Experimentation to favor innovation: Promoting the success of Article 51 transformation projects

Summary Article 51 of the French social security financing act for 2018 creates a derogatory funding system to support experimentation with new ways of organizing care pathways. The growing interest local leaders have expressed for this very open framework has led to a large number of candidate projects presented to public authorities in charge of the system. In order to sustain this dynamic movement and favor the success of these experimental projects, our work focused on clarifying the roles and responsibilities of project leaders and the need for a specific evaluation system that takes into account the evolving nature of these projects and the need for operational adaptability. We propose three levels of evaluation (feasibility, intermediary results and impact assessment) needed to decide on generalizing a given experiment based on its intermediary results, or on the contrary, terminating projects not meeting feasibility expectations. Our work emphasizes the importance of networking and of developing favorable conditions for fruitful collaboration between participating stakeholders–healthcare professionals, health providers, economic partners, learned societies–interested in improving the performance of care pathways.