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    Home > Active Ingredient News > Drugs Articles > Health care payment reform, the latest development

    Health care payment reform, the latest development

    • Last Update: 2021-03-22
    • Source: Internet
    • Author: User
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    544px;'>544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;overflow-wrap:break-word ;'>38,《2020》。,:38,《2020》。,:

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    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> “,30DRG,30,;71DIP。”

    “,30DRG,30,;71DIP。”544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;overflow-wrap:break-word ;'>544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;overflow-wrap:break-word ;'>,DRG,DIP。,DRG,DIP。544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;overflow-wrap:break-word ;'>

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> As early as May 2019, the National Medical Insurance Administration announced a list of 30 DRG-paying national pilot cities, and then released 376 ADRG groups and 618 DRG sub-groups in October 2019 and June 2020, respectively, to further promote DRG Payment reform.


    Judging from the current progress , all 30 pilot cities have passed the pre-simulation evaluation and entered the simulation operation stage .
    It is expected that all pilot cities will enter the actual payment stage in 2021.

    As early as May 2019, the National Medical Insurance Administration announced a list of 30 DRG-paying national pilot cities, and then released 376 ADRG groups and 618 DRG sub-groups in October 2019 and June 2020, respectively, to further promote DRG Payment reform.
    Judging from the current progress , all 30 pilot cities have passed the pre-simulation evaluation and entered the simulation operation stage .
    It is expected that all pilot cities will enter the actual payment stage in 2021.

    544px;text-align:justify;white-space:normal;font-family:-apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif;background-color:#FFFFFF;box-sizing:border-box ;'>

     

    544px;white-space:normal;font-family:-apple-system, system-ui, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif;background-color:#FFFFFF;text-align:center;box-sizing:border-box ;'>

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;overflow-wrap:break-word ;'>544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;overflow-wrap:break-word ;'>On November 4, 2020, the National Medical Insurance Administration website announced the "Notice of the Office of the National Medical Security Administration on Printing and Distributing the List of Pilot Cities for Regional Point Method Total Budget and Dice-based Payment", and 71 cities in 27 provinces (municipalities directly under the Central Government) are included in DIP The paid pilots are:On November 4, 2020, the National Medical Insurance Administration website announced the "Notice of the Office of the National Medical Security Administration on Printing and Distributing the List of Pilot Cities for Regional Point Method Total Budget and Dice-based Payment", and 71 cities in 27 provinces (municipalities directly under the Central Government) are included in DIP The paid pilots are:544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;overflow-wrap:break-word ;'>

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Tianjin, Shanghai,

    Tianjin, Shanghai,

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Hebei Province: Xingtai City, Tangshan City, Langfang City, Baoding City 

    Hebei Province: Xingtai City, Tangshan City, Langfang City, Baoding City 

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Shanxi Province: Yangquan City 

    Shanxi Province: Yangquan City 

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Inner Mongolia Autonomous Region: Ordos City, Chifeng City, Hulunbuir City 

    Inner Mongolia Autonomous Region: Ordos City, Chifeng City, Hulunbuir City 

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Liaoning Province: Fushun City Yingkou City 

    Liaoning Province: Fushun City Yingkou City 

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Jilin Province: Liaoyuan City   

    Jilin Province: Liaoyuan City   

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Heilongjiang Province: Jiamusi City, Yichun City, Hegang City 

    Heilongjiang Province: Jiamusi City, Yichun City, Hegang City 

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Jiangsu Province: Huai'an City, Zhenjiang City, Suqian City 

    Jiangsu Province: Huai'an City, Zhenjiang City, Suqian City 

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Anhui Province: Suzhou City, Huainan City, Wuhu City, Fuyang City, Xuancheng City, Huangshan City 

    Anhui Province: Suzhou City, Huainan City, Wuhu City, Fuyang City, Xuancheng City, Huangshan City 

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Fujian Province: Xiamen City, Ningde City, Putian City, Longyan City 

    Fujian Province: Xiamen City, Ningde City, Putian City, Longyan City 

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Jiangxi Province: Ganzhou City, Yichun City, Yingtan City 

    Jiangxi Province: Ganzhou City, Yichun City, Yingtan City 

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Shandong Province: Dongying City, Zibo City, Weifang City, Dezhou City, Jining City, Tai'an City, Binzhou City  

    Shandong Province: Dongying City, Zibo City, Weifang City, Dezhou City, Jining City, Tai'an City, Binzhou City  

