T2A, (In)cohérence

The T2A pricing system includes various measures that go beyond the theoretical definition of activity-based pricing. The implementation of GHMs is a prerequisite for the introduction of lump-sum payments. However, the allocation of fixed rates to each GHM has evolved over time to create fixed rates that reflect a combination of spending recovery observed by GHM, political objectives to improve patient care in line with therapeutic innovation, and budgetary control constraints. Only 10% of hospital stays are medium severity or above. These medium, severe, and very severe stays account for over 60% of GHM codes. Less than 500 GHM/GHSs (around 20%) are enough to cover 80% of hospital activity, considering all activities together, and excluding GHSs corresponding to stays without fixed charges. In summary, the T2A system is gradually shifting from a results-based pricing system to one that is based on resources.