Interpretation 丨 4 major starting points of dental implants price treatment

With the continuous deepening of my country's population aging and the continuous improvement of people's living standards, the people's demand for oral planting medical services has shown a rapid growth trend. According to statistics, the number of dental implants in my country in 2020 reached about 4 million, and sales increased by 28.2%. For a long time, problems such as irregular fees and heavy costs in the field of oral planting have been the pain points of people's livelihood that plagued the masses.

On August 18, the National Medical Insurance Bureau issued an announcement that the "Notice on the Development of Oral Planting Medical Services and Special Governance of Consumption (Draft for Soliciting Opinions)" (hereinafter referred to as the "Draft for Soliciting Opinions") was publicly solicited. The release of the "Draft for Opinions" has passed a very strong signal -the special governance work of oral planting medical services and consumables will be officially launched. Therefore, correctly understanding and grasping the policy essentials in the article has objective practical necessity.

1. Standardize charges, start with the project composition

It is understood that the fees of dental implants on the market are mainly composed of three parts: consumables, physician service fees, and hospital operating fees. Among them, consumables account for about 25%, physician service fees account for about 40%, and the rest are the hospital's operating fees. In order to regulate oral planting charges, the "Draft for Soliciting Opinions" starts with the project composition and takes the following measures:

The first is the implementation of "skill consumption separation". The service items and special consumables are separated, that is, the prices of implant implantation fees and implant consumables are priced separately; the crowns are priced separately from the prices of crown products; bone planting costs are priced separately from bone meal prices. Regarding the current consumable merger charging in the price of medical service projects, the "Draft for Soliciting Opinions" proposes a specific solution -deducting the average price of online procurement of relevant consumables and simultaneously lowered the project price.

The second is integrating price projects. Specifically: 1. The first phase implantation (implant implantation) and the second phase of surgery (placed healing base platform) are merged into implant implants; 2. Crown entry service Plaza relationship records and transfer, base platform and crown installation, commissioning and modification, etc., merge into the crown of the implant; 3. Bone planting surgery, soft tissue repair, repairs and removal of implants for dental implants , Set independent medical service price projects; 4. In order to ensure the accuracy of dental repair, medical institutions use various inspection methods such as medical images and digital technologies, artificial intelligence, etc. The service output set up corresponding medical service price projects.

The third is to straighten the relationship between comparison. The implant fees, crown crowns, and bone planting surgery fees with strong reflection of the masses and heavy cost burdens are mainly reduced. Specifically, 1. The government guidance price of public medical institutions is significantly higher than the average price of private medical institutions in the region, and special arguments and key prices are reduced; Active callback of medical institutions above the average level; 3. Items with high technical difficulty and high risk of wearing sculpted surgery, complex bone implantation, etc., allow the proper gap with conventional dental implants; The medical service price of the lack of dental repair is a reasonable relationship with the oral planting, encouraging medical institutions to give priority to providing patients with appropriate dental repair services; Low it can increase the price appropriately.

Second, price regulation, start with full process management

Due to the long -term consumption of oral planting, many processes, and complex surgery, full process management must be performed. To this end, the "Draft for Soliciting Opinions" stipulates:

First, the medical insurance department should focus on a single conventional planting, clarify the regulatory goals of the entire process price, guide the centralized band procurement, standardize medical service price projects, and strengthen the regulation of the price control of oral planting medical services.

Second, for areas with a single process of a single conventional planting, targeted measures should be taken to import the price of the entire process to each new range that does not exceed the prescribed standards.

The third is to control the proportion of implants and crown in the entire process price at about 60%, and the proportion of inspection design is controlled at about 10%, highlighting the technical labor value of the entire implanted service.

The fourth is the areas where the implant implantation fee, crown plants, and bone planting costs are implemented in areas where government guidance management is implemented. While regulating price projects, the medical insurance department has re -developed and announced government guidance.

Fifth, for areas that implement the autonomous pricing of public medical institutions, the medical insurance department shall regulate the price of various medical institutions within the prescribed time of the implementation of new prices in accordance with the project price control target.

Sixth, the service price of oral dental implants in private medical institutions implements market regulation, followed the principles of pricing principles of fairness and legal, honesty, and quality price, and proactively publicized the price level in obvious areas.

