National Medical Insurance Bureau: adjust the price of medical services to ensure that the burden of the masses does not increase
2022-07-20
In order to do a good job in the price of medical services at this stage in a stable and orderly manner, strengthen the public welfare attribute of basic medical services, promote the innovative development of medical services, and ensure that the masses can obtain high-quality, efficient and affordable medical and health services, the National Medical Insurance Bureau recently issued the notice on further improving the price management of medical services (hereinafter referred to as the notice). The notice points out that we should strengthen the macro management and dynamic adjustment of medical service prices, unify the specific rules of the dynamic adjustment mechanism at the provincial level, clarify the starting conditions and constraints, improve the price adjustment procedures, rules and index system, and avoid going its own way. Make an assessment according to the set adjustment cycle and trigger mechanism. If the conditions are met, adjust the price of medical services in a timely manner within the scope of the total amount, actively and flexibly use the price tools of medical services, effectively support the high-quality development of public medical institutions, and ensure that the overall burden of people's medical expenses does not increase. The notice requires that we should fully listen to the professional opinions and suggestions of medical institutions and medical personnel, and give priority to the selection of items from the treatment, surgery and traditional Chinese medicine (referring to the items with the "classification and code of medical service items" codes of the National Medical Insurance Bureau 001201-001206, 003201-003206, 003301-003316, 004100-004300) whose prices have not been adjusted for a long time The price items dominated by the value of technical services (the part of technical services in the price composition accounts for more than 60%) are included in the scope of price adjustment. In principle, the number and amount of items dominated by the value of technical services in each price adjustment plan account for more than 60% of the total, which objectively reflects the value of technical services and prevents them from being bound by the falsely high price of equipment and materials. For medical service projects that are technically difficult, high-risk and really necessary, price differences can be appropriately reflected. In addition, for large-scale examination and treatment equipment donated by the society and purchased with government funds, when calculating the project pricing cost, equipment depreciation, investment return, repayment of principal and interest and other expenses should be deducted according to the principle of public welfare, and large-scale equipment examination and treatment projects should be actively included in the scope of dynamic adjustment to continuously reduce the high price. In terms of dealing with the relationship between the price of medical services and the centralized procurement of medicine, the notice clarifies that the price of medical services and the centralized procurement of pharmaceutical consumables have their own functional positioning, the trigger mechanism of price adjustment is not directly linked to the centralized procurement of pharmaceutical consumables, and the total amount of adjustment is not directly shifted. For projects that are deeply related to medical consumables and medical services, it is necessary to accurately analyze the specific impact of centralized procurement, classify and implement policies, and coordinate scientifically. Among them, if consumables are charged separately outside the medical service price items, and the falsely high prices are squeezed out by centralized procurement, the items with low relevant prices will be preferentially included in the dynamic adjustment range of prices, and special adjustments can be implemented when necessary; If consumables are incorporated into the medical service price items and are not charged separately, the price of medical service items shall be appropriately reduced according to the effect of centralized procurement on reducing material consumption costs, so as to release reform dividends to the masses. The national medical security work conference held at the beginning of this year stressed that in order to promote the high-quality development of medical insurance in combination with the central government's judgment on the situation and the requirements of people's livelihood, we should accurately grasp the connotation of common prosperity, gradually reduce the development imbalance between medical insurance regions, and solidly promote common prosperity. It is also required to straighten out the payment and compensation mechanism, do a solid job in deepening the pilot reform of medical service prices, carry out dynamic adjustment of drug catalogs, comprehensively deepen the reform of payment methods, and maximize the efficiency of medical security. (outlook new era)
Edit：sishi Responsible editor：xingyong
Source：http://www.people.com.cn/
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