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Expand the scope of medical insurance coverage such as acupuncture and massage

2018年02月08日

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Expand the scope of medical insurance coverage such as acupuncture and massage

Feb. 08, 2018 liaoshen evening news


Liaoshen evening news, chat shen client chief reporter LAN xiaoyu reports this year, shenyang will carry out the reform pilot with the disease diagnosis related group payment method reform. We will gradually expand the scope of non-drug treatment technologies for traditional Chinese medicine, such as TCM preparations and acupuncture and therapeutic massage, and explore the payment methods that meet the characteristics of TCM services.

The implementation plan of deepening the reform of the medical and health system during the 13th five-year plan period of shenyang city has been stipulated in detail.

Two years later, basic medical insurance reimbursement.

The proportion is stable at about 75%.

This year, shenyang will carry out a pilot program to reform the payment methods of related groups for disease diagnosis. To establish the incentive and restraint mechanism of balance retention and reasonable overexpenditure.

Implement the support for Chinese medicine service policy, and gradually expand into medicare pays medical institutions of traditional Chinese medicine preparation and acupuncture, therapeutic massage and other non-drug treatment technology in TCM and explore the mode of payment in accord with the characteristics of Chinese medicine service. By 2020, the medicare payment reform gradually cover all medical institutions and medical services, common implementation to adapt to different diseases and multivariate composite health care payment service characteristics, according to the project payment proportion decreased obviously.

We will gradually establish a dynamic financing mechanism linking the individual contributions of urban and rural residents with the income of residents. By 2020, the guarantee rate of basic medical insurance will be stable at more than 95%.

Shenyang will combine with the budget management of the health insurance fund to comprehensively promote the total paid total control. Improve individual account, carry out outpatient cost plan. We will speed up the establishment of a direct settlement mechanism for long-distance medical treatment, and promote the direct settlement of basic medical insurance nationwide and long-distance medical treatment. By 2020, we will set up a balance mechanism for the adjustment of medical insurance funds, and the proportion of reimbursement within the scope of basic health insurance policies will be stable at around 75%.

Hospitals should take the initiative to patients.

The supply of prescriptions must not limit the outflow.

According to the plan, the medical institution should prescribe the generic name of the drug and offer it to the patient voluntarily, and the prescription should not be restricted. The patient can buy the medicine at the retail pharmacy by prescription. We will improve the payment standards for medical insurance drugs and gradually formulate drug payment standards according to the general name. We will explore the establishment of a general pharmacist system in hospitals, and improve the management system of pharmacists in medical institutions and retail pharmacies.

Shenyang will implement the centralized procurement mechanism of online drugs on provincial platforms, implement the procurement of drugs in public hospitals, and carry out the same price. The implementation of the drug purchase "two-ticket system" reform, that is, the drug from the pharmaceutical factory to the first dealer to issue invoices, the dealer to the hospital to open another invoice, strictly according to the contract payment.

Explore the practice of medical association.

The total cost of health care.

In the aspect of graded diagnosis and treatment, shenyang will strengthen the construction of the traditional Chinese medicine building of the primary medical and health institutions, and meet the needs of people to see TCM first. By 2020, we will strive to have the capacity of traditional Chinese medicine in all community health service institutions and township hospitals and 70% of village clinics.

We will explore ways to pay for the total medical insurance, and form a smooth referral mechanism. By 2020, a relatively complete policy system for the medical system will be formed, which will gradually establish a graded diagnosis and treatment mode of primary diagnosis, two-way referral, rapid and slow treatment, and up and down linkage. Basically realizes the family doctor to sign the service system full coverage.

Explore public hospitals.

Target annual salary and agreement compensation.

In the aspect of hospital management, the plan points out that public hospital management autonomy should be implemented and the administrative level of public hospitals will be phased out. We will implement the status of independent legal persons in public hospitals and improve the corporate governance mechanism of public hospitals. The President assumes overall responsibility. Regulating public hospital restructuring, infectious hospital, mental hospital held by government, in principle, occupational disease prevention and control of hospital, maternal and child health care and maternity hospital, children's hospital, hospital of traditional Chinese medicine (such as national hospital) not the restructuring.

Public hospitals should be determined rationally pay levels, allowing the regulation and control of medical and health institutions to break through the current institution wage, allow the medical service revenue after deducting costs and in accordance with the provisions, extraction of various funds is mainly used for reward.

In the performance salary allocation, to achieve the multi-labor, excellent performance. To explore the implementation of target annual salary and agreement compensation in public hospitals. The competent departments of public hospitals shall determine the level of the President's remuneration and maintain a reasonable proportional relationship with the performance salary of hospital staff.

At the same time, we will further improve the hospital performance evaluation system, and implement the classification assessment for medical personnel in different positions and ranks.

Medical staff are not paid.

Income linked to drug testing.

In the area of reform, the programme stipulates that public hospitals should not provide more than 10 per cent of all medical services. Supports grassroots health institutions provide signed medical care for the elderly family, establish and improve the medical and health institutions and pension institutions cooperation mechanism, support pension institutions in rehabilitation nursing, gerontology and hospice care, support social forces to set up a combined with institutions. By 2020, all medical institutions to open for the elderly to provide convenient services such as registration, the green channel, all pension institutions can be in various forms to provide medical and health services in the elderly.

In addition, it is necessary to reasonably determine the treatment of medical and health institutions, and gradually realize the same salary as the same salary. It is strictly forbidden to set income-generating targets for medical personnel, and medical staff compensation should not be linked to the business income of drugs, consumables, inspections and tests. The internal performance allocation of primary medical and health institutions can be used to set up the general practitioner's allowance and other methods, and will be inclined to the personnel who bear the clinical front-line tasks such as contract signing service.