1. The "Guiding Opinions" put forward to improve the health insurance payment mechanism and benefit adjustment mechanism, the implementation of refined management, to stimulate the medical institutions to regulate behavior, cost control, reasonable treatment and referral of the endogenous motivation, to guide the rational allocation of medical resources, the patient orderly access to medical care, support the establishment of hierarchical diagnosis and treatment model, support the healthy development of grassroots health care institutions, and to effectively safeguard the majority of the insured people's basic medical rights and interests, to ensure that the long-term sustainability of medical insurance system. rights and interests of the majority of participants, to ensure the long-term sustainable development of the medical insurance system.
2. It can be seen that the establishment of the National Health Insurance Bureau will greatly promote the implementation of the document, which will have a very important impact on medical institutions and pharmaceutical companies. Medical Insurance Bureau has become the most concerned department of pharmaceutical companies and medical equipment companies. Medical Insurance Bureau has become the most concerned government departments of pharmaceutical enterprises and medical equipment enterprises.
1. The reasons are:. Market access For the domestic pharmaceutical industry, we can narrowly understand:Bidding, medical insurance. If the drugs can not pass the bidding, they will lose the whole hospital market. Moreover, if the drugs cannot enter the health insurance catalog, even if they pass the bidding, it will have a great impact on their market. Bidding and health insurance catalog are both market access, and the importance of both rights now falls into the hands of the Health Insurance Bureau.
2. The Medicare Bureau has the power to control costs at the source and will have direct control over former drugs and high-dose ancillary drugs. In addition, under Medicare payment standards, hospitals will be motivated to treat patients with the lowest cost drugs based on rational drug use. In the future, the game of interests will become more pronounced in the Medicare environment.
3. Directly determine the price of drugs Previously, the price of drugs by the National Development and Reform Commission is responsible for pricing, the Ministry of Human Resources and Social Security is responsible for the health insurance catalog, the Health Planning Commission is responsible for the bidding and purchasing, and ultimately paid for by health insurance. Spenders could not talk about prices and standardized use, leading to increasing pressure on health insurance. Now, the bidding and purchasing of medicines is taken over by the Medical Protection Bureau, which on the one hand reflects "who pays the bill and who controls the market". On the other hand, under the actual health insurance funds, the winning price of drugs will be closely linked to the health insurance payment standards to maximize the interests of all parties.