How to set the price of "Internet plus" medical services? Response from medical insurance department

2024-03-06

The reporter learned from the National Health Insurance Bureau that the National Health Insurance Bureau attaches great importance to the innovative development of "Internet plus" medical services. At present, all provinces in the country have issued the "Internet+" medical service price policy documents. The "Internet plus" medical services, such as remote consultation, pregnancy diagnosis, re diagnosis of some common diseases and chronic diseases, have played an important role in solving the normal medical treatment and drug use of people. "Internet plus" medical service is an important measure to improve the unbalanced supply of medical resources, promote the preference of high-quality medical resources to the grass-roots level, and solve the problem of people's difficulty in seeing doctors. At present, the Internet diagnosis and treatment only opens the re diagnosis service, which is mainly to prescribe medicine for patients with relatively stable conditions such as common diseases and chronic diseases, and the corresponding charges are subject to the price of ordinary outpatient diagnosis and treatment. For example, in the future, the competent department of the industry will expand the scope of Internet diagnosis and treatment from the second visit to the first visit and pharmacy clinic. In accordance with the principle of consistency between online and offline, the medical insurance department will timely implement the policy of differentiated pricing of medical personnel levels for the first visit and the charging of "Internet plus pharmacy clinic". In addition, "Internet plus nursing service" mainly means that the hospital sends nurses to provide medical services on site through Internet booking. For this, the medical insurance department has deployed all regions to speed up the improvement of the price policy of on-site medical services, and adopts the "medical service price+on-site service fee" method to collect fees, of which medical services, drugs and medical consumables are subject to the medical price policy implemented by the medical institution, The on-site service fee can be determined independently by public medical institutions. It is understood that "Internet+" medical services are included in the scope of fixed-point protocol management. Under the framework of the relevant regulations of the health and traditional Chinese medicine management departments at or above the provincial level, medical institutions that carry out "Internet plus" medical services can voluntarily apply to the medical insurance agencies in the areas where they are in charge of overall planning to sign the "Internet+" supplementary medical insurance agreement for medical services through the physical medical institutions they rely on. By the end of May 2023, among the designated medical institutions in Zhejiang Province, there are 148 Internet hospitals that can provide online medical insurance settlement, and there are 74 designated medical institutions in Beijing that can carry out Internet medical insurance payment for diagnosis and treatment. In addition, the National Health Insurance Bureau has instructed local governments to rely on the national unified medical security information platform to realize the "Internet plus+medical insurance" service functions such as medical insurance mobile payment. As of now, all provincial medical insurance departments across the country have launched the promotion of medical insurance mobile payment applications, and have the ability to interconnect medical insurance information systems with designated medical institution information systems, meeting the needs of insured people to complete online medical insurance settlement through multiple channels. Designated medical institutions can also use medical insurance comprehensive service terminals that comply with medical insurance technical specifications to verify the identity of personnel through various methods such as facial recognition for medical insurance settlement. At the same time, the National Medical Insurance Administration, guided by the needs of the masses, continues to enrich data application scenarios, deeply explore the value of data, provide data support for the formulation and adjustment of policies to combat fraud and insurance benefits, continuously deepen data applications in payment methods, remote medical treatment, drug consumption procurement, intelligent supervision, and other aspects, and continuously promote data empowerment of medical insurance management, medical insurance services, and medical insurance reform. Next, the National Medical Insurance Administration will continue to expand the access range of medical insurance mobile payments and improve the settlement rate of medical insurance mobile payments; Further standardize the data to

Edit:GuoGuo    Responsible editor:FangZhiYou

Source:cctv.com

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