The new standard of drug mining in Anhui Province will be launched soon, and the joint mining of "Shanghai, Jiangsu, Zhejiang, Anhui and Fujian" will be completed by October

Source: Medical Mobile News May 8, 2018, Anhui Province announced the key work and task list of comprehensive medical reform in 2018 According to the document, the province will improve the centralized drug procurement mechanism and the "two ticket system" for drug consumables procurement, implement a new round of centralized drug bidding procurement, continue to carry out joint volume procurement, actively participate in the joint procurement of drug consumables in four provinces and cities of "Shanghai, Jiangsu, Zhejiang, Anhui and Fujian", and further reduce the price of drug consumables In addition, the third-party unified payment method for drug payment of public medical institutions will be formulated, the medical insurance fund settlement and payment process will be optimized, and the financial cost of drug distribution enterprises will be reduced Through the lines of the above documents, we can smell out the next work of medical reform in Anhui, especially the change of purchasing methods of medical consumables 1 On November 6, 2017, the website of Anhui health and Family Planning Commission posted two draft for comments: Guidance on improving the volume purchase of drugs in public medical and health institutions in Anhui Province (Draft for comments); implementation plan for online centralized transaction of clinical laboratory reagents in public medical institutions in Anhui Province (Draft for comments) Among them, the "volume purchase plan" seems to be a drug purchase plan, but in fact, it integrates policies such as medical association, medical insurance payment, and drug use, especially the Medical Association policy It is almost the first province to elaborate and endow the procurement function of Medical Association after the state issued a document requiring the establishment of Medical Association before October 2017 This time, the key tasks of medical reform were announced, and the Tianchang model was put forward Therefore, in Anhui's future drug procurement, we should first study the organization and procurement methods of the medical community According to the 2018 comprehensive medical reform task list, the time node for improving the centralized drug procurement mechanism, implementing a new round of drug procurement, continuing to carry out joint procurement, and participating in the joint procurement of "Shanghai, Jiangsu, Zhejiang, Anhui and Fujian" drug consumables is before October 2, the joint procurement of four provinces and cities in Shanghai, Jiangsu, Zhejiang, Anhui and Fujian Up to now, it has remained on paper, at most "joint working conference mechanism", without further implementation Does this proposal in the key work of medical reform mean substantive progress? If not, it is difficult to reflect the sentence of "improving the centralized drug purchase mechanism", which will be revealed before October 3 In the volume purchase document, the statement "continue to carry out joint volume purchase" is used Since April 1, 2015, the basic tone has remained the same In fact, 16 + 1 volume purchase has evolved into a n + n multi-party game The purchase project is highly fragmented and the secondary price negotiation is diversified Because of this, there will be a base gas of "further reducing the price of drug consumables" 4 Two vote system According to the 2018 comprehensive medical reform task list, the time node to improve the two vote system is before August As the first pilot province of medical reform to implement the two vote system after the implementation of the two vote system, Anhui initially introduced a program with loopholes (reflected in the fact that commercial companies regarded as production enterprises have no limited uniqueness), and later corrected the policy when it was implemented, and timely adjusted the direction In the future, it will also be strictly implemented and pay close attention to the introduction of the detailed version of the national two vote system policy, which should be related 5 According to the 2018 comprehensive medical reform task list, the time node for formulating the third-party unified payment method for drug payment of public medical institutions is before December How to understand the sentence "formulate the third-party unified payment method for drug payment of public medical institutions, and optimize the process of medical insurance fund settlement and payment"? There are two key words: first, what is "third party"? Medical institutions and drug suppliers are the two parties of drug transaction, and the payer of medical insurance is regarded as the third party? Or to introduce the adjusted health insurance bureau as a third party? Or financial institutions? After poetry and wine, everything is possible Second, how to optimize the payment process of medical insurance funds? It is believed that the construction of medical insurance business system in Hefei, Bengbu and Chuzhou should be considered in combination with the construction of Medical Association and the unified construction plan of medical insurance business system platform in the whole province The following is the main content of the document: consolidate the existing achievements of medical reform, build a new model of hierarchical diagnosis and treatment with Anhui characteristics, promote the Tianchang model of county medical community construction, implement the lump sum payment of medical insurance fund according to the total head budget, and realize the full coverage of the whole province's counties (cities, districts); the first three pilot counties at least build a close county medical community with unified management of personal property Support social medical institutions to participate in the construction of medical community We will integrate the county and township drug purchase platforms, build the central pharmacy of the medical community, and improve the county and village integrated drug supply guarantee system Build county health information platform to ensure the close connection and sharing of diagnosis and treatment information in the medical community Standardize the signing service of family doctors, organize and implement the signing service project of family doctors for people's livelihood, and promote the signing service mode of rural family doctors in Dingyuan county According to the health needs of the masses, the service package shall be designed scientifically, the price shall be determined reasonably, and the paid contracted service fee of family doctors meeting the regulations shall be included in the reimbursement of medical insurance Implement the policy that the income distribution of paid contracted services of family doctors is not included in the total performance salary We will further improve the drug supply