funding providers vary also for medical and personal LTC services. Regardless, none of the payment mechanisms take into account the quality of service providers. Lack of information on actual costs and care quality of the LTC providers hinders the capacity for improving the quality and efficiency of care provision in the LTC sector.

This chapter provides an overview of the funding and price setting mechanisms used in the LTC sector today in France, with the objective of staging the mechanisms used and issues raised. It first presents the main providers involved in the LTC sector and the major institutions responsible for funding and managing LTC services. By analyzing price setting mechanisms for different providers, we aim to identify major issues and possible solutions for advancing LTC services in France and in other countries