Third, reduce costs, start with centralized procurement

The income of dental implants consumables will inevitably increase the use of procurement funds and reduce the cost of consumables, thereby reducing dental implanted medical services and high prices of consumables, and reducing the burden on the people's costs. The specific measures proposed by the "Draft for Soliciting Opinions" include:

The first is to form a procurement alliance. The provincial provinces should participate in the provincial provincial provincial procurement alliance led by the Sichuan Provincial Medical Security Bureau, and all provinces should participate. The centralized procurement is based on a complete set of implant systems, including implants, repair base platforms, and accessories covering screws, healing base platforms, metastasis rods, alternatives. The second is extensive organizational mobilization. Organize public medical institutions (including military medical institutions) to participate in centralized procurement of dental implant consumables, and mobilize private medical institutions to participate. Public medical institutions doctors practice multi -point practice in private medical institutions and as the person in charge or business backbone. The public medical institution shall urge them to regulate the participation in the collection. Medical institutions need to reply in writing or not to participate in this collection. For private medical institutions with high dental implants, high use of high -quality product usage, high economic advantages of oral planting expenses, and high -quality economy advantages, and the top evaluation rankings will display the price and expenses on the official website by the medical security bureaus. Provide patients with medical guidelines.

The third is to report truthfully and accurately. The provinces organize the province's participation in the collection of public and private medical institutions to fill in the procurement needs of dental implants. In principle, the demand for reporting shall not be lower than the actual procurement of the previous year. At the same time, the factors of dental implant demand are considered to ensure the accurate and reasonable reporting volume, and promote the better realization of volume replacement, and facilitate the selection of enterprises to ensure the supply. Differentiated price policies for public medical institutions that carry out dental implant services but refuse to report or report less than 80%of the previous year. In the region, the actual charges shall not exceed 80%of the government's guidance price; areas that implement autonomous pricing management shall not exceed 80%of the average level of autonomous pricing in public medical institutions in the region.

Fourth, achieve long -term, start with comprehensive governance

Oral planting medical services charges and consumable price special treatment work is a complex systematic project. It cannot be described as a battle. It must be based on determination, lasting war, long -lasting work, and effectiveness. To this end, the "Draft for Soliciting Opinions" proposes specific measures to implement comprehensive governance:

The first is to establish an abnormal warning system. Establish a price abnormal warning system for oral planting in the units and cities, and the price complaints report more, the pricing is significantly higher than the local average, refusal or negatively participate in dental implants, and various medical institutions. And publicly report on the official website of the local medical security bureau every quarter. During the year, the medical institutions that entered the warning list many times were reported by the provincial medical security department; if the circumstances were bad, the National Medical Security Bureau was uniformly exposed. For medical institutions that are included in the list of abnormal price warnings, supervision methods such as monitoring early warning, inquiry and interviews, reminders, warnings, cost investigation, information disclosure, and public exposure are used to promote the formation of good market order; Restrictions are taken in the aspects of adjusting medical services prices and accepting new medical service price projects.

The second is to carry out special price investigation and inspection. It is divided into three stages: 1. Special governance start -up phase. In accordance with the principles of "horizontal to the edge, vertical to the end, and full coverage", the investigation and registration of oral planting charges and medical services is fully carried out, laying a solid foundation for regulating projects and prices and implementing centralized band procurement. The illegal charging clues discovered during the investigation and registration period should be investigated and corrected in a timely manner; 2. The implementation stage of special governance. The medical security department focuses on monitoring work, closely pays attention to the implementation of the prices of oral planting medical services at all levels and various medical institutions at all levels, and the actual procurement of the prices of the medical services of the medical services and the implants, as well as the key points of dental implants, dental implants, and the average cost of patients' secondary expenses. The indicator changes to ensure the implementation of various governance measures, and the provincial medical security department forms a report to report to the National Medical Security Agency in a provincial unit; 3. The "look back" stage of price governance. The medical insurance departments in various places, in conjunction with relevant departments, are ranked among the high prices in the region, a lot of complaints and reports, and refusing to participate in dental implants or concealing reports. During the inspection process Violations and regulations such as false propaganda, as well as unreasonable and irregular examination and diagnosis and treatment behaviors in the process of providing oral planting medical services, and inform the industry authorities and administrative law enforcement departments in a timely manner.

Columnist | Cai Haiqing Jiangxi Provincial Medical Insurance Bureau Treatment Security Office, the former director of the Division, the original first -level investigator

Source | China Medical Insurance

Edit | Zhang Yanxuan Wu Yixiao

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