Medical net on July 26, medical treatment of medical treatment of medical treatment of medical treatment of medical treatment of medical treatment of hospital of medical treatment of hospital of medical treatment of hospital of direct settlement is in successive provinces. The country's first farmers WeChat new payment on July 24, also live in shenzhen longhua people's hospital, after standard referral farmers across the province medical new patients in hospitals across the province by WeChat and long-distance real-time knot. Arguably, the health care system has entered the 2.0 era.
The ministry of human resources has just posted on the website of the website "basic medical insurance cross-provincial medical treatment for medical expenses directly settlement of the third batch of district, designated medical institutions opening status list". As of press release, the national medical insurance straight network access work is basically completed. 31 provinces and xinjiang production and construction corps have access to the national platform, and 390 districts have been opened, accounting for 97.5%. A total of 4,055 patients with two or three levels of medical treatment for hospitalization were set up. Plus health development planning long-distance medical billing center with tencent company signed the farmers (new) of urban and rural residents basic medical insurance reimbursement cooperation framework agreement on the settlement of medical network across the province, the industry believes that "the national health insurance settlement scenario and major change will happen."
Regional list of direct settlement of medical expenses for medical treatment in different provinces (as at 21 July 2017)
The system is connected to the big test
After the completion of networked access, real operation will be the next topic to be discussed. From different people's point of view, they generally believed that "to realize different ground settlement is a good thing, but the good thing need more grinding, not only has health system internal cohesion problems among them, also, cohesion between doctor and patient and medical system, both inside and outside two aspects are key to fall to the ground."
The ministry also stressed that "future fairness, liquidity, and sustainability will be an important part of the settlement of long-distance health care." From the perspective of policy design, the problem of funding source is solved in the first prepaid and liquidated settlement. According to the previous years, the ministry of the ministry of the ministry of the ministry of the ministry of finance and the government of the ministry of finance shall allocate funds for the two months in advance, which shall be allocated to the provincial financial households.
Social security institute, vice President of China, sun yat-sen university professor shu-guang shen told reporters: "in fact insurance settlement nationwide network just technical means, in order to adapt to the liquidity requirements. You need to attach importance to, around the settlement diseases, health care reimbursement ratio, price, payment standard inconsistent problem." He pointed out that due to the local economic development level is different, different medical insurance settlement standard, the provinces reimbursement ratio difference is big, and health care medicine directory also has the difference, how to coordinate is a big test in patients with efficient service.
There is a real problem is that the general different record people's more developed city in the types of medical insurance directory, the medical service prices are often higher than the local level, ginseng to department of health care will be worried about the pressure of the fund pays. "These new issues will determine the breadth and breadth of policy implementation." Shen shuguang said that there are still provinces that have yet to set up a provincial settlement center, which is still being settled by the whole area as a unit and medical institution. In other words, the implementation process needs to be constantly improved and "patched".
To point-to-point settlement ginseng to hospital, also has the representative of the medical institution reflected: "realizing provinces and settlement of the difficulty lies in the standardization of medical treatment cost information transmission. If the summary in exchange for a national health care billing info, means that a hospital with tens of thousands of area as a whole for data exchange and expense settlement directly. Relative to character, settlement costs will increase, also bring new challenges to the medical service supervision."
What's more, the technology means to keep the demand for medical care in the big cities, and how to achieve the organic connection with the tiered medical reform system needs to be noticed.
The market has been growing geometrically
If you look at the above practical thinking, you can deduce that the system and system of medical insurance should be continuously optimized and upgraded in practice. However, in the demand for the release of the drug, relevant enterprises have to make a good match in the layout and marketing strategy in advance.
Why? First, compare two sets of data: according to official statistics, the total number of floating population in China reached 245 million in 2016, or about 1/5 of the total population. It is important to draw attention to the fact that in this part of the population, the young migrant population has obvious characteristics, and they have requirements for medical health. And national health development planning commission, according to the latest figures in the first half of this year the knot to achieve cross-regional medical networking service 2369 person-time, submitted to the total amount of 26.47 million yuan, this group of contrast data has the potential market space mapping.
A domestic pharmaceutical enterprise executives declined to be named, told reporters: "we are very pay attention to the mining of medicare drug market and precise marketing. Different ground settlement to solve the issues of cross-regional transverse, balancing and hierarchical diagnosis is the medical resources of longitudinal problem, if the implementation policy coordination, or there is a lot of space to dig."
Words, the executive to the current policies of collaborative slightly worried: "our company recently in the busy bidding, feel now is the policy level change quickly, zero rate, pharmacy custody saga and grading diagnosis and treatment, basic medicine out of medicine, and even social security branch dominant bidding, etc., overwhelmed. If you say, I think the national network is actually a big data strategy, so will the platform of information to the public? Data, one can share the information of product strategy and their enterprise marketing will have a very precise guidance function, and utility efficiency of the whole supply chain system will be further improved."
In addition, the national various provincial long-distance medical billing system with people club department after the completion of the docking, if this is possible: commercial insurance as a supplement of social security role will gradually realize networking, in order to achieve inter-provincial long-distance medical treatment in hospital medical costs, and even keep the direct settlement.
Experts say: "not rule out the big trend. Business can bring traffic to the hospital, out to the patient, adding the social security system, I think no matter to what extent, the future service people and knot amount will into a geometric growth, enterprise products and services will be more accurate." |
