Health Insurance Bureau: Cross the hospital directly and arms enterprise settlement

Antable repayment problem NO.1direct and supplies production and operation enterprises balancerecently, the Shenzhen Municipal Health Insurance Bureau issued the "Shenzhen Municipal Governance of High-value medical supplies reform implementation plan" (hereinafter referred to as the "Reform Program").The Reform Programme clearly calls for strengthening centralized settlement management. In accordance with the principles of unity, standardization and efficiency, the establishment of a centralized settlement mechanism for transaction funds, the establishment of a centralized settlement supervision account in Shenzhen Sunshine Platform, to achieve the full process of supervision of transaction behavior.Explore the medical insurance fund through centralized settlement supervision account directly with medical supplies production and operation enterprises to settle.It is understood that recently, the Guangdong Provincial Health Insurance Bureau also issued the "<> public consultation public consultation", made it clear that the payment settlement mechanism should be reformed.The above-mentioned draft for comments shows that the settlement of purchase prices should be strengthened, medical institutions should be prepaid in advance in accordance with not less than 30% of the purchase amount, and the medical insurance fund should be actively promoted to settle the purchase price directly with pharmaceutical production enterprises or circulation enterprises, so as to enhance the efficiency of repayment.In addition, on March 5, the State Council issued the Opinions of the State Council of the CPC Central Committee on Deepening the Reform of the Medical Security System, which also made it clear that the direct settlement of medical insurance funds and pharmaceutical enterprises should be promoted, and the coordination mechanism between medical insurance payment standards and centralized procurement prices should be improved.Industry analysis, this is the health insurance to improve the efficiency of medical institutions checkout, medical institutions will lose the right to settle payments directly with enterprises.Improving the efficiency of the closing of arms enterprises, is conducive to improving the enthusiasm of enterprises to participate in the procurement of volume, because the purchase price of the volume is low, so the gross margin of enterprises is also particularly low, coupled with six months or even a year or two before the return, enterprises will generate a large number of financial costs, pressure is great, is not conducive to the further development of the procurement of volume.

NO.2

a number of supplies, focus on governancein addition to the closing matters, Shenzhen's above-mentioned "reform plan" also requires a clear focus on the scope of governance. Referring to the national and Guangdong Province medical supplies key management list, to carry out a baseline survey of the use of medical supplies in public medical institutions,will directly act on the human body, have strict requirements for safety, clinical use of large, relatively high prices, the masses of heavy cost burden of medical supplies into the high-value medical supplies management scope, unit price and resource consumption accounted for a relatively high proportion of high-value medical supplies into the key governance list.On January 14 this year, the State Health And Wellness Commission Medical administration issued the Notice of the General Office of the National Health and Health Commission on the Issuance of the First Batch of National High-Value Medical Supplies Key Governance List, and published the National High-Value Supplies Governance List.At the same time, it is required that the provincial health administrative departments, on the basis of the list, appropriately increase the variety according to the actual situation in each locality, form the provincial list, and guide the medical institutions within the jurisdiction to formulate the list of medical institutions.Local health administrative departments at all levels and all types of medical institutions at all levels should strictly implement the relevant requirements of the Measures for the Administration of Medical Supplies for Medical Institutions (Trial), strengthen the management of medical supplies, and do a good job in accordance with the requirements for the reform of high-value medical supplies. As early as July 31, 2019, the State Council issued the "Reform Program for the Management of High-Value Medical Supplies", which explicitly calls for strengthening the standardized management of high-value medical supplies, clarifying the scope of governance, and using high-value medical supplies, which account for a relatively high proportion of unit price and resource consumption, as the key governance object. In addition, on November 18, 2019, the official website of the State Council issued the Notice of the Leading Group of the State Council on Deepening the Reform of the Medical and Health System on Further Promoting the Experience of deepening the reform of the Medical and Health System in Fujian Province and Sanming City, which also made it clear that in 2020 all regions should strengthen the management of the use of consumables in accordance with the list of key management of high-value medical supplies formulated by the State and the relevant work requirements. At the same time, it was emphasized that the 11 pilot provinces of comprehensive medical reform should ensure the achievement of phased results. (Cypress Blue Equipment)