April 8, all public medical institutions in Beijing will abolish registration fees, consultation fees, abolish the drug markup, the establishment of medical service fees.
The core of the reform is the abolition of the 15% drug markup in public medical institutions, the implementation of zero-differential rate sales; the abolition of registration fees and consultation fees, the establishment of medical service fees.
(a) The abolition of drug markups, registration fees and consultation fees, and the establishment of medical service fees. Participate in the reform of the medical institutions to abolish the drug markup (excluding Chinese medicine tablets) and registration fees, consultation fees, all drugs to implement zero-differential rate sales, the establishment of medical service fee (medical service fee standard see annex), to achieve the compensation mechanism conversion. Medical service fee is mainly used to compensate for the operating costs of medical institutions, reflecting the value of the technical labor of medical personnel.
(ii) the implementation of drug sunshine procurement. The implementation of the drug purchase and sale of the "two-invoice system" (production enterprises to the circulation of the enterprise to open an invoice, the circulation of the enterprise to the medical institutions to open an invoice). Group purchasing, medical consortium purchasing and regional joint purchasing are encouraged and standardized, and the participation of medical institutions in centralized purchasing of medicines is further increased, so as to reduce the prices of medicines and consumables. Drug purchases are all conducted on the government-built online centralized drug procurement platform, and drug procurement prices are dynamically linked to the lowest prices of centralized drug procurement at the provincial level nationwide. Publicizing the varieties, prices, quantities and changes in drug adjustments in public medical institutions ensures that all aspects of drug procurement operate under the sun.
(3) standardize the price of medical services. In accordance with the principle of "total control, structural adjustment, rise and fall, gradually in place", to promote the reform of medical service prices, establish and improve the dynamic adjustment, multi-party participation in the formation of medical service price mechanism. Prices for large-scale medical equipment examination items were reduced, prices for medical services reflecting the value of medical personnel's technical labor and high technical difficulty and practice risk were raised for Chinese medicine, nursing care, surgery, and other medical services, and the price relationship between medical services was gradually rationalized. The first batch of 435 items were selected for price standardization.
(4) Improvement of medical services. Implementation of the action plan to improve medical services, strengthen the service consciousness of medical personnel, and improve the quality and level of medical services. Establish and improve the long-term mechanism of medical quality management, comprehensive consideration of medical quality and safety, basic medical needs and other factors, strengthen the management of clinical paths, promote the refinement and standardization of treatment programs; strengthen the drug prescription audit and prescription review, and promote the rational use of drugs. Vigorously implement non-emergency booking and treatment services, promote the service model of well-known expert teams, standardize the service process, and improve patients' experience of medical treatment. Enriching the content of contracted services for family doctors, so that residents can enjoy more convenient medical consultation and referral services. Promote mutual recognition of examination results among medical institutions in Beijing, Tianjin and Hebei.
(V) Strengthening cost and expense control. Improve the monitoring system of medical costs and key performance indicators of public medical institutions, and promote the control of costs and expenses by public medical institutions. Adopting information technology means, increasing the early warning and analysis of abnormal and high medical expenses, and controlling the unreasonable use of high-value medical consumables. Strict access to and management of new technologies, new programs, and special-needs services. Strengthening the feasibility demonstration for the purchase of large-scale equipment, and improving the efficiency of medical equipment utilization. Strengthening the internal performance appraisal of public medical institutions, and maintaining a reasonable increase in the number of personnel and remuneration in medical institutions.
(6) Improving the system of graded diagnosis and treatment. Improve the policy system of graded diagnosis and treatment, improve the mechanism of division of labor and cooperation among medical institutions, and gradually realize the first diagnosis at the grassroots level, two-way referral, emergency and slow treatment, and up and down linkage. Promoting the construction of close-knit medical associations and specialized medical associations to provide continuous medical services. Guiding doctors and returning specialists from large hospitals to work at the grassroots level, and improving the capacity and level of grassroots medical service provision. Improve the contracted services of family doctors, unify the procurement and reimbursement catalogs of large hospitals and primary healthcare institutions for commonly used medicines in the stabilized period of four types of chronic diseases, including hypertension, diabetes, coronary heart disease, and cerebrovascular disease, so that eligible patients can enjoy the convenience of a two-month long prescription at primary healthcare institutions, and divert outpatient volume of tertiary hospitals in an orderly manner.
