In order to extensively listen to the opinions of all parties, the full text of the "Anshun City's Implementation Plan for the Cancellation of Medical Consumables and Adjustment of Medical Service Price (Consultation Draft)" is published on the Internet. We welcome all community opinions and suggestions within the legal time limit. Email: firstname.lastname@example.org, Correspondence address: Anshun Medical Security Bureau. Contact: Yang Di; Tel: 33238611, 18908536266
Attachment: "Anshun City Cancelled Medical Consumables Bonus and Adjusted Medical Service Price Implementation Plan (Consultation Draft)"
According to the requirements of relevant provincial departments on the dynamic adjustment of medical service prices for comprehensive reform of public hospitals and the simultaneous adjustment of medical treatment by the Provincial Medical Security Bureau, the Provincial Health and Health Committee, the Provincial Department of Finance, and the Provincial Market Supervision and Administration Bureau The "Notice of Service Price" (Qian Yi Bao Fa  No. 59) is based on the spirit of our city, and formulates this plan.
I. Purpose of price adjustment
Fully implement the decision-making and deployment of the Party Central Committee and the State Council, further advance the reform of pharmaceutical prices, comprehensively eliminate the increase in medical consumables in public medical institutions, gradually reduce the fees for inspection and inspection projects, actively and steadily advance the dynamic adjustment of medical service prices, and further rationalize the price comparison relationship between medical services To solve the historical problem of “one county, one price” for the price of medical services in each county and district, to form a unified city-wide price standard for medical service prices, improve the efficiency of medical insurance funds, achieve affordable medical insurance funds, increase the overall burden of the population, and improve hospital development. Ongoing goals.
Second, the price adjustment principle
(1) Total amount control and structural adjustment. In accordance with the general requirements of "promoting space, adjusting structure, and ensuring convergence", adjustments are made according to the price adjustment space vacated by the inspection and inspection revenue of public hospitals and the price adjustment space freed by the consumption of consumables, focusing on improving medical services that reflect the value of medical staff services Item price.
(2) The city is unified and the price difference is reasonable. The city's public medical institutions implement a unified medical service price classification, comprehensively consider the medical institution level, physician level and market demand and other factors to set medical service item charging standards and reasonably open the price gap.
(3) Three-medicine linkage and supporting implementation. Adhere to the "three-medicine linkage" of medicine, medical insurance and medical treatment, and ensure that the adjustment of medical service prices is synchronized with the reform of medical insurance payment methods, hospital operating mechanisms, and comprehensive supervision mechanisms.
(4) Dynamic adjustment and strengthening of supervision. We will improve the mechanism for dynamically adjusting the price of medical services, and conduct price adjustments for medical services in a timely manner; we will establish a monitoring mechanism for the implementation and operation of medical service prices in public hospitals.
Time and scope of implementation
On December 31, 2019, all public medical institutions in the city completely canceled the medical consumables bonus, allowing medical consumables that are individually charged to patients to be sold on the basis of the actual purchase price as “zero margin” sales; the adjusted medical services will be executed simultaneously price.
Fourth, the price adjustment content
一）取消耗材加成，调整医疗服务价格。 ( 1) Take the bonus of consumables and adjust the price of medical services.
The medical consumables bonus has been completely cancelled. At the same time, medical service prices have been adjusted up and down based on the current 2003 version of Guizhou Province's medical service prices and their amendments. According to the principle of relevance and the principle of reasonable price parity, priority is given to subjects with relatively concentrated medical consumable charges and low levels of medical service cost recovery to be included in the price adjustment range, focusing on improving the low-cost surgery, treatment, pathology, The price of medical services such as pediatrics and comprehensive medical care, which reflects the labor value, technical difficulty and degree of risk of medical staff. The city adjusted a total of 1496 medical service charge items, of which 1345 were adjusted at the municipal level (64 items were reduced and 1281 items were increased), and 1496 items were adjusted by the county and districts (92 items were reduced and 1404 items were increased).
