The National Medical Insurance Bureau answered every question: More than 200 areas are promoting the reform of the payment method of hospitalization expenses

On July 22, the National Health and Health Commission held the eleventh session of the "All for the Health of the People's —— Our Ten Years" series, introducing the results of deepening the progress of medical reform since the 18th National Congress of the Communist Party of China.

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In terms of medical insurance payment, how to reform the money "spend on the blade" through payment? "Daily Economic News" reporter asked questions at the press conference: In recent years, what measures did the medical insurance department take on the reform of medical insurance payment methods?

Li Shuchun, deputy director of the Medical Management Department of the State Medical Insurance Bureau, said in a question from the reporter of "Daily Economic News" that deepening the reform of medical insurance payment methods is a major decision -making arrangement made by the Party Central Committee and the State Council. In 2017, the General Office of the State Council issued the "Guiding Opinions on Further Deepening the Reform of the Payment of Basic Medical Insurance".

"Deepening the reform of the medical insurance payment method is also the development of the medical insurance system itself, and the need to use practical medical insurance insured‘ life -saving money ’.” Li Shuchun emphasized.

At the same time, it was revealed that at present, more than 200 regions across the country are promoting the reform of the hospitalization expenses DRG (paid by the disease diagnosis)/DIP (paid by the diseased score) payment method.

Promote the reform of medical insurance payment methods

At this press conference, Mi Feng, a spokesman for the National Health and Health Commission and deputy director of the Propaganda Department, said that over the past ten years, my country has comprehensively promoted the five basic medical care of class diagnosis and treatment, modern hospital management, national medical insurance, drug supply guarantee, and comprehensive supervision. Sanitary system.

"There is a 15 -minute medical and health service circle around the people, and more experts have a consultation at the door of the house. The proportion of residents' personal hygiene expenditures has dropped from 34.34%in 2012 to 27.7%in 2021. , More efficient and smoother. "Mi Feng introduced.

Medical reform is a major people's livelihood project involving millions of households. Xu Shuqiang, director of the Reform Department of the State Health and Health Commission's System Reform, introduced to solve the two key and difficult problems of the difficulty of seeing a doctor and expensive medical treatment. Effective.

In terms of the reform of the medical insurance payment method, Li Shuchun said that in 2019, the National Medical Insurance Bureau carried out a pilot state pilot to pay the relevant groups in accordance with the diagnosis of disease diagnosis, that is, the CHS-DRG paid pilot.

In 2020, my country launched the total budget of the regional point method in 71 cities and paid pilots based on the type of disease, that is, the DIP payment pilot.

At the end of 2021, all 101 cities have entered the actual payment stage. While the national organization paid the pilot, relevant provinces also promoted the provincial pilot.

In 2022, my country launched the three -year action plan of DRG/DIP payment method reform, focusing on the four aspects of "grasping the expansion, building mechanism, laying the foundation, and pushing coordination". Full coverage.

"At present, more than 200 regions across the country are promoting the reform of the DRG/DIP payment method of hospitalization expenses. From the perspective of the progress of reform, some pilot areas have indeed produced the level of personal medical expenses in the insurance. The effect of improved service capabilities has initially achieved the goal of patients' benefits, sustainable medical insurance funds, and development of medical institutions. "Li Shuchun emphasized.

Regarding the next deployment of medical insurance payment reform, Li Shuchun said that the National Medical Insurance Bureau will continue to promote the reform of medical insurance payment methods, monitor the effectiveness of the reform of payment methods, truly play the role of "beef nose" in medical insurance payment, and promote the high -quality development of medical insurance.

Ji Cai has saved 300 billion yuan

In terms of solving the key issues of the masses, Xu Shuqiang introduced that since the 18th National Congress of the Communist Party of China, the problems of valuables for seeking medical treatment have been reduced. "In 2020 and 2021, the proportion of personal expenditure in total health expenses for two consecutive years dropped to 27.7%."

Pharmaceutical collection has played an important role in solving the problem of the people's precious problems. Li Shuchun said that since 2018, the State Medical Insurance Administration, together with relevant departments, purchases with quantity procure expand.

The first is to promote the collection of seven batches of national organizational drugs, covering a total of 294 medicines, most of which are commonly used for common diseases and chronic diseases, which involve 35%of the amount of chemical drugs and biopharmaceutical procurement in public medical institutions.

The second is to focus on the collection of high -value medical consumables in the Department of Cardiology and Orthopedics. The collection of cardiac stents has been running steadily for a year and a half. The selection results in the collection of artificial joints have been successfully implemented in various places, and the supply of products selected in China is generally stable.

The third is to actively promote the procurement of provincial and inter -provincial alliances, involving three major areas: chemical, biopharmaceuticals, and proprietary Chinese medicine. At present, the collection of coronary ball pockets and artificial crystals has covered all provinces, drug balloon and orthopedic trauma consumables, and so on have been included in the collection of most provinces, forming a normalized recruitment pattern of upper and lower linkage and coordinated promotion.

"From the perspective of reform, the collection has strongly promoted the reasonable level of the price return of drugs and consumables. The average price reduction of the national organizational drugs exceeded 50%, the average price reduction of cardiac stents and artificial joints exceeded 80%.At about 300 billion yuan. While the price reduction, the collection of promises with the amount of consumption was redeemed.Improve. "Li Shuchun emphasized.Daily Economic News

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