(7) Establishment of a financial categorization compensation mechanism. According to the public medical institutions affiliated to the implementation of financial input policy, actively participate in the comprehensive reform of the separation of medicine and good results of the medical institutions to give appropriate subsidies to protect the public medical institutions of capital construction and equipment purchases, retired personnel costs, the development of key specialties, the construction of human resources, the government's directive tasks and undertake the expenditure of the public **** health services. Continuously improve the financial classification of input policy, Chinese medicine (including integrated Chinese and Western medicine, ethnic medicine), infectious diseases, mental illness, occupational diseases, maternity, children, rehabilitation, oncology, geriatrics and other medical institutions and primary medical and health care institutions to be tilted to promote the coordinated development of various types of medical institutions at all levels.
(viii) Increase the reform of medical insurance protection and payment methods. The burden on insured patients will be reduced by improving the health insurance payment system, the medical insurance system, and the medical assistance system. Under the framework of the total budget management of the medical insurance fund, explore a composite payment method that is mainly based on payment by type of disease, supplemented by payment by headcount, payment by service unit, and payment by disease diagnosis-related group, and gradually reduce payment by item. For inpatient treatment of severe mental illness, rehabilitation during recovery from illness, community rehabilitation for non-communicable diseases, and geriatric care, the reform of payment per bed day is being explored. Give full play to the role of various types of medical insurance in regulating and guiding medical service behaviors and costs, as well as in monitoring and controlling them. Comprehensively implementing major disease insurance for urban and rural residents, and promoting the accelerated development of commercial health insurance. It will also improve the medical assistance system for low-income and other difficult groups, and strengthen the operational synergy between medical assistance and medical insurance, so as to prevent poverty caused by illness.
Security measures
(1) Improve the working mechanism. In accordance with the requirements of the CPC Central Committee and the State Council, set up by the Beijing Municipality and the relevant departments of the Central Government, as well as the People's Liberation Army, the Armed Police Force and other **** with the composition of the reform of the separation of medicine coordination group, coordinating and coordinating the work of the comprehensive reform of the separation of medicine. Give full play to the role of the Beijing Municipal Healthcare Reform Leading Group and the Working Group on Separation of Medicine Reform, study and solve major problems encountered in the reform in a timely manner, and ensure that the various reform measures are synergistic and smoothly promoted. Each district government should establish corresponding working mechanism, carefully organized, carefully deployed, and take strong initiatives to ensure that the reform measures are implemented.
(ii) refine the division of responsibility. Separation of medicine reform working group office (located in the Municipal Health and Family Planning Commission) to scientifically analyze the risks in the implementation of the reform, improve the preventive measures and emergency disposal plan, and strengthen the supervision and inspection of the implementation of the reform. The Municipal Health and Family Planning Commission shall do a good job in the organization of sunshine procurement of medicines, supervision and management of medical institutions, improvement of medical services, and promotion of the construction of hierarchical diagnosis and treatment system and other related work. The Municipal Finance Bureau shall improve the financial input policy and study and formulate a categorized compensation method according to the affiliation. The Municipal Development and Reform Commission shall guide and supervise medical institutions to update their price catalogs and publicize them, strengthen price management, and severely investigate and deal with price violations. The Municipal Bureau of Human Resources and Social Security shall implement the health insurance policies in this reform and improve the composite health insurance payment system. The Municipal Civil Affairs Bureau shall improve the medical assistance measures for social assistance recipients. The city editorial office should do a good job of public medical institution establishment management.
(C) do a good job of publicity and guidance. Adhere to the correct orientation of public opinion, make full use of all kinds of news media, strengthen the policy publicity and interpretation, reasonable guidance of social expectations, timely response to the concerns of the masses, a wide range of cohesion **** knowledge in the whole society to form a good atmosphere of concern for the reform, support for the reform, participation in the reform.