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 over the entity. It also takes into consideration AP-HP's key position in the provision of health care services in France, robust business profile, satisfactory financial performance, and debt levels that are moderate by national and international standards. The gradual introduction, since 2004, of the output-oriented reimbursement scheme, which links AP-HP's revenues to its annual level of activity, should not alter significantly its financial balance in the medium term. It will nevertheless require AP-HP to pursue
