Internet health care: The trend in hospital scenarios after medicare is included

With the inclusion of Internet medical insurance reimbursement, the development of the market has entered a new stage.
, since all Medicare reimbursements are based entirely on offline health insurance, the impact of health insurance on Internet health care still requires an observation of the actual number and cost of hospitals.
, with the real needs of users and the disclosure of actual costs, the future trend of the market will be clarified to a certain extent.
, because the sample size is still low, the status quo does not fully represent the overall trend of the future, still need to be observed.
According to Health Insurance Letter (2020) No. 182: "As of the end of June this year, 12 medical institutions in Shanghai have realized real-time online settlement of medical insurance, with more than 178,000 settlements, involving a total cost of 2.5982 million yuan."
As of July 13, 15 hospitals in Beijing's 6 districts had interfaced with the health insurance information system, and a total of 5,122 people had received medical treatment through the Internet, with a total cost of 1.686 million yuan, of which 970,000 yuan was paid for medical insurance.
, according to this set of data, there were not many users of the online real-time billing of health insurance that was launched during the outbreak.
assumes that this is only a month's worth, meaning that in Shanghai, the average daily number of online visits per hospital is close to 50.
Beijing, the average daily number of visits is close to 12.
from the opening of medical institutions distribution, one, two, three hospitals have, comprehensive and specialized hospitals are also covered.
but the user's enthusiasm is not very high, the average daily outpatient volume online is less than 1% offline.
this aspect is that offline outpatient clinics are quickly restored, patients have returned to the line, on the other hand is also the practice of medical treatment.
From the small samples of these two cities, the frequency of Internet medical use in hospitals is still very low, although this is related to the user's medical habits, but the number of patients is generally slow patients, while the slow patient group is mainly the elderly, the use of Internet medical technology obstruction and willingness are larger factors.
, even if the re-diagnosis is the majority of the need for examination, this can not be done online.
, the proportion of general visits to hospitals on the whole line will not rise rapidly.
addition, the re-diagnosis is based on prescription, considering that most hospitals are currently on-line consultation or free-based, medical institutions initiated the average cost of Internet medical treatment has not been low.
statistics released by the Health and Safety Commission, the average cost of outpatient visits in Shanghai in 2019 was 404.6 yuan, of which 172.7 yuan was 172.7 yuan for medicines and 55.8 yuan for examinations.
the average outpatient fee in Beijing is 561.4 yuan, of which 258.2 yuan for medicine and 59.7 yuan for examination.
because the medical institution initiated online consultation costs are low or directly free, online also does not involve any examination and specific treatment, can be considered on-line average cost is mainly the cost of drugs.
from publicly disclosed data, the average cost of an online consultation initiated at a hospital is 145.97 yuan in Shanghai and 329.17 yuan in Beijing.
If compared with offline consultation, Shanghai's online drug average cost is very close to offline, but Beijing's online cost is significantly higher than offline, which shows that Beijing's online consultation department issued the number of drugs or drug prices may be higher than offline.
In the original self-financing state, pure third-party Internet medical platform's average drug expenditure of 60 yuan, compared with the positive driving force of medical insurance on the average drug expenditure is beyond doubt.
, however, from Beijing's figures, the proportion of reimbursements for health insurance is below 60 per cent, meaning that the personal and out-of-the-way part is more than 40 per cent.
the current opening of online consultation mainly to staff medical insurance- and mainly, which is significantly lower than the proportion of offline workers' medical insurance reimbursement, which has formed a certain degree of obstruction to the user's willingness.
From the limited disclosure data, the hospital initiated online consultation and third-party platform initiated consultation, mainly to obtain drugs, but because of medical insurance reimbursement, the hospital's online consultation has a higher average drug costs.
and the cost of online medicines is already very close, even beyond, offline.
Thever, as we have mentioned in previous articles on Medical Analysis of the Internet, Medicare reimbursement for online consultations is primarily based on convenience, starting with the benefit of the people and the promotion of medical institutions to have more means to serve good patients.
but because Internet health care not only does not help control fees, but may even create new scenarios of health care abuse, health care regulation of Internet health care will continue to strengthen in the future.
the U.S. market, the cost of offline consultations is around $160, and online medical care can drop to about $70, which greatly boosts the use of commercial insurance.
, however, we also want to see that Medicare in the United States has more restrictions on online consultations, low prices, and many doctors are reluctant to use them.
as the outbreak progressed, CMS, the U.S. health care regulator, raised the price of online consultations to the same level as offline, which boosted doctors' enthusiasm for use.
From a practical point of view, the reason why Commercial Insurance can be more successful in the use of online consultation, because of its use of convenience to drive the development of users, essentially to create new needs, and health insurance is more of an alternative relationship, which also leads to a completely different motivation of doctors.
Because U.S. commercial insurance is dominated by group insurance, or remote consultation companies like Teladoc are also sold through corporate health benefits, employees' health consultation needs are catalytic through online convenience.
this is similar to corporate clinics, and while it is easier for employees to access medical care, convenience also reverses the misuse of medical resources by employees, resulting in higher levels of visits than previously available.
, from the experience of the United States, the original Chinese third-party platform large number of inquiries is essentially created demand, and offline is not a substitute relationship.
health care is in place, online consultations in hospital settings are more of an alternative relationship, and patients who simply go back to get drugs won't have similar consultations online.
So, based on the hospital scenario of online consultation will appear on-line and offline average cost is very close to the situation, its growth will not be too fast, because the hospital is only left-handed right hand, not much significance.
Of course, the significance of online consultations is highlighted from the point of view of accessing and retaining patients, but hospitals do not expect much revenue from it, but rather as an extension of their offline business capabilities.
therefore, hospitals are driven by the maintenance and growth of patient numbers, and even if there is a partial replacement, they are willing to try it from this perspective, which will be the logic of the future development of Internet hospitals in the hospital scenario.
in short, in the case of their own regulatory capacity is not enough, health insurance through the integration of the total amount of offline to ensure that limited health care funds will not be lost, but also for users to provide convenient services.
because online consultation under health care management does not produce a significant incremental market, third-party platform companies want to use health care development will not have an effect.
The future of third-party platforms, while continuing to create prescriptions through its own Internet hospitals, will remain an out-of-the-box market, meaning that health products and other non-drugs will remain the mainsse to out-of-hospital sales in the long term, rather than drugs.
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