Status as a public health care establishment, which confers strong state support; Robust business position in a context of continuously growing health care needs in the region of Ile-de-France; Ambitious yet prudent management, committed to cost-efficiency and a cautious investment strategy; and Satisfactory financial performance and moderate debt levels. Uncertainties related to the gradual introduction of the output-oriented reimbursement scheme; Limited flexibility linked to regulated revenues and expenditures, which are subject to public price setting. The rating on French public-hospital organization Assistance Publique–Hôpitaux de Paris (AP-HP) reflects Standard&Poor's Ratings Services' expectations that the French state will uphold AP-HP's existing status as a public health care establishment ("établissement public de santé") and maintain its strong financial and operational oversight
