At the end of our study, it should be remembered that our ambition was to evaluate the financial management autonomy of Performance-Based Financing, then see the reasons and remedies to propose for the improvement of the services offered to the ‘HGR Gemena. In carrying out this work, our main objective is to evaluate the level of management autonomy of the HGR/Gemena in the performance-based financing approach. Through this evaluation, this study will explain the mechanisms likely to guide this institution towards the performance so desired in the Performance-Based Financing approach. To carry out this study, we used the descriptive and documentary method, supported by observation and documentary review for this study it is based on the autonomy of financial management, to collect data on the variables of the study, namely: Human resources management, Material management, Financial management, MEG management and other inputs, Flat rate pricing. To achieve these objectives, it was useful for us to use different techniques to collect data and information, including the documentary review. In the data analysis the following methods were used analytical methods, structural-functionalist method, statistical and dialectical method. Indeed, the results of the present study reveal that the contribution of Performance-Based Financing to the financial management autonomy of the HGR/Gemena takes into account distribution keys in relation to the contract signed by the EUP: drug purchase, performance bonus, investment, operation, social marketing and bank reserve which led to the financial management autonomy of the HGR/Gemena.