Prevention is one of the four core missions that the interprofessional agreement (accord conventionnel interprofessionnel, ACI) requires of every CPTS (local health professional network — communauté professionnelle territoriale de santé). Mon bilan prévention, France’s national prevention check-up program, is fully covered (100%) by French National Health Insurance (Assurance Maladie), open to four professions and offered at four key ages: it is the simplest lever for making this prevention mission concrete and measurable. Here is how to roll it out, step by step.
What is a CPTS, and why is the prevention mission mandatory?
A local health professional network (CPTS) is a voluntary grouping of health professionals from the same area who organize themselves to coordinate their work and structure their patients’ care pathways. Prevention is mandatory because the ACI, which has funded CPTSs since 2019, made it one of its core missions: no prevention mission, no complete ACI contract.
The legal framework: Article L1434-12 of the French Public Health Code
The text is short: “Health professionals may decide to form a local health professional network” in order to better coordinate their work and help structure health care pathways. A CPTS brings together primary and secondary care professionals and may involve medico-social stakeholders. Its members formalize a health project, sent to the regional health agency (ARS), which defines the area covered; it is deemed approved unless the ARS director general objects within two months. CPTSs were introduced by the French law on modernizing the health system (loi de modernisation de notre système de santé); the article was last amended by the law of December 27, 2023.
In practice, according to ameli.fr, a CPTS takes the form of a nonprofit association under the French law of 1901 (association loi 1901), open to any health professional as well as to multi-professional health centers (MSPs) and health centers, health care facilities, medico-social organizations and care coordination support services (dispositifs d’appui à la coordination).
The ACI: a three-party contract signed on June 20, 2019
The interprofessional agreement supporting the rollout of CPTSs was signed on June 20, 2019 between French National Health Insurance and the unions representing the health professions and health centers, then supplemented by Amendment 1 (March 23, 2020) and Amendment 2 (December 20, 2021). Locally, it takes the form of a contract between the CPTS, the CPAM (the local French National Health Insurance fund) and the ARS, reviewed every year on its anniversary date, at the end of five steps: approaching the ARS and French National Health Insurance, letter of intent, health project, ARS approval, signature. In early March 2022, 243 contracts had been signed according to ameli.fr, covering more than a quarter of the French population.
What are a CPTS’s core missions, and where does prevention fit?
The ACI distinguishes four mandatory core missions and two optional missions. Prevention is the third core mission, under the heading “mission to develop local prevention initiatives.” Each mission unlocks its own funding, made up of a fixed portion linked to resources and a variable portion linked to results.
| Type | Mission | Summary |
|---|---|---|
| Core 1 | Improving access to care | Making it easier to find a regular doctor; improving unscheduled care in community practice |
| Core 2 | Organizing multi-professional pathways around the patient | Coordination between professionals, between community practice and hospitals, and with the medico-social sector |
| Core 3 | Developing local prevention initiatives | Organized screening programs, vaccination, adapted physical activity, addictions, therapeutic patient education, Mon bilan prévention |
| Core 4 | Responding to serious health crises | Added by Amendment 2: preparing and deploying actions in a crisis situation |
| Optional | Quality and appropriateness of care | Practice improvement initiatives |
| Optional | Support for health professionals | Welcoming, setting up practice, mutual support in the area |
Sources: PAPS Hauts-de-France (ARS) and ameli.fr. The headings vary slightly from one document to another; those in the local contract are authoritative.
Which prevention topics does the ACI target?
French National Health Insurance’s press release of June 19, 2019 listed three priority topics: iatrogenic risks, loss of independence and obesity. ARS portals give broader examples: organized screening programs (cancers, high blood pressure, heart failure), promoting vaccination, addiction prevention, adapted physical activity, therapeutic patient education. The choice belongs to the CPTS, based on its local health assessment.
How is the prevention mission funded?
