Public health care establishment status, which confers strong state support. Robust business position. Strong governance, underpinned by ambitious yet prudent management committed to reforming and modernizing the organization toward greater cost efficiency and service provision. Satisfactory financial performance. Moderate debt. Uncertainties related to the gradual introduction of an output-oriented reimbursement scheme, T2A, which should not, however, significantly hamper AP-HP's financial balance. Limited flexibility linked to regulated revenues and expenditures, which are subject to public price setting. Growing competition from the private sector. The rating on French public-hospital organization Assistance Publique – Hôpitaux de Paris (AP-HP) reflects Standard&Poor's Ratings Services' expectation that the French state will uphold AP-HP's existing status as a public health care establishment ("établissement public de