guarantee, improve the centralized drug procurement mechanism and the "two ticket system" for drug consumables procurement, implement a new round of centralized drug bidding procurement, continue to carry out joint volume procurement, actively participate in the joint procurement of drug consumables in four provinces and cities, namely, Shanghai, Jiangsu, Zhejiang, Anhui and Fujian, and further reduce the price of drug consumables We will work out a unified third-party payment method for drug loans to public medical institutions, optimize the payment process of medical insurance funds, reduce the financial cost of drug distribution enterprises, and ensure the supply of drugs and the demand for drugs by the masses Consolidate clinical pathway management + pay by disease to consolidate the effect of clinical pathway management in county-level public hospitals, covering more than 150 diseases; promote clinical pathway management in provincial and municipal public hospitals We will carry out double evaluation of diseases and cases, standardize diagnosis and treatment, and control the unreasonable growth of medical expenses We will continue to promote the payment by disease in public hospitals at or above the second level, expand the range of disease types, and improve the implementation rate Among them, the implementation rate of new rural cooperative medical system (NRCMS) has reached 50% for 150 disease types, the implementation rate of employee medical insurance and urban residents medical insurance has reached 30% for 100 disease types, and the implementation rate of 150 disease types has reached 40% in three pilot cities of Hefei, Bengbu and Chuzhou We will promote the reform of the payment method for the dominant diseases of TCM appropriate technology, covering 15 outpatient dominant diseases and 10 inpatient dominant diseases corresponding to 13 TCM appropriate technologies We will improve the pilot reform measures, deepen the reform of the medical insurance management system, and supervise Hefei, Bengbu and Chuzhou to accelerate the pilot reform of the medical insurance management system, and form a mature model as soon as possible Formulate a unified plan for the construction of medical insurance business system platform in the whole province, and promote the construction of medical insurance business system in Hefei, Bengbu and Chuzhou as a whole We will integrate medical insurance for urban and rural residents, unify the directory of basic medical insurance for urban and rural residents, and work out the directory of drugs and medical services for basic medical insurance We will unify the treatment of basic medical insurance for urban and rural residents, and work out a plan to guide urban and rural residents to make overall compensation for basic medical insurance Guide and urge commercial insurance institutions to handle the pilot of basic medical insurance business, encourage other regions with conditions to introduce commercial insurance institutions to handle basic medical insurance business, and explore the establishment of a new mechanism for basic medical insurance management We will promote the development of Internet plus healthcare, and formulate the plan, implementation plan, construction standards and evaluation criteria of Anhui smart hospital, and establish the Institute of artificial intelligence Build the provincial telemedicine information system, carry out telemedicine services, and realize the full coverage of county and township telemedicine Accelerate the construction of national health information platform, guide and urge the construction of "national health and medical big data regional center" project in Hefei Promote the implementation of Artificial Intelligence Aided Diagnosis System (Intelligent Medical Assistant), carry out the pilot construction of county intelligent medical treatment, and timely summarize and promote Relying on the Anhui medical convenience service platform, it provides intelligent Internet plus health services such as intelligent guidance, appointment registration, online payment, two-way referral, and chronic disease management We will promote the development of traditional Chinese medicine, promote the inheritance and innovation of traditional Chinese medicine, strengthen project tracking and financial support, and build a national platform for the inheritance and innovation of traditional Chinese medicine To explore the establishment of a new model for the development of health industry of traditional Chinese medicine, and to create the "top ten Anhui medicine" brand We will support Bozhou to build a capital of traditional Chinese medicine and promote the construction of Jiuhuashan health tourism demonstration base Innovative solutions to new problems explore the establishment of a close Urban Medical Association to guide Tongling City to carry out the pilot construction of a close Urban Medical Association, reform the payment method of medical insurance, integrate medical prevention resources, improve the benefit distribution mechanism, support public health institutions such as disease prevention and control, maternal and child health care to participate in the construction of Medical Association, and build a community of responsibility, interest, service and management To explore the clinical practice of pharmacists in the provincial top three public hospitals and Hefei, Bengbu and Chuzhou three pilot city level public hospitals of medical insurance management system reform, to carry out the pilot clinical practice (Ward) of pharmacists, to promote clinical rational use of drugs and reduce unreasonable costs We will explore the establishment of a comprehensive regulatory system to formulate and implement the Interim Measures for the supervision and administration of basic medical insurance in Anhui Province, further standardize the behaviors of the insured, the provider of medical drug services, and the agent of medical insurance, ensure the safety of medical insurance funds, and safeguard the legitimate rights and interests of the insured We will comprehensively strengthen the supervision of medical services, establish and improve the mechanism of equal emphasis on incentives and penalties, implement the measures for the treatment of commercial bribery of medical and health institutions and their staff in Anhui Province (for Trial Implementation), and seriously deal with violations of laws and regulations Establish a record file of medical personnel's honest practice based on the unique practice code, and standardize the practice behaviors of various medical institutions and medical personnel We will improve the construction of a comprehensive regulatory platform for medical services, use big data information technology, innovate law enforcement and regulatory means, realize the "three legitimations" of institutions, personnel and medical subjects, and promote the "three rationalizations" of inspection, drug use and fees.