Recently, the National Medical Insurance Bureau issued the notice on printing and distributing the three-year action plan for DRG / Dip payment reform (hereinafter referred to as the notice). The notice proposes to fully complete the task of DRG / Dip payment reform from 2022 to 2024, promote the high-quality development of medical insurance, promote the supply side structural reform, and safeguard the rights and interests of the insured. Implement step by step and start the reform of DRG / Dip payment method Although the traditional medical insurance payment by project has the advantages of clear cost and easy operation, it is easy to form waste because it only pays for the elements of treating diseases rather than the "results". In 2019, China began to pilot two new payment modes: group payment for disease diagnosis (DRG) and payment by disease score (DIP). DRG payment is to divide patients into diagnosis related groups with similar clinical symptoms and resource consumption according to their disease type, disease severity, treatment methods and other factors. By formulating payment standards, the hospital is forced to reduce the costs of drugs, consumables and inspection, compress the water in treatment, and realize the retention of balance and reasonable sharing of overspending. While the management is more efficient, it also allows patients to avoid unnecessary medical expenses. Dip payment is an original creation in China, which combines the point method, total budget, payment by disease score and other methods, in order to expand the coverage of diseases, improve the refinement level of management, and effectively control the fund risk. In 2019 and 2020, the National Medical Insurance Bureau successively launched chs-drg pilot reform and dip pilot reform. So far, 30 DRG payment pilot cities and 71 dip payment pilot cities have completed the cross assessment and entered the actual payment stage. According to the unified deployment, all DRG and dip payment reform pilot areas will carry out the actual payment before the end of this year. The notice specifies that by the end of 2024, all overall planning areas in China will carry out DRG / Dip payment method reform, start pilot areas in advance, and constantly consolidate the reform achievements; By the end of 2025, DRG / Dip payment will cover all qualified medical institutions carrying out inpatient services, and basically realize the full coverage of diseases and medical insurance funds. Promote the tripartite win-win of medical insurance patients As DRG / Dip payment is implemented and blossomed in many parts of the country, the reform of "three medical" linkage with medical insurance as a lever is also under way. Zhejiang Province incorporated the provincial, whole population and full caliber hospitalization expenses into the DRG payment reform, gradually reduced the impact of historical expenses on the payment standard, converted the amount of hospitalization services provided by each hospital into corresponding points, and used points as the measurement standard to participate in the distribution of medical insurance funds in the overall planning area in the current year, which effectively mobilized the enthusiasm of medical institutions, Promoted the implementation of mutual recognition of inspection results in the province. Since 2018, Guangdong Province has fully implemented dip payment, established a unified disease score database and payment system evaluation organization, formulated grass-roots diseases, carried out characteristic treatment of traditional Chinese medicine and reform of payment mode of medical community, and continuously improved the payment mechanism. Shandong Province, Jiangsu Province and Henan Province have achieved full coverage of DRG or dip in prefecture level cities. Wuhan, Hubei Province is one of the first batch of pilot cities. All designated medical institutions at or above the second level in the city have been included in the pilot, and the coverage and reform depth have been continuously promoted. After DRG / Dip payment is fully implemented, how can medical institutions empower management and take advantage of development? Shanghai Tenth People's hospital is a dip payment pilot hospital. Through the phased pilot, a set of rapid feedback mechanism and cost control model have been established to make the allocation of medical resources more scientific and reasonable. Qin Huanlong, President of Shanghai Tenth People's Hospital, said that DRG / Dip payment emphasizes the connotation of hospital fine management. As a manager, we should comprehensively consider the core indicators of dip and establish a hospital wide medical insurance budget model; Analyze the grouping data of medical records in real time to realize the rapid identification, feedback and application of new technologies and projects; Adjust the proportion of total index in low, medium and high disease group and optimize the structure of total index; Build a cost management model, establish the corresponding relationship between clinical pathway and disease weight, and standardize medical behavior with high-quality clinical pathway; CMI and other indicators will be introduced into the assessment index system to urge the clinical to improve the diagnosis and treatment ability and service level. Ying Yazhen, vice president of the National Medical Security Research Institute and vice president of the China Medical Insurance Research Association, believes that the implementation of DRG / Dip payment will effectively change the disadvantages of passive payment of medical insurance, extensive development of hospitals and heavy burden on patients for a long time. It is a win-win and mutually beneficial reform for medical insurance patients. According to Ying Yazhen's analysis, for hospitals and doctors, DRG / Dip payment will turn part of inspection and drug consumables from income to cost, which will encourage hospitals and doctors to consciously and actively standardize medical services, control costs and reduce resource waste. On the other hand, it will also guide medical institutions to improve disease diagnosis and treatment capacity and attract patients to the hospital with high-quality service and technical level. For insured patients, by setting different weights (scores) and coefficients, the hospital can get reasonable returns for the treatment of difficult and miscellaneous diseases and critical and severe diseases. Common and frequently occurring diseases can be diagnosed and treated in grass-roots medical institutions. The cost of seeing a doctor is less, and the personal burden is reduced. Moreover, Ying Yazhen said that for medical insurance, DRG / Dip payment is more scientific, standardized and can better optimize medical services. We can use the limited medical insurance fund to buy higher quality services for the insured, improve the use efficiency of medical insurance fund, and help to promote the high-quality development of medical insurance. (outlook new era)