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Henan Province: Jiaozuo City and Shangqiu City 

    Henan Province: Jiaozuo City and Shangqiu City 

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Hubei Province: Yichang City and Jingzhou City 

    Hubei Province: Yichang City and Jingzhou City 

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Hunan Province: Changde City, Yiyang City, Shaoyang City 

    Hunan Province: Changde City, Yiyang City, Shaoyang City 

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Guangdong Province: Guangzhou City, Shantou City, Zhuhai City, Shenzhen City, Heyuan City 

    Guangdong Province: Guangzhou City, Shantou City, Zhuhai City, Shenzhen City, Heyuan City 

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Hainan Province: Sanya City 

    Hainan Province: Sanya City 

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Sichuan Province: Luzhou City, Deyang City, Nanchong City 

    Sichuan Province: Luzhou City, Deyang City, Nanchong City 

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Guizhou Province: Zunyi City, Bijie City, Qiannan Autonomous Prefecture 

    Guizhou Province: Zunyi City, Bijie City, Qiannan Autonomous Prefecture 

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Yunnan Province: Wenshan Prefecture Zhaotong City   

    Yunnan Province: Wenshan Prefecture Zhaotong City   

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Tibet Autonomous Region: Lhasa City Xigaze City 

    Tibet Autonomous Region: Lhasa City Xigaze City 

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Shaanxi Province: Hancheng 

    Shaanxi Province: Hancheng 

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Gansu Province: Dingxi City, Wuwei City, Longnan City  

    Gansu Province: Dingxi City, Wuwei City, Longnan City  

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Qinghai Province: Haidong City 

    Qinghai Province: Haidong City 

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Ningxia Hui Autonomous Region: Shizuishan City, Guyuan City 

    Ningxia Hui Autonomous Region: Shizuishan City, Guyuan City 

    544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;'> Xinjiang Uygur Autonomous Region: Aksu Region Hami City

    Xinjiang Uygur Autonomous Region: Aksu Region Hami City544px;text-align:justify;white-space:normal;background-color:#FFFFFF;box-sizing:border-box ;overflow-wrap:break-word ;'>
    The above list is determined based on voluntary declarations made by the provincial (regional, municipal) medical security bureaus.


    The National Medical Insurance Bureau requires relevant provincial medical insurance bureaus to strengthen guidance, supervise the pilot city medical insurance bureaus to strengthen organization and leadership, clarify the division of responsibilities, and fully implement the pilot tasks And requirements to ensure tangible results.
    By the end of 2021, all pilot areas will enter the actual payment stage.


    DRG (Diagnosis Related Groups), namely disease diagnosis related groups.
    In the 1970s, as medical expenses continued to rise, it put greater pressure on medical insurance units.
    DRG was first introduced by the United States as a means of payment management.



    DIP (Big Data Diagnosis-Intervention Packet), that is, diseases based on big data.
    Use the complete management system established by the advantages of big data, explore the common characteristics of "disease diagnosis + treatment" to objectively classify medical record data, and form a standardized combination of each disease and treatment method in the full sample case data in a certain area Positioning, which objectively reflects the severity of the disease, the complex state of treatment, the level of resource consumption, and the norms of clinical behavior.



    Whether it is DRG or DIP, the reform of the medical insurance payment system is undoubtedly a profound revolution and reform, which has an impact on the behavior and thinking of the government, medical insurance, hospitals, and patients.



    Under the supervision and guidance of the National Medical Insurance Administration at an extraordinary speed, DRG and DIP payments have become the general trend, requiring public hospitals to transform from scale expansion to connotation construction, and from extensive operation to intensive operation.



    A pharmacy expert told Cyberlan that DRG payment and DIP payment will be more strict and effective cost control methods than policies such as controlling the proportion of drugs and restricting auxiliary drugs.



    It is also very important for pharmaceutical companies to understand DRG and DIP.
    For example, in the usual department promotion meetings, pharmaceutical companies should know how to capture the attention of customers.
    Representatives of traditional medicine only introduce the information on how to use our products.
    The future medical promoters must understand the relevant terms of DRG, learn to interact with doctors, combine the evaluation indicators of DRGs, and embed the information they want to convey.
    It can be seen that it is a very important task for pharmaceutical companies to ensure that the company's products enter the standard treatment procedures for disease group treatment.
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