Health insurance is about to be "expanded", will affect all pharmaceutical companies!

"Pharmaceutical Network Industry Dynamics" August 26, the State Health Insurance Administration issued "on the establishment of a sound basic medical insurance outpatient co-insurance mechanism guidance (draft for comments)" for public comments.
Among them, it is worth noting that the opinion draft focuses on the need to include outpatient medical expenses in the scope of payment of the basic medical insurance co-ordination fund, the proportion is not less than 50%;
it is understood that the composition of the current employee health insurance personal account for individual contributions are fully included, while 30% of unit contributions are also included.
the implementation of outpatient help, the establishment of outpatient reimbursement mechanism, the industry believes that this means that the health care funds will usher in a large "expansion."
is the size of the house? According to the data, in 2019, the income of the Workers' Health Insurance Fund (including maternity insurance) was 1584.5 billion yuan, an increase of 10.7% over the previous year.
, in 2019, the income of the Workers' Health Insurance Co-ordination Fund (including maternity insurance) was 100.5 billion yuan, an increase of 10.9% over the previous year, and the income from the personal accounts of workers' medical insurance was 584 billion yuan, an increase of 10.3% over the previous year.
based on 2019 data, it will bring about 430 billion yuan in incremental funds to the health insurance co-ordination account, assuming that at a growth rate of 10% year-on-year, the increase in health care funds from the reform will reach 520 billion yuan starting in 2021.
In addition, in the past outpatient reimbursement has a limit of 1800 yuan, the proportion of this general outpatient reimbursement from 50%, another account relatives available, will further activate the medical insurance balance of the individual account funds, two parts of the account will directly stimulate the growth of outpatient medication, so this expansion, is the expansion of the industry.
because the general clinic involves a wide variety of drugs, all pharmaceutical companies should pay more attention to this "expansion".
, the state's reform of the basic health insurance system bodes well.
June 4, 2019, the State issued the "Key Tasks for Deepening the Reform of the Medical and Health System 2019", which mentions the need to "develop a policy document to improve the personal accounts of workers' health insurance."
February 25 this year, the state issued the Opinions on Deepening the Reform of the Health Care System, which also explicitly mentioned the need to improve the basic medical insurance system.
to unify the basic medical insurance co-ordination level, medical insurance directory, regulate the medical insurance payment policy to determine the method.
to gradually incorporate outpatient medical expenses into the scope of payment of the basic medical insurance co-ordination fund, reform the individual accounts of basic medical insurance for employees, and establish and improve the mechanism for the protection of outpatient assistance.
, the release of this draft of the opinion is proof that the reform of the health care system is only when it is carried out, not when it is not completed.
with economic and social development, economic growth and financial subsidies to the nourishment of health insurance will increase, the health insurance fund will continue to strengthen the ability to protect, the future proportion of general outpatient expenses medical insurance reimbursement should continue to increase.
this will have a profound impact on the drug market in public medical institutions, primary medical institutions and retail pharmacies.