The ACI provides two components: funding for the CPTS’s operations, paid from signature, and funding per mission. Amounts depend on the size of the area, in four brackets: fewer than 40,000 inhabitants, 40,000 to 80,000, 80,000 to 175,000, more than 175,000. According to ameli.fr and PAPS Hauts-de-France, the operating budget ranges from €50,000 to €90,000 per year depending on size; Amendment 2 raised total support to a maximum of €580,000 (up from €450,000) for the largest areas when all missions are deployed. The breakdown by mission is set out in the ACI’s financial annex and in each local contract.
One point deserves to be clear: the CPTS does not bill for prevention check-ups. ACI funding pays for coordination, facilitation and resources; the service itself is billed by the professional who carries it out.
Why is Mon bilan prévention the natural lever for the prevention mission?
Because it ticks every box of a local prevention initiative: it is multi-professional, funded per service by French National Health Insurance, time-bound, supported by official documents, and it produces a written record, the Personalized Prevention Plan, that can be counted. For a CPTS, it is a ready-to-deploy prevention mission, whereas other initiatives require designing the program from scratch.
What the official program provides
Mon bilan prévention is “a time for discussion dedicated to health prevention,” lasting 30 to 45 minutes, offered once per person at each of four key ages: 18 to 25, 45 to 50, 60 to 65 and 70 to 75 inclusive. It is fully covered (100%) by French National Health Insurance, with no upfront payment and no extra fees. The framework is set by the decree of May 28, 2024 on the professionals who carry out prevention appointments, their content and their pricing (arrêté du 28 mai 2024).
The appointment takes place in three stages: risk screening using a self-assessment questionnaire filled in beforehand, jointly choosing one or two priority topics, then writing the Personalized Prevention Plan (PPP). The PPP and the risk-screening aid form “must be sent to the patient’s regular doctor (médecin traitant), unless the patient objects.” We describe its content in our article on the Personalized Prevention Plan.
Four professions, one €30 service
The decree designates four professions: doctors, midwives, nurses and pharmacists. The fee is €30 in mainland France and €31.50 in the overseas departments and regions, with the codes RDV (doctors and midwives), RDI (nurses) and RDP (pharmacists). If a need is identified during the consultation, an additional service can be billed the same day (vaccination, Pap smear, electrocardiogram depending on the profession). The sante.fr portal now also mentions physiotherapists.
| Profession | Code | Fee (mainland France) | Specifics |
|---|---|---|---|
| Doctor | RDV | €30 | Often the regular doctor themselves |
| Midwife | RDV | €30 | Well placed for the 18-25 and 45-50 age groups (sexual health, perimenopause) |
| Nurse | RDI | €30 | Possible at home, travel costs billable |
| Pharmacist | RDP | €30 | Private consultation area required; walk-in access |
Our articles by profession detail billing codes and how the check-up works: the prevention check-up carried out by a doctor, by a nurse and by a pharmacist. For a CPTS, the check-up has an additional advantage: it produces built-in monitoring data (check-ups performed, PPPs sent, referrals) that feed the variable portion of the prevention mission and the annual report to the CPAM and the ARS.
How do you roll out Mon bilan prévention in an area, step by step?
A successful rollout comes down to seven steps, from the local assessment to tracking indicators. The order matters: recruiting professionals before choosing your priority populations, or reaching out to residents before you have appointment slots, are the two costliest mistakes we see.
1. Carry out the local health assessment
Start from the available figures: population by age group (Insee, the French national statistics institute), share of insured people without a regular doctor, participation in organized screening programs, vaccination coverage, area profile provided by the CPAM or the ARS. Identify the towns or neighborhoods where indicators are poorest and the populations with poor access to care: young adults with no follow-up, isolated people over 70, employees working irregular hours. This assessment sets your priorities by age group and justifies your indicators to the CPAM.
