Blockbuster!A province purchases, compare price, health insurance bureau issues consumable management plan
Blockbuster!A province purchases, compare price, health insurance bureau issues consumable management plan
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At present, the list of 14 interprovincial high value medical consumables alliance is: shaanxi, sichuan, Inner Mongolia, ningxia, qinghai, gansu, xinjiang, hunan, heilongjiang, liaoning, guizhou, guangxi, hainan, xizang.
Every move of the league's members is a matter of rhythm.
Comprehensive implementation of classified procurement of consumables, sunshine procurement
On September 24, the medical insurance bureau of gansu province issued the "implementation opinions on implementing the reform plan for the management of high-value medical consumables", which was formulated according to the general idea of the CPC central committee for the reform of shenzhen municipality on the management of high-value medical consumables.
The main purpose is to promote the linkage between medical treatment, medical insurance and consumables, establish a mechanism for sunshine procurement and supervision, reduce the price of artificially high consumables, and reduce the burden of medical treatment on the people.
From the perspective of content, it involves procurement standards, access rules, medical insurance payment and other links, and requires implementation in a very detailed manner. The full text is nearly 5,000 words in total, and the main points are summarized as follows:
Provinces are inferior to each other
The scheme points out that it will perfect the rules for the formation of the reference price of high value medical consumables.All medical institutions in the province using high-value medical consumables must purchase and trade the medical consumables on the sunshine purchasing platform.
In terms of price, drug procurement agencies at the provincial level through the collection and self-directed declare provincial now perform high value medical consumables, lower comparing with the actual purchase price of provincial medical institutions, provincial higher medical institutions are formed by price section management actual purchase price, according to the principle of "low" reference price price purchasing and dynamic adjustment of implementation of screening.
Thus, the lower principle means that the prices offered by suppliers are determined by comparing provincial data with historical provincial procurement data.
Negotiation, no higher than the lower standard
In terms of the enterprise product access rules, the plan points out that for the clinically necessary high-value medical consumables that have not been hooked up in the list of hooked up medical products, the applicant should submit the enterprise and the product compliance qualification materials to the provincial pharmaceutical purchasing agency according to the clinical use requirements.
On the price should be lower than the price of similar varieties of the provincial platform, and not higher than the lower price of the product implemented in the provinces.
For high-value medical consumables not listed in the online catalogue and high-value medical consumables newly approved to be marketed with new technologies, medical institutions can apply for record purchase after basic prevention and control science and evidence-based medicine evaluation.
Medical institutions should apply to provincial drug purchasing institutions to be included in the list of medical consumables for archival procurement, and then purchase through online negotiation.
Support domestic consumables procurement, cancel the addition
The program clearly points out that it encourages and supports the procurement and use of domestic high value medical consumables.In order to promote the domestic use of high-value medical consumables and support the improvement of core competitiveness of domestic high-value medical consumables with independent intellectual property rights, the original innovative medical devices with independent intellectual property rights approved by the former food and drug administration are directly connected to the network through the "green channel".
In terms of consumables addition, gansu province has abolished medical medical institutions' medical consumables addition in 2004, and the sales price of high-value medical consumables has been implemented according to the purchase price.
The reduced reasonable income due to the cancellation of medical consumables addition has been absorbed through the adjustment of medical service price and medical insurance payment policy.Medical institutions should reduce costs through classified centralized procurement, strengthening cost accounting, and standardizing rational use.
Inter-provincial alliance centralized procurement, negotiations to reduce prices
The plan points out that for high-value medical consumables with large clinical dosage, high purchase amount, mature clinical use, wide range of use and strong competitiveness and produced by many enterprises, inter-provincial alliances will be actively explored for centralized procurement by category, and the consortium of medical institutions will be encouraged to carry out bulk procurement through negotiation to promote substantial price reduction.
For high-value medical consumables with high purchase amount, clinical necessity and insufficient competition, an open and transparent multi-party medical insurance access negotiation or price negotiation mechanism should be established to promote the price reduction of medical consumables.
