Established as part of the 2016 medical agreement, the structural allowance is an annual financial aid paid by the Health Insurance system to support doctors in modernizing their tools (software, prescription assistance, electronic treatment forms, secure messaging, etc.) and adopting coordinated practice methods.

All private doctors registered with the national health service, whether general practitioners or specialists, practicing alone or in a group, are eligible.

This is a lump sum grant.

Payment of this aid is based on compliance with various indicators related to the modernization and digitization of medical practices. Each indicator corresponds to a certain number of points, which are converted into a monetary value. For example, in 2024, the value of a point is set at €7.

The amount varies depending on the indicators achieved. The amounts paid may contribute to covering the costs of IT equipment and services (subscription or secure teleconsultation solution).

The structural package is broken down into 12 indicators, divided into two main categories: practice equipment and patient services, with a specific amount allocated for each indicator.

• Part 1 (prerequisites): 4 mandatory indicators that group together criteria related to practice equipment (software that has been referenced by Ségur, HAS-certified prescription assistance software (LAP), Carte Vitale application (ApCV), remote transmission, etc.). All criteria must be met in order to receive the corresponding remuneration.
• Part 2: 8 indicators covering patient services (use of the DMP, Mon espace santé health messaging service, online sick leave, electronic care protocol, etc.). Each criterion in this part operates independently. The corresponding remuneration is only available if all the indicators in part 1 are met.

Each criterion is associated with a number of points to be accumulated. Depending on the indicators achieved, a certain number of points are awarded, allowing the structural flat-rate remuneration to be calculated. For example, component 1 is worth 280 points (€1,960), and component 2 is worth 835 points (€5,845).

The structure fee is paid annually in April, based on indicators calculated on December 31 and declarations made on amelipro in December-January.

The eligibility criteria are as follows: 

• Be a private practitioner registered with the national health insurance system; 
• Practice in an individual or group practice, regardless of medical specialty and sector of practice (sector 1 or 2);
• Meet the indicators defined in the medical agreement: have Ségur-approved software and HAS-certified LAP, use the Carte Vitale app (ApCV), have a remote transmission rate of over 67%, display practice hours in the ameli.fr health directory, etc.

Doctors must report their indicators on the amelipro portal and submit the necessary supporting documents before the deadlines set by the Health Insurance Fund. Each year, in December and January, they must report the previous year's indicators to the French national health insurance system. Indicators relating to calculated indicators (rate of electronic transmission of treatment forms, rate of digitization) are automatically filled in. 

To help physicians with this process, the French national health insurance system has developed useful guides and documents.

A similar conventional scheme also exists for other healthcare professions: the flat-rate subsidy for the modernization and computerization of professional practices (FAMI).

This package combines various conventional subsidies previously paid to contracted professionals (telecommunication assistance, maintenance assistance, SCOR assistance) with new indicators (DMP-compatible business software, secure healthcare messaging, telehealth indicators, etc.). It is paid once a year in the form of a single automated payment. As with the structure allowance, in order to benefit from the FAMI, it is necessary to declare your indicators each year on amelipro during the data entry period.