The first round of medical service price adjustment will be implemented

The "Pilot Program for Deepening the Price Reform of the Medical Service" formulated by the Eight Departments of the National Medical Insurance Bureau has been issued for a year, and five cities will successively implement the first round of medical service price adjustment.

From the perspective of the implementation of pilot cities such as Suzhou and Ganzhou, the establishment of total control, classification pricing, dynamic adjustment and other mechanisms are the main content of the first round of medical service price adjustment.

At the same time, the price adjustment of medical services will be associated with the comprehensive reform of public hospitals, standardize the diagnosis and treatment of public medical institutions and medical staff, and reasonably determine the salary level of public hospitals.

Tuyuan National Medical Insurance Bureau official website

Zhang Xiao, director of the Medical Insurance and Social Security Research Center of Southeast University, said that the reform of the price of medical services has been carried out in recent years, but the past reform has not responded to how the doctors' labor value is determined. Doctors' labor value is the core cost in medical services. In the new round of medical service price adjustment, the enthusiasm of medical personnel to participate in reform should be mobilized by emphasizing technical labor services and reducing the resistance of reform.

Recently, the National Medical Insurance Bureau said in response to the suggestions of the people's congress representatives that the National Medical Insurance Administration has further proposed that the price adjustment of medical services should highlight the support of technical labor value. In the next step, the National Medical Insurance Administration will continue to guide localities to implement the dynamic adjustment mechanism of medical services. While taking into account the burden of patient costs, it will better reflect the value of technical labor.

The first round of medical service price adjustment is ready

In May 2021, the 19th meeting of the Central Committee of the Central Committee for Comprehensive Deepening the Reform Commission reviewed and approved the "Pilot Program for Deepening the Price Reform of Medical Services"; on August 31, 2021, the National Medical Insurance Administration and other eight departments issued the "Pilot Program for Deepening the Price Reform of Medical Services" It is clear that through the pilot of 3 to 5 years, the exploration can form the experience reform experience of copyable medical services; in November 2021, five cities in Ganzhou, Suzhou, Xiamen, Tangshan, and Leshan became pilot cities.

The State Council has listed the reform of medical services price reform in the "Key Work Tasks of Deepening the Reform of the Medical and Health System in 2022". The task is clear that the provinces will be issued before the end of June 2022 to establish a dynamic adjustment mechanism for medical service price adjustment mechanisms, and the medical service price will be transferred out of the cost supervision and price hearing catalog before the end of the year.

On July 1st this year, the National Deepening Pilot Price Reform Pilot Promotion Association was held in Xiamen City to deploy and promote the adjustment of the first round of medical service price adjustment, which marked that the national deepening medical service price reform pilot has officially entered the implementation stage. The National Medical Insurance Bureau requires that pilot cities to grasp the key links and basic requirements of the implementation stage of the reform pilot, and carefully organize the implementation of the first round of price adjustment.

● Leshan City formulated a pilot implementation plan for deepening medical service price reform at the end of 2021, and clarified that the operating rules and substantial initial price adjustment work was clearly determined in the first quarter of 2022, and the implementation of the second quarter was implemented;

● Pilot cities such as Suzhou and Ganzhou have also announced specific implementation plans in the first half of this year;

● Xiamen has formulated four mechanism operation rules and related supporting policies. At present, all preparations are ready;

● Early reporting, review, and research of Tangshan medical service price reform have been completed, and subsequent work is being promoted.

The price of medical services refers to the charging standards of medical service items for patients' services, including outpatient clinics, hospitalization, and various examinations, treatment, inspection, and surgical items. The price of medical services is an important livelihood price, involving 1.4 billion people, 7.87 million medical personnel, more than 50,000 medical institutions, and the size of trillions of benefits per year.

The relevant person in charge of the National Medical Insurance Bureau stated at the beginning of the reform last year that the price of medical services involved in the profound adjustment of various interests. Deepening the price reform of medical services is not simply pricing price adjustment, not unilateral price increases instead of reform. In order to enable the price trend to be associated with the performance indicators of medical control costs and cost reduction, there are pressures, pressure, rise and lower.

There are some growth requirements for medical care for medical care

A few days ago, the National Medical Security Bureau once again emphasized the four main contents of medical service price reforms on the response of the Fifth Session of the 13th National People's Congress No. 2195. One is to strengthen the macro management of prices, and the other is to classify and form medical services. The third is to dynamically adjust the price of medical services, and the fourth is to standardize the management of medical service price projects.

Industry insiders believe that because the price of medical services involves people's livelihood, it has been emphasized in the past, but the new medical price reform has a certain growth requirement for the medical and health undertakings itself, so that the development of price macro management and the development of medical undertakings, social affordability of social affordability, Wait for macro factors to match. Suzhou's plan proposes that a natural year is used as a price adjustment cycle, and the total income of medical services in public medical institutions in the region is based on the number of medical services (excluding drugs and sanitation materials) as the base, and scientifically sets the growth coefficient.

The Ganzhou Plan proposes that during the pilot period, the city's public medical institutions in 2021 (excluding medical income including drugs, consumables, inspections, and testing income) are used as historical bases. The total amount is controlled at the level of 10%of the historical base. The plan of Ganzhou also mentioned that changing the practice of reducing the price of drugs and consumables as the source of the total source of the medical service price, eliminating the "seesaw" relationship between the price of medical services and the reduction of drug consumables, and the prices of drugs and consumables reduced dividends to patients first towards patients. Transmission. Highlighting technical labor value

my country has not yet formed the pricing mechanism of medical service projects centered on technical labor value, risk, and technical difficulty. After the cancellation of drug additional income, the operating income of public hospitals has been impacted. The price is seriously deviated from the cost of project and the value of technical personnel.

This is why the adjustment of medical prices is very sensitive, but it is also "unmotivated". Zhang Xiao said that the price of medical services is led by the government, reflecting the government's responsibility. With the increasing medical and health expenses and the increasing investment in medical insurance, there are structural problems in medical prices. What the government needs to do is regulate the structure. One of the important directions is to emphasize technical labor, that is, to improve the treatment of doctors. In mid -July, the State Medical Insurance Bureau issued the "Notice on Further Doing a Better Management of Medical Services", which particularly emphasized that the adjustment of medical services price adjustment should highlight the support of technical labor value.

The notice proposes that it is necessary to fully listen to the professional opinions and suggestions of medical institutions and medical personnel, and choose priority to select the price from the treatment, surgery and traditional Chinese medicine for a long time, and the value of technical labor services (the price of the technical labor part of the price composition is 60%. The above) price items are included in the scope of price adjustment, and the amount and amount of projects based on the value of technical labor in each price adjustment plan accounted for more than 60%of the total amount. Objectively reflect the value of technical labor, prevent the equipment from being consumed by the equipment, and the price bundled with high price binding. Essence The pilot plans of the eight departments and the implementation plans of Suzhou, Ganzhou and other places have clearly stated that the comprehensive reform of public hospitals must be deepened and the diagnosis and treatment of public medical institutions and medical staff should be standardized. Reasonably determine the salary level of public hospitals, reform and improve the assessment and evaluation mechanism, realize the transparency of the salary of medical staff. It is strictly forbidden to issue income innovation indicators. The salary of medical staff shall not directly linked to the department and personal business income.

Source: First Finance

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