At the same time, we will select some of the main varieties of high-value medical consumables to monitor, independently declare the purchase amount through the medical institutions, and the platform will automatically collect and summarize the purchase amount and negotiate with the enterprises, so as to realize the link between quantity and price.Explore new modes such as documentary purchase, renewal purchase, commission purchase and negotiation purchase.
For high-value medical consumables that have passed the medical insurance admittance and defined the medical insurance payment standard and the price is relatively stable, direct online procurement will be implemented.
High value medical consumables directory management, in exchange for price
The document stipulates that medical insurance access and directory dynamic adjustment will be implemented, the establishment and improvement of the provincial access system for basic medical insurance of high-value medical consumables, the implementation of high-value medical consumables directory management, the formation of dynamic adjustment mechanism.
Specifically, the necessary new technical products will be added in time, and the products that are no longer suitable for clinical use will be withdrawn.We will carry out price negotiations on medical insurance market access for high-value medical consumables, so as to achieve "quantity for price".
Meanwhile, the enterprise report system of high value medical consumables is established.For the products to be included in the medical insurance, the enterprise shall submit the relevant price, market sales volume, health economics evaluation, adverse event monitoring and other reports as required, which shall serve as the necessary basis for the medical insurance access evaluation.Gradually establish the medical insurance evaluation management system and standard system of high value medical consumables.
We will formulate new regulations on medical insurance payments and adjust them dynamically
According to the plan, medical insurance payment standards for high-value medical consumables will be set up and a dynamic adjustment mechanism will be established.
For those who have passed the negotiation on medical insurance access, the medical insurance payment standard shall be determined according to the negotiated price.We will explore the development of a unified medical insurance payment standard for high-value medical consumables of the same category and similar functions.
At the same time, the medical insurance fund and the patients will pay the cost of high-value medical consumables respectively according to the medical insurance payment standard, and guide the medical institutions to take the initiative to reduce the purchase price.And encourage medical institutions to participate in the alliance procurement, carry out negotiations, the reduction of the total medical costs will not reduce the total amount of the current year's medical insurance budget.
What needs to be pointed out in particular is that the price of centralized procurement, procurement negotiation and procurement of medical insurance access negotiation for inter-provincial and intra-provincial alliances should be taken as the medical insurance payment standard, and the medical insurance fund should be settled according to the payment standard.
Determine the main governance varieties, will implement DRG
On the requirements of standard use of consumables, the plan points out that the high value medical consumables with relatively high ratio of unit price and resource consumption are taken as the main governance object, and the supervision of the actual purchase amount of high value medical consumables in medical institutions is strengthened.
At the same time, will accelerate the disease diagnosis according to macro-reforms, according to the related group (DRG), and other health care payment reform, establishing medical institutions "balance retention, overspend reasonable share of" incentive and risk sharing mechanism, to promote medical institutions will be high value medical consumables used as the running cost, active control of high value medical consumables.
We should attach equal importance to the control of medical expenses and the standardization of medical service quality, combine clinical path management, reasonably formulate a pay-per-disease scheme, expand the coverage of pay-per-disease, increase the supervision of medical service behavior of medical personnel, and promote the standardized use of medical consumables.
Consumable code implementation, the establishment of the whole process supervision platform
The plan points out that the standard coding system will be unified, the provincial medical consumables coding database will be established and dynamic maintenance will be carried out.Promote the application of medical device identification and medical consumable coding standard in the fields of bidding, procurement, circulation, use, settlement and supervision, so as to realize the information exchange between the procurement platform, medical institutions and medical insurance agencies.
In terms of supervision, it will establish a price monitoring and centralized procurement management platform for high-value medical consumables, explore the closed-loop management of the whole chain of procurement, procurement, distribution, use and management of medical consumables, strengthen statistical analysis, and strengthen the monitoring and analysis of the procurement data and prices of medical institutions.
In connection with the medical insurance, it will be interconnected with the medical insurance payment audit platform, establish a mechanism for sharing and linkage information of the price of high-value medical consumables among departments, and strengthen the monitoring of the purchase and sale price information.