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    Home > Medical News > Latest Medical News > Medical insurance balance retention hospital assessment rules clear non-selected product procurement and other indicators score!

    Medical insurance balance retention hospital assessment rules clear non-selected product procurement and other indicators score!

    • Last Update: 2020-09-03
    • Source: Internet
    • Author: User
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    On August 14th, the official website of the Medical Security Bureau of Inner Mongolia Autonomous Region issued the Implementation Plan for the Implementation of the Retention of The Balance of Medical Insurance Funds in the Central Procurement of Drugs by the State Organization (draft for comments) (hereinafter referred to as the "Draft of Opinions").
    opinion draft is drafted in accordance with the Guidance of the Ministry of Finance of the State Administration of Health Insurance on the retention of the balance of medical insurance funds in the centralized procurement of drugs organized by the State (Medical Insurance Issue (2020) No. 26), in the light of the actual situation of the autonomous region. The
    opinion draft points out that the implementation of the drug collection policy of the state-organized drug collection and collection of fixed-point medical institutions will be carried out, including the implementation of the relevant provisions on centralized drug procurement, reasonable control of drug costs and the implementation of reform policies such as collection and collection, price, and so on, according to the content of the assessment and score of the fixed-point medical institutions to score.
    if the assessment score fails, the balance will not be paid to retain the health insurance funds.
    Strict control of the proportion of non-selected drug use according to the opinion draft, after the reference assessment content of the scoring calculation, the total score of 80 is divided into excellent, by the co-ordination area according to the balance of 50% of the calculation base to the fixed-point medical institutions to pay the balance retained medical insurance funds; The total score of 0 is qualified, and the balance retention medical insurance funds shall be paid to the fixed-point medical institutions by 25% of the base calculated by the overall area according to the balance; The "target medical institution assessment indicators and points" in the opinion draft of the
    stipulates that "whether to complete the centralized procurement of national organizations on time;
    and "medical institutions 30 days return rate" "targeted medical institutions drug cost growth rate" and "offline procurement ratio" score of 15 points, is also a very important assessment indicators.
    addition, "non-selected product purchase volume ratio" "non-selected product purchase amount ratio" are 5 points.
    opinion draft clearly encourages the use of selected drugs, and points out that the use of selected drugs in designated medical institutions exceeds the agreed purchase amount of the part, in the approved balance measurement base may not be included in the collection of generic name drugs medical insurance payment amount.
    Ne mongolia fixed-point medical institutions assessment indicators and points of the third batch of national procurement decline or a new high according to the "National Health Insurance Administration, Ministry of Finance on the centralized procurement of drugs in the state organization of medical insurance fund balance retention guidance" (medical insurance issue (2020) No. 26), the overall areas in the total budget or total control indicators of fixed-point medical institutions, included in the national procurement of medical insurance catalogue drugs, in the procurement cycle in accordance with the annual budget management.
    opinion draft also clearly, "collecting drug medical insurance funds budget - agreed procurement volume base x pre-collection generic drug weighted average price x co-ordination area medical insurance fund actual payment ratio x collection of generic name drug co-ordination area patient use ratio" Residual measurement base - collection of pharmaceutical medical insurance fund budget - (selected product agreed purchase amount x selected price x non-selected product use amount) x co-ordination area medical insurance fund actual average reimbursement ratio x collection of generic name drug co-ordination area patient use ratio."
    , the agreed purchase quantity of the selected product is the agreed purchase quantity base multiplied by the "band ratio" (50% to 70%).
    means that the use of selected drugs by designated medical institutions exceeds the agreed purchase amount, and the amount of medical insurance payment for the collection of generic drugs may not be included in the calculation base of the approved balance.
    addition, it can be said that clinical drug use has since been limited by the medical insurance budget, in the budget and agreed procurement limits, fixed-point medical institutions also need to report more carefully.
    industry insiders point out that in an era of failed gold sales models and incentives for health insurance balances, medical institutions will be more inclined to choose products that have achieved significant price reductions, especially for medical institutions with large budgets and products with large price reductions.
    at least three levels of medical institutions, the failure to select drugs will be completely out.
    for mature companies, taking the lowest price not only means having the right to choose the market first, but also means taking over the market of key competitors.
    , analysts infer that the third batch of national volume procurement price reductions than the previous two batches or will be a new high.
    .
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