National Medical Insurance Bureau: Strengthen the price of macro management and dynamic adjustment of medical services prices

Recently, the State Medical Insurance Bureau issued the "Notice of Further Doing a Better Management of Medical Services". The "Notice" requires to strengthen the macro management and dynamic adjustment of medical services price, establish a dynamic adjustment mechanism for medical services and operate substantially, and uniformly dynamically adjust the specific rules of the mechanism at the provincial level, clarify the initial conditions and constraints, and improve price adjustment Programs, rules, and index systems to avoid each line.

National Medical Insurance Bureau: It is necessary to highlight the support for the value of technical labor services

The "Notice" requires that medical insurance departments at all levels must do a good job of daily management of medical services. The specific implementation of price projects should be practically responsible for management responsibilities, do a good job of explaining the connotation boundary, applicable scope and other policies, and respond to clinical concerns in a timely manner. Implement the report system for important matters of medical services, improve the quality of reports, and ensure that up and down and horizontal collaboration.

The "Notice" states that the adjustment of medical service price should highlight the support of technical labor value. Priority selection of prices from the treatment, surgery, and traditional Chinese medicine has not been adjusted for a long time, and the price of technical labor is mainly (more than 60%of the technical labor service part of the price composition). In principle, the number and amount of projects with labor value account for more than 60%of the total. It objectively reflects the value of technical labor services and prevents the price of equipment from being tied to high prices. For medical service items that are difficult to technical, highly risky, and indeed necessary to carry out, price differences can be appropriately reflected. Summarize the special adjustment experience of the new coronary virus nucleic acid detection price, in accordance with the principle of separation of technical labor and material consumption, scientifically grasp the elements of the price composition of the test project, reduce the cost of material consumption in various ways such as centralized procurement. Reform dividends.

National Medical Insurance Bureau: To accelerate the progress of the acceptance of the new medical service price project

The National Medical Insurance Administration stated that it is necessary to accelerate the progress of the acceptance of new medical service price projects, effectively strengthen the quality of innovation, and clearly support the innovation and development of medical technology.

The "Notice" requires that the new price project will focus on supporting clinical value -based medical technology innovation. For major innovative projects that optimize the diagnosis and treatment of major diseases or fill the gap in diagnosis and treatment, open up green channels. For priced projects with the cost of new equipment and new consumables and high prices, innovative and economical evaluations are made. Careful treatment of capital -driven, simply seeking investment returns, and local protection characteristics to avoid setting up exclusive medical service price projects in accordance with elements such as specific equipment, consumables, inventors, and technical genres. Regarding the medical services that the regional medical center introduced from the key introduction of the hospital, in principle, according to local existing price projects, there are no corresponding price projects, and the price project application process is simplified.

The "Notice" clearly states that the medical services that should be applied and clarified by the industry authority should be used as the specific scope of the acceptance of the new price project. Among them, the medical services listed in the technical specifications, the existing price items can be compatible, and the existing price is implemented. When it belongs to the different operation steps, technical details, and job division of the same medical services, when it is transformed into a price item, it is consolidated in principle to avoid excessive splitting. If the same medical service is used in a new way or in the new situation, the resource consumption is large, and the collection or reduction of the existing price items.

The "Notice" requires that for the in -depth correlation of medical consumables and medical services, it is necessary to accurately analyze the specific impact of centralized procurement, and classify policies and scientific collaboration. Among them, if the consumables are charged separately outside the medical service price project, the virtual high prices are procived and squeezed out of the water, and the relevant pricing projects with low pricing are prioritized into the scope of price dynamic adjustment, and special adjustments can be implemented if necessary; consumables merged at medical service price If the project is not charged separately, according to the effect of reducing the cost of reducing the cost of the goods in centralized procurement, the price of medical service projects is appropriately reduced, and the reform dividends are released to the masses.

Source: CCTV News Client head map: Guangzhou Daily Information Map Guangzhou Daily · Xinhuacheng Editor: Zhao Xiaoman

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