Hierarchization of Acts
Seance of wednesday 19 february 2025 (Nouvelle nomenclature, nouveaux paradigmes)
DOI number : 10.26299/jgqv-8p26/2025.07.03
Abstract
After validation of the labels by HCH, the principle of hierarchization is to determine the medical work through a work score for each act relative to a global scale.
1) **Intra-family Hierarchization**
The first step consists, within each of the 43 families, in performing a hierarchization relative to a list of benchmark acts that are the most known and/or the most frequent, of varying difficulty; the clinical committee chooses a reference act, known to all and rather median, validated by HCN, with a score set at 100. The other benchmark acts will be classified in relation to this act. Subsequently, the other acts within the family will be hierarchized based on the scores of the benchmark acts. This process yields the "intra" hierarchization.
2) **Inter-family Hierarchization**
To maintain the possibility of retaining identical acts that will serve as bridges and thereby ensure the robustness of the methodology, the acts of a multi-specialty family are hierarchized both by the multi-specialty family and by each of the single-specialty families. We then look for linking acts that require the same medical work (as in the original method); we initiate the optimization process under constraints and develop the unique inter-point scale, with the constraint being that the hierarchization of scores on the intra-family scale is preserved on the inter-family (general) scale. It is based on these scores that the remuneration of practitioners will be developed according to the formula:
H = score(FC + CP) (currently 5 to 3990)
FC = monetary conversion factor (medical convention)
CP = cost of practice
Dr. Jacques Meurette, President of CHAP
1) **Intra-family Hierarchization**
The first step consists, within each of the 43 families, in performing a hierarchization relative to a list of benchmark acts that are the most known and/or the most frequent, of varying difficulty; the clinical committee chooses a reference act, known to all and rather median, validated by HCN, with a score set at 100. The other benchmark acts will be classified in relation to this act. Subsequently, the other acts within the family will be hierarchized based on the scores of the benchmark acts. This process yields the "intra" hierarchization.
2) **Inter-family Hierarchization**
To maintain the possibility of retaining identical acts that will serve as bridges and thereby ensure the robustness of the methodology, the acts of a multi-specialty family are hierarchized both by the multi-specialty family and by each of the single-specialty families. We then look for linking acts that require the same medical work (as in the original method); we initiate the optimization process under constraints and develop the unique inter-point scale, with the constraint being that the hierarchization of scores on the intra-family scale is preserved on the inter-family (general) scale. It is based on these scores that the remuneration of practitioners will be developed according to the formula:
H = score(FC + CP) (currently 5 to 3990)
FC = monetary conversion factor (medical convention)
CP = cost of practice
Dr. Jacques Meurette, President of CHAP