2. Recruit the professionals who carry out the check-up
Among your members, list the doctors, midwives, nurses and pharmacists who volunteer. Professionals join the program via sante.fr with their CPS or e-CPS card (the French health professional ID card), which lists them in the public directory. Aim for a multi-professional mix from the start: pharmacies for ages 18-25 and 45-50, nurses for ages 70-75 at home, regular doctors for the patients they already follow. Hold a kickoff meeting where everyone leaves with the official self-assessment questionnaires, screening forms and PPP templates.
3. Train without adding burden
No training is mandatory. The EHESP (the French School of Public Health) offers voluntary online modules (formation.bilan-prevention.ehesp.fr): prevention, motivational interviewing, brief interventions. We recommend adding a practice-sharing evening after the first check-ups: that is where practical questions get settled (actual duration, patients with multiple conditions, what to do when a serious risk is identified).
4. Organize screening and appointments
The check-up benefits greatly from preparation. The official self-assessment questionnaire can be filled in on Mon espace santé (France’s personal digital health record) or as a PDF by age group; making sure it is completed before the appointment keeps the consultation within 30 to 45 minutes and devotes it to the action plan. Regular doctors’ patient lists and pharmacy records make it possible to identify people entering an age group; dedicated slots (half a day per week, a set session at the pharmacy) work better than fitting check-ups in as they come. Our article on the prevention check-up questionnaire describes its content by age.
5. Coordinate with regular doctors
This is the first thing evaluations look at. When the professional carrying out the check-up is not the regular doctor, the PPP and the screening form are sent to the regular doctor, unless the patient objects, via secure health messaging, via the shared medical record in Mon espace santé, or handed to the patient. Define a single, verifiable process. For patients without a regular doctor, connect the check-up to your core mission 1: it becomes a gateway to registering with a regular doctor.
6. Reach out to residents
Use the official materials (booklet, posters, topic sheets on ameli.fr) and local relays: town halls, municipal social action centers (CCAS), France Services centers, employers, associations, higher education institutions for ages 18-25. The message fits in one sentence: a 30- to 45-minute appointment, fully covered (100%), to take stock with a local professional. Communicate in waves, age group by age group, rather than in a single campaign.
7. Track indicators and report
From the outset, set the indicators you will present to the CPAM and the ARS, the source of each data point and how often it is consolidated. A quarterly dashboard shared at the general assembly is often enough to keep momentum going. Amendment 2 created a “project accelerator,” methodological support that includes help co-designing indicators: request it from your CPAM.
Which indicators should you track for the prevention mission and the ACI?
The ACI’s contractual indicators are negotiated locally, mission by mission, between the CPTS, the CPAM and the ARS; they distinguish resource indicators (fixed portion) from results indicators (variable portion). The table below is a suggested dashboard for a Mon bilan prévention rollout, to be adapted to your contract.
| Suggested indicator | Type | Source | Why track it |
|---|---|---|---|
| Active professionals by profession | Resources | CPTS register, sante.fr directory | Measures actual multi-professional involvement |
| Check-ups performed by age group | Results | Self-reporting by professionals, CPAM data (codes RDV, RDI, RDP) | Core of the mission; flags neglected age groups |
| Check-ups by profession | Results | Same | Checks that the check-up does not rely on a single profession |
| Coverage rate by age group | Results | Check-ups / eligible population (Insee) | Relates the effort to the area’s population |
| Share of check-ups with the self-assessment questionnaire completed beforehand | Quality | Self-reporting | Preparation and controlled duration |
| Share of PPPs sent to the regular doctor | Quality | Self-reporting, MSSanté (secure health messaging) | Program requirement; coordination with the regular doctor |
| Referrals made (screening, vaccination, addiction care, adapted physical activity, psychologist) | Results | Structured self-reporting | Shows that the check-up leads to action |
| Share of beneficiaries without a regular doctor or with poor access to care | Equity | Self-reporting, CPAM data | Expected target of local prevention |
| Communication initiatives and relay partners | Resources | CPTS register | Record of local outreach |
| Beneficiary and professional satisfaction | Quality | Short questionnaire | Useful for the annual report and for adjustments |
Two precautions. Individual data stays with the professionals: the CPTS consolidates only aggregated, anonymized counts. And do not set a coverage target against a national benchmark: to date, no official Mon bilan prévention rollout figures have been published on ameli.fr.
