According to incomplete statistics, as of April 15, Shandong, Shaanxi, Jiangxi, Guizhou, Fujian, Tianjin, Liaoning, Henan, Hunan and other provinces across the country have begun to implement the policy of direct settlement of medical insurance for the purchase of drugs and medical consumables.
"The policy of direct settlement of the payment of selected varieties in the centralized procurement of medical insurance is mainly to straighten out the problem of payment collection after the implementation of the results of centralized procurement, solve the long-standing problem of triangular debt owed by hospitals to pharmaceutical companies, and make the results of centralized procurement more reflective in the payment collection link. Yao Yu, a professor at the School of Economics at the University of Chinese Academy of Social Sciences, told reporters.
Among them, on April 12, Henan issued a notice on the implementation plan for the direct settlement of medical insurance funds and pharmaceutical enterprises for centralized procurement of drugs and medical consumables in Henan Province, according to the payment settlement data of the selected products confirmed by pharmaceutical enterprises and medical institutions, the payment for the selected products will be allocated to the pharmaceutical enterprises through the direct settlement sub-account before the end of the month, and deducted from the medical insurance settlement of relevant medical institutions. At the same time, it is stipulated that the part that is insufficient to be deducted shall be returned by the medical institution in a timely manner.
At present, in addition to the system requirements of the medical insurance department for the timely payment of hospitals, some provinces have also carried out the exploration of direct settlement between medical insurance funds and pharmaceutical companies. According to Yao Yu's analysis, the purpose of this is to reduce the production cost and capital cost of drugs as much as possible, and help enterprises reduce their burden, so as to supply drugs with better quality and lower prices. Judging from the current results, the results of these systems after their implementation are remarkable.
Liao Zangyi, an associate professor at the School of Politics and Public Administration of China University of Political Science and Law, analyzed in an interview with reporters that the implementation of the direct settlement policy of the medical insurance fund has made the "quantity and price" problem of the medical insurance fund and the procurement of drugs more clear from the perspective of medical insurance. The back-end is the supply guarantee and payment settlement, and the direct settlement between the medical insurance fund and the supplier is also "how much money is bought and how much is paid", and the problem of quantity and price is found from the discovery of the real price of drugs, quantitative pricing and procurement, and payment according to the quantity and price, forming a complete closed loop, reducing management and operating costs, improving the management and use efficiency of the medical insurance fund, and successfully achieving the goal of special funds.
Original title: Implement the direct settlement policy of medical insurance in many places, and straighten out the problem of payment collection after the implementation of centralized procurement
Source | People's Daily Health Client
Edit | Yang Zixuan, Liu Xinyu
Hot Article
• The direct settlement of inter-provincial hospitalization and non-local is over 80%, and the door is slowly expanded to 3~5 diseases!
• Data survey: In 11 years, the cost of medical treatment in other places has increased by 7 times, and 4 percent of patients have flowed into Shanghai, Beijing and Guangdong
• The "three medicines" work together to explore the mechanism of drug price formation