Medical network - July 11 public hospital medicine distribution enterprise payment in arrears has long been a problem. Although the business has been calling for, file management and government also put forward the opinions and demands, but the problem is always didn't get full and effective relief.
The receivable problem -- pain of the drug companies
Hospital for drug firms payback periods are usually 3 months, but in some cases payback periods even for half a year or even one year, a lot of drug companies suffered pain of hospital long payback periods.
In mid-june, the securities times published Shandong Sinobioway Biomedicine Co., Ltd. Reply to the shenzhen stock exchange information announcement, the company's accounts receivable in 2016 than last year's 37.8% growth, the current provision for bad debts to 6.78 million, one of the explanation is: health insurance fee and public hospital drug sales bonus to zero and a series of reform measures to the implementation of the collection period hospital and pharmaceutical businesses medicines are extended, resulting in the company's accounts receivable extended, balance increases. In late April, medicine mining center of jilin province issued "government-run grassroots health institutions in 2013 won the bid drugs directory online centralized purchasing drugs should be clearing of the county (city, area) remit payments bulletin, as of March 21, 2017, 53 counties in the province (city, area) of grassroots medical institutions, drug payment owed $220 million, including 15 counties (city, area) the medical institutions of arrears for more than six months, the longest time of more than a year and a half.
The receivable problem -- and of the hospital
First, hospital, medicine "zombie" problem between the supplier and healthcare sector, is one of the collection at the root of the problem. Why, then, there will be a "zombie"? Because, according to the original medical insurance payment mechanism, after general hospitals advances YaoKuan, settlement health care and hospital again, one thousand medicare settlement is not timely, the hospital overall operation will be affected, the hospital naturally reluctant to advance payment.
Second, at the end of September this year all public hospital will cancel the drug addition. Bonus income didn't, how to make up for? Many places use "8:1:1 compensation principle", namely by medical service price up 80%, local financial subsidies by 10%, 10% own hospital digestion. But medical price adjustment reform involves the mixed actuarial problem, estimates that the medical fees make up for the short term is difficult to balance.
Finally, there is a phenomenon that nots allow to ignore, it is the national public hospitals long-term overall business income balance is negative, many hospitals run in debt, and public hospital long-term debt also needs to be resolved.
Collection problem - the government were evident
Can be seen from the calendar year issued policy file, the government is considering for hospital collection problems early.
In 2010, for example, jointly issued by the seven ministries and commissions of the state of the medical institutions and drug centralized purchasing job specification 37 provisions: "medical institutions shall be in strict accordance with the contract time collection and the lead time from the longest do not exceed 60 days from the date of arrival of the goods. Without justifiable reasons not the lead time as stipulated in the contract, shall pay a certain percentage of penalty due to breach of contract."
In February 2015, issued by the state council "about perfecting public hospital drug centralized procurement guidelines" requirements: "hospitals will decrease in the budget management, in strict accordance with the contract, the time of payment to the acceptance of payment shall not exceed 30 days from delivery".
In February 2017, the general office of the state council issued "on further reform and improve the pharmaceutical production circulation use policy several opinions put forward further: medical institutions to prompt settlement YaoKuan, in violation of the contract, without any justified reason, not timely collection or disguised extended loan payment cycle of medical institutions, health family planning department to rectify and be criticized, rectification within a time limit, shall be ordered to pay penalty due to breach of contract, such as lower level processing.
Collection problem - the solution
2015 state 7 shows the three specific solution paths: one is established by the fiscal support drug purchase circulating funds, 2 it is to fund health care department according to the drug expense proportion in advance in advance to the hospital, the third is to encourage through the mutual reciprocity and mutual benefit, centralized open bank accounts, provide corresponding drugs circulating funds by the bank service, speed up the lead time.
Since last year, in the opinions of the state council, under the guidance of zhejiang, gansu province, fujian and other places have been carried out all kinds of useful exploration.
The medical insurance fund shall be paid in advance in zhejiang province hospital two months of medical expenses, by purchasing platform to introduce 30 ~ 56 days interest-free credit bank loans. Set up a unified provincial YaoXie joint procurement regulation account, purchase accounts for a hospital to regulate, hospital after drug check incoming, within 30 days from the purchase account will play to the regulation of payment account, regulatory accounts to pay again the next day supply business.
Gansu province plans to unify the introduction of a bank as a third party to provide liquidity funding, provided by the bank according to the provincial drug procurement platform of purchasing data, provide drug suppliers YaoKuan 30 days to pay (within 30 days from the acceptance of incoming days). Banks provide hospital XX days credit terms, more than credit terms as the bank charge a penalty due to breach of contract by the regulation, and funding to medical institutions according to the agreed contract account collection or deduct directly. In provincial health insurance agency orgnaization YaoKuan centralized payment account, regulation of hospitals, drug companies, YaoKuan flow to regulate Banks.
In fujian province, the provincial public medical establishment that decide a dot of drugs by the health department monthly payment settlement, unified and distribution enterprise. The medical insurance fund as a whole the area shall be established in accordance with the unified electronic payment system, execute apanage management, classification and settlement. In order to ensure YaoKuan can timely settlement by the month, also asked the city divided into districts in the province to establish settlement reserve fund system, according to ginseng protect personnel to the region last year in the medical establishment that decide a dot 1 month average settlement deposit insurance settlement amount check and ratify, subject to approval by the medical insurance agency orgnaization to the financial department at the same, fiscal revenue from medicare funds allocated to orgnaization of agency of insurance fund spending.
The exploration of the three provinces is expected to solve the problem of drug lead long, dissolve between hospitals, pharmaceutical suppliers and health care department "zombie", reduce the pressure of pharmaceutical enterprise's capital takes up, to a certain extent, also can promote reasonable drug prices fall. |
