Commons in Hospitals: from T2A to Cycle of Care Based Tariffs

This article provides a contribution to the reflection on the ways by which the current acute care hospital funding framework called activity based tariffs (Tarification A l’Activite, T2A in French) could be refined borrowing to Elinor Ostrom’s work on the commons. Stemming from an updated state of the T2A limitations addressed via a hospital performance management view, we call for revisiting the hospital funding issue in the light of incentives. Drawing from these bases we introduce a proposition to reform the current frame that leads to set tariffs on care cycles and that renews the way, by which we address hospital performance and its management.