What common mistakes slow down the rollout?
Rollouts that run out of steam almost always share the same causes: a single-profession setup, unprepared check-ups, neglected transmission to the regular doctor and indicators defined after the fact.
- Mobilizing only doctors. Their time is the scarcest resource; without pharmacists, nurses and midwives, volume quickly plateaus. Remedy: a target distribution by profession.
- Doing the check-up without a prior self-assessment questionnaire. The consultation runs over and the plan is rushed. Remedy: make completing the questionnaire a condition of the appointment.
- Forgetting to send the plan to the regular doctor. It is a program requirement and the first coordination criterion the ARS looks at. Remedy: a single, traceable process with a dedicated indicator.
- Aiming for volume rather than populations with poor access to care. The check-up then mostly reaches people who are already well followed. Remedy: an equity indicator and relays to social services.
- Confusing Mon bilan prévention with the preventive health examination (EPS, examen de prévention en santé). The latter is a two-hour examination at a health examination center, with lab tests; the former is a 30- to 45-minute consultation with a local professional. You can have both: see French National Health Insurance’s free health check.
- Defining indicators at the end of the year. By then they cannot be documented. Remedy: the dashboard is approved along with the action plan.
- Communicating only once. Awareness of the program remains low. Remedy: communicate by age group, several times a year, with local relays.
- Letting each professional cobble together their own documents. Remedy: distribute the official self-assessment questionnaires, screening forms and PPP templates, identical for everyone.
Which official resources should you use?
Everything a CPTS needs is published by French National Health Insurance, the French ministry of health and the EHESP.
- ACI text and amendments: the “Accord conventionnel interprofessionnel pour les CPTS” pages on ameli.fr, with the financial annex.
- Decree of May 28, 2024 on the professionals who carry out prevention appointments, their content and their pricing (Légifrance).
- Professional pages on ameli.fr by profession: billing codes, PDF self-assessment questionnaires by age group, risk-screening aid forms, PPP templates, presentation booklet.
- sante.fr: professional registration (CPS or e-CPS card), public directory, map of prevention resources for referrals.
- Mon espace santé: online self-assessment questionnaire on the patient side, shared medical record for filing the PPP.
- EHESP training platform: formation.bilan-prevention.ehesp.fr.
- ARS support portals (PAPS): missions, funding, indicators and support for CPTSs in your region.
- Opinion of the French High Council for Public Health (HCSP) on the rollout of prevention appointments.
Key takeaways
- Prevention is the third of the ACI’s four core missions; without it, the CPTS contract is incomplete.
- Mon bilan prévention is multi-professional (doctors, midwives, nurses, pharmacists), paid €30 per service and offered at ages 18-25, 45-50, 60-65 and 70-75: the CPTS organizes it, it does not fund it.
- The Personalized Prevention Plan must be sent to the regular doctor unless the patient objects: it is the most closely watched coordination indicator.
- Define your indicators (check-ups by age and by profession, PPPs sent, referrals, populations with poor access to care) before the first check-up, with the CPAM and the ARS.
- No national rollout figures have been published: set local targets, not comparisons.
How to organize this pathway with Sokrate
Sokrate offers CPTSs a Mon bilan prévention pathway prepared online: the patient fills in an adaptive questionnaire at home, the member professional receives a structured check-up summary and signs the Personalized Prevention Plan, which is sent to the regular doctor unless the patient objects. The CPTS has an aggregated, anonymized local dashboard (check-ups by age and by profession, dominant risks, referrals), useful for tracking the prevention mission and for the ACI report; no individual data is visible to the CPTS. Learn more on our page for CPTSs; to discuss your area, contact us.