15
2020
-
05
Blockbuster! New medical insurance policy issued, strict control of drug costs
On May 11, Zhejiang Provincial Health Insurance Bureau issued the Implementation Rules of DRGs Point Payment for hospitalization Fees of Zhejiang Provincial and Hangzhou Basic medical Insurance (Trial) (hereinafter referred to as the Rules).
On May 11, Zhejiang Provincial Health Insurance Bureau issued the Implementation Rules of DRGs Point Payment for hospitalization Fees of Zhejiang Provincial and Hangzhou Basic medical Insurance (Trial) (hereinafter referred to as the Rules).
According to the detailed rules, Zhejiang will further reform the payment method of basic medical insurance at the provincial level and in Hangzhou, one of the most important points of which is to control the cost of medical insurance.
The detailed rules require that a responsibility sharing mechanism of "remaining balance and overspending share" will be "established" and that "85% of the remaining balance of the medical insurance fund in 2020 will be retained by designated medical institutions; Eighty-five per cent of the overexpenditure was shared by designated medical institutions ".
On one side is the encouragement of "keeping 85% of surplus", on the other side is the pressure of "sharing 85% of overexpenditure". Under such a mechanism, hospitals will naturally have enough motivation to control costs.
In addition, DRGs payment also makes hospitals have to implement scientific cost control.
As is known to all, since DRGs payment is a mechanism of payment in advance, according to the principle of the same disease, the same treatment, the same quality, the same price, according to the patient's clinical diagnosis, age, comorbidities, complications and other factors, patients with similar medical expenses incurred in the treatment of diseases are divided into the same diagnosis group for management. In simple terms, related diseases are divided into a group and paid in a package.
Some pharmaceutical experts told Cerberan that DRGs payment would be a more stringent and effective means of cost control than policies such as controlling the proportion of drugs and restricting adjuvant drugs. Under DRGs payment, medical staff will try to adopt the most reasonable and economical treatment plan. If the actual cost of treatment exceeds the provisions of the relevant documents, it needs to be absorbed by the hospital itself; If some of the costs can be saved by improving management and treatment procedures, they will be added to the hospital's profits.
Doctors do not need to face the pressure of rising costs, and can carry out effective treatment under their relevant diagnostic classification criteria. Patients can not only get good treatment results, but also shorten the course of disease as far as possible and get better recovery.
What is worth paying attention to is that under the DRGs payment mechanism, many kinds of clinical drugs for the same disease can actually be cut off, which not only saves money for patients, but also saves more medical insurance funds for hospitals.
Therefore, medical practitioners must know the location of their products in the hospital. Is it that no matter what policy can be struck, or is it already facing the state of being cut, or is it in the critical position of being able to cut or not cut? I believe in different positions, coping with the handling methods are different.
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Pannacean (Henan) Medicine Science Technologies, Ltd.
Address: Henan Pilot Free Trade Zone Zhengzhou Area (Jingkai) Hanghai Road Jingkai 2nd Street Hanghai East Road No. 1291
Pannacean (Henan) Medicine Science Technologies, Ltd.
Address: Henan Pilot Free Trade Zone Zhengzhou Area (Jingkai) Hanghai Road Jingkai 2nd Street Hanghai East Road No. 1291
Mail：haifeng.zhang@pannacean.com
Tel:0371-55159968