Outpatient care is slipping from the target set by the 2024 Social Security budget and risks increasing the planned deficit by an additional €500 million. This is the conclusion of a warning committee on the evolution of health insurance spending, whose latest opinion was revealed by The echoes this Monday, July 29. “There is a high risk of exceeding the sub-target for community care given the increase in these expenses during the first six months of 2024,” warned the group of experts, whose mission is to monitor every six months the gap between the actual expenses of Health Insurance and the target set by the Social Security Financing Act (LFSS).
The latter predicted that city care would represent an expenditure of 108.4 billion euros in 2024. But over the first six months of the year, “effective gross expenditure” related to city care increased by +5.7% compared to the same period in 2023, or 1.5 additional points compared to the target set at +4.2%, they analyse. The gap concerns “most” city care items: medical biology, patient transport, fees for specialist doctors and physiotherapists, sick leave, medications and medical devices, the committee indicates, observing the “dynamics” of the volume of care.
Insufficient reserve
In the second half of the year, several variables are expected to further change expenditure according to experts, citing in particular an increase in revenue via the doubling of “deductibles” – the remaining cost to patients for medication or consultations – which occurred on April 1 and May 15, or increases in expenditure following the revaluation of private doctors’ fees, recently concluded between unions and health insurance. Ultimately, the committee estimates that gross expenditure could slip by around €1 billion at the end of 2024.
The LFSS still includes a “reserve” in case the national health expenditure target (Ondam) is exceeded, but this is “insufficient”, experts believe. They point out the significant deficit of public hospitals, and note that an extension of 170 million euros was granted in mid-2024 to private, for-profit health establishments. By using the few mobilizable reserves, and anticipating a drop in medical biology expenditure recently negotiated with representatives of analysis laboratories, the committee estimates that the Ondam could ultimately be exceeded by more than 500 million euros at the end of the year. This “significant” amount is however “lower than the alert threshold”, set at 0.5% of the forecast amount of expenditure, or 1.3 billion.