The reform of medical service price is coming!

Under the new compensation mechanism, government investment has been increasing year by year At the end of last year, the proportion of direct financial subsidy revenue of public hospitals in the total revenue reached about 10%, which means that about 90% of the compensation still depends on the medical services provided " On June 14, the National Health Commission held a press conference on the comprehensive reform of public hospitals At the meeting, Zhu Hongbiao, inspector of the Department of physical reform of the national health and Health Commission, introduced that an important way to explore the reform of public hospitals in recent years is to "make room, adjust the structure and ensure the connection", and mentioned that the next reform focus of public hospitals is to improve the compensation mechanism, and one of the core is to deepen the reform of medical service prices False high price of drugs reduces to make room for medical service price negotiation, 4 + 7 volume purchase In 2018, under the influence of many measures taken by relevant departments of the state, the comprehensive reform of public hospitals also made positive progress In the continuous deepening of drug reform, 17 kinds of expensive anticancer drugs were included in the medical insurance catalogue through negotiations with pharmaceutical enterprises At present, the average price of 17 kinds of anticancer drugs has been reduced by 56.7%; the pilot work of centralized purchase and use of drugs organized by the state has been carried out in 11 cities, and the average price of the first 25 selected drugs has been reduced by 52% In addition to the policy guidance of relevant departments of the state, various explorations have also been carried out in various regions Shanghai, the pioneer city of medical reform, has implemented the GPO for varieties that have not been purchased with medical insurance The first five tertiary hospitals and six districts have formed a public medical institution Procurement Alliance Through the measures of giving full play to the advantages of "group purchase", improving the procurement concentration and optimizing the supply chain, it has reduced In terms of drug price and purchase cost, the average price of 42 drugs purchased is reduced by 60% In this regard, Zhu Hongbiao pointed out that reducing the virtual high price of drugs through centralized procurement and other means is conducive to making room for adjusting the price of medical services, reflecting the labor value of medical personnel, and gradually transiting to a reasonable price In the past, there have been many medical institutions in China, such as medicine, consumables and inspection, which can reflect the lack of medical services and drug price formation mechanism in line with the market economy Last year, more than 270.5 billion yuan of financial subsidies were granted to public hospitals at all levels to dynamically adjust the price of medical services In 2017, the comprehensive reform of public hospitals across the country was launched, an important sign of which was the cancellation of drug markup The compensation of public hospitals has changed from three channels: service charge, drug markup income and government subsidy to two channels: service charge and government subsidy Under the new compensation mechanism, the government investment increases year by year Sina Pharma learned that the direct subsidy from all levels of finance to the national public hospitals increased from 84.9 billion yuan in 2010 to 270.5 billion yuan in 2018, with an average annual growth of 15.6% In 2018, the proportion of financial direct subsidy revenue of national public hospitals in total expenditure reached 10.1%, and that of Shenzhen and Beijing reached 31.6% and 21%, respectively According to Zhu Hongbiao, at the end of last year, the proportion of the direct financial subsidy revenue of the national public hospitals in the total revenue reached about 10%, which means that about 90% of the compensation depends on the medical services provided He stressed that the focus of the current reform of public hospitals is to improve the compensation mechanism, among which deepening the reform of medical service prices is one of the key points Prior to the comprehensive reform of public hospitals, all provinces adjusted the price of medical services, but the adjustment was more about making up for the reasonable income from the reduction of drug addition Some problems such as the price of medical services is lower than the cost and the price comparison relationship is unreasonable have not been solved It is worth noting that in 2018, 19 more provinces adjusted the price of medical services Shanghai has adjusted 1894 medical service prices five times in succession, preferentially adjusting service items with wide application range, large deviation of price comparison relationship, serious inverse connection with actual cost, lower price than surrounding cities and cities of the same type, and great response in the industry Shandong, Guangdong, Fujian and other provinces clearly stipulate that prices should be adjusted once a year Sanming City, Fujian Province adjusted 4318 medical service prices six times The proportion of public hospitals' medical service income (excluding medicine, consumables, inspection and laboratory test income) in medical income increased to 42%, the highest hospital reached 68.6%, and the hospital income structure was optimized It can be seen that the dynamic adjustment mechanism of medical service price is gradually implemented The adjusted medical service price does not increase the burden of patients More than 2800 public hospitals pilot the reform of salary system "There are two links in adjusting the medical service price." Zhu Hongbiao pointed out that the first is to link up the medical insurance and adjust the medical service price to be included in the medical insurance reimbursement according to the regulations, without increasing the burden on the masses as a whole; the second is to link up the reform of the salary system, reform the salary system of public hospitals, and gradually improve the salary treatment of medical personnel, so that their income and work pay match, so that their income can be more sunshine, decent and dignified Zhu added that the future focus will be on improving the prices of medical services such as diagnosis and treatment, surgery, rehabilitation, nursing and traditional Chinese medicine Adjusting the price of medical services can reflect the value of technical services of medical staff, guide the medical staff to improve their ability to focus on learning, growth and progress, and ultimately benefit the masses of the people According to reports, at present, more than 2800 public hospitals have carried out the pilot reform of salary system, which is more than 20% of the total number of public hospitals in China Six provinces, including Shanghai, Fujian, Anhui, Jiangsu, Zhejiang and Qinghai, have fully implemented the "two permits" (allowing medical and health institutions to break through the current wage control level of public institutions, allowing medical service income to deduct costs and withdraw each according to regulations The fund is mainly used for personnel reward) and explore the establishment of a salary system in line with the characteristics of the medical industry.