The items for the price adjustment and reduction of medical services this time are inspection and inspection items. The number of reduction items is small but the frequency of occurrence is high, which is beneficial to reducing the burden on the general public. For outpatients, the cost of patients undergoing large-scale equipment inspections and inspections has dropped significantly; for inpatients, the costs of patients with different diseases have risen and decreased, such as the use of diseases with more high-value consumables, and medical costs will increase. The medical expenses will increase for diseases mainly treated by technical labor services, but the actual expenditure of patients will not change much because the price adjustment items are all included in the medical insurance payment. The number of increase items is relatively high, but the frequency of occurrence is relatively low, and they are all technical labor treatment projects, which can better reflect the labor value of medical personnel.
(2) The prices of medical services at the city and county levels shall be straightened out.
理顺全市不同级别医疗机构的比价关系，合理拉开市级与县级的差距。 The first is to straighten out the parity relations between different levels of medical institutions in the city and reasonably open the gap between the city level and the county level. The county-level medical service projects are priced at 15% lower than the city-level project charging standards, and individual medical technology diagnosis and treatment projects at the city and county-level medical institutions are implemented according to the same standard. Second, in accordance with the city's principle of grading and unifying, taking into account the previous price adjustment projects of each county. In the process of canceling the adjustment of medical treatment and price adjustment of medicines, the items that were adjusted by counties and districts but not adjusted by the city level were revised this time in accordance with the principle that the county level is not higher than the city level charge standard. The third is to support the improvement of county-level medical service capabilities. For projects launched at the municipal level but not implemented at the county level, the adjustment will be made at the county level to make full use of the guiding role of medical service prices in medical consultation behaviors, guide patients to seek medical treatment reasonably, and actively promote hierarchical diagnosis and treatment.
V. Safeguard measures
一）做好医保支付衔接。 ( 1) Connect well with medical insurance payment. The medical security department has done a good job of linking the medical insurance payment policy with the adjustment of medical service prices, and incorporated the adjusted medical service prices into the scope of medical insurance reimbursement. In principle, it does not reduce the total medical insurance control standards of medical institutions because of the addition of consumables.
二）加强医疗机构内部管理。 ( 2) Strengthen internal management of medical institutions. Medical institutions should actively adapt to reforms, strengthen cost management, scientifically calculate costs, and actively control costs; regulate medical service behaviors and strictly control the unreasonable use, unreasonable inspection, and unreasonable treatment of medical consumables; improve the quality of medical services and optimize medical care Service process to improve medical experience and achieve quality and price match.
三）加强对医疗行业的监管。 ( 3) Strengthen supervision of the medical industry. The health department strengthens comprehensive supervision and policy guidance to the medical industry, fully utilizes the performance evaluation methods of public medical institutions, and urges public medical institutions to proactively adapt to reforms, actively transform and upgrade, and regulate medical service behaviors to improve medical service efficiency and achieve high-quality development ; Guide public medical institutions to optimize the allocation of medical consumables, optimize the use of management and other methods to reduce costs, reform and improve the internal distribution mechanism to achieve a healthy and stable operation.
四）建立价格监测机制。 ( 4) Establish a price monitoring mechanism. The medical security department establishes a sound and intelligent pharmaceutical price monitoring mechanism, and monitors the medical expenses, service volume, income distribution, and prices of medicines, medical consumables, and medical equipment by promoting the docking with the information system platform data of medical institutions. And other related information to monitor and evaluate the operation of the reform.
五）查处价格违法行为。 ( 5) Investigate and punish price violations. The market supervision department has strengthened price supervision in the medical device field, opened channels for complaints and reports, investigated and dealt with price violations and monopoly behaviors in the medical services, drugs, and medical device fields in accordance with the law. Construction of integrity system.
(6) Strengthen publicity guidance and propaganda. The reform of medical service prices is closely related to the vital interests of the masses. It involves a wide range of issues and is highly policy-oriented. The medical security department and the health and health administration department should strengthen policy training for relevant departments, medical institutions, and medical personnel, so as to promote better understanding and Grasp the reform policy of medical service prices. Extensive use of new media platforms to publicize and interpret the main practices, necessity and significance of comprehensively eliminating medical consumable bonuses and adjusting medical service prices, actively respond to social concerns, reasonably guide the expectations of all parties, and create a good environment for public opinion.
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