Reforming the "medicine for medicine" mechanism and encouraging the exploration of various forms of separation of medicine. Eliminate the drug markup policy, and change the compensation of pilot county hospitals from three channels of service charges, drug markup income and government subsidies to two channels of service charges and government subsidies. Reasonable income reductions by hospitals will be compensated by adjusting the prices of medical technology services and increasing government investment. Charges for diagnosis and treatment, surgery and nursing care have been raised to reflect the reasonable cost of medical technology services and the value of the technical labor of medical personnel. Charges for medical technology services are incorporated into the scope of medical insurance payment policies in accordance with regulations, and the reform of medical insurance payment methods is being promoted simultaneously. Increased government investment by the central government to give a certain amount of subsidies, the local financial to adjust the expenditure structure in accordance with the actual situation, and effectively increase the investment.
(I) play the role of medical insurance compensation and cost control. County hospitals should provide appropriate technical services that are compatible with the scope of basic medical insurance coverage, and control pharmaceutical services outside the scope of basic medical insurance. Medical insurance fund through the purchase of services to hospitals to provide basic medical services to be timely compensation. Narrowing the gap between the reimbursement rate within the policy scope of the medical insurance fund and the actual reimbursement rate. Reform the medical insurance payment system. Give full play to the role of medical insurance in rationally controlling costs and the quality of medical services. Implementing budgetary management of the income and expenditure of the medical insurance fund, establishing a mechanism for the medical insurance to control the growth of medical costs in the integrated region, formulating the overall control objectives of the medical insurance fund's expenditures and decomposing them into designated medical institutions, and including the control of the growth of the medical costs of the medical institutions' sub-average (types of illnesses) and the control of the fixed amount of the burden on individuals in the grading and evaluation system. Payment methods such as total prepayment, per-case, per-person, and per-service-unit are being implemented, and total control is being strengthened. Scientifically and reasonably measuring and determining payment standards, establishing and improving the negotiation and consultation mechanism and risk-sharing mechanism between health insurance operators and medical institutions, and gradually determining the scope of services, payment methods, payment standards and service quality requirements through negotiation between health insurance operators and public hospitals. The medical insurance payment policy is further tilted toward the grassroots level, encouraging the use of Chinese medicine services, guiding the public to seek reasonable medical treatment, and promoting the formation of a hierarchical diagnosis and treatment system.
(2) Adjustment of medical service prices. In accordance with the principle of total control, structural adjustment, reduce the price of drugs and high-value medical supplies, reduce the price of large medical equipment inspection, treatment, government-funded acquisition of large-scale medical equipment according to the reasonable cost of equipment depreciation does not include the development of inspection and treatment prices, has been loaned or pooled funds to purchase large-scale equipment in principle by the government to repurchase, repurchase the difficulties in reducing the price of a limited period of time. Hospitals are strictly prohibited from taking out loans or pooling funds to purchase large-scale medical equipment. Reasonable increase in Chinese medicine and reflect the value of the technical labor of medical personnel diagnosis and treatment, nursing, surgery and other items price, so that medical institutions through the provision of quality services to obtain reasonable compensation. Price adjustments should be articulated with health insurance payment policies. Reform the item-based pricing of medical services, and actively carry out the pilot project of charging according to the type of disease, with the number of types of disease not less than 50.
(3) Standardize the procurement and supply of drugs. Adhere to the principle of quality first, reasonable price, the establishment of drugs (including high-value medical supplies) quantity and price linkage, recruitment and procurement of a centralized bidding and procurement mechanism. Mobilize the enthusiasm of enterprises to produce and supply medicines, vigorously develop modern pharmaceutical logistics, reduce and standardize the circulation links, and reduce distribution costs. On the basis of exploring centralized procurement at the provincial level, localities can actively explore procurement and supply methods that can effectively guarantee the timely supply of medicines and consumables, with reliable quality and reasonable prices. Resolutely combating commercial bribery in medicines and consumables. Improving policies and measures to encourage the use of basic medicines, county-level hospitals should prioritize the provision and use of basic medicines, and increase the proportion of basic medicines used.
(4) implement and improve the government investment policy. The full implementation of the public hospital capital construction and the purchase of large-scale equipment, the development of key disciplines, personnel training, in line with the national provisions of the retiree costs, policy loss subsidies, undertake public **** health tasks and emergency treatment, support the border, support for agriculture and other public **** services of the government investment policy. County governments fulfill their responsibility to fund the hospitals they run, and county hospitals are prohibited from incurring debt for construction.
For county hospitals located in sparsely populated and remote areas, the implementation of the two lines of income and expenditure can be explored, the government to give the necessary guarantees, the average salary level of the hospital and the average salary level of the local institutions in line.