Developing specific bundled (lump-sum) payments per patient for following up chronic diseases or for long-term services would help. This could partly affect the supply of new specialists, and care will be needed in the adjustment. Around 45% of specialists are allowed to extra- bill patients, except CMU-C and ACS recipients. The authorities offered voluntary contracts to some specialists guaranteeing, in particular, partial coverage of their social contributions if they limited extra billing, but they have had a modest take-up.