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DRG payment is a medical insurance cost control management tool, which aims to divide patients into different diagnosis groups according to different conditions and pay for packaged treatment
.
On December 30, 2021, the National Medical Insurance Administration and other two departments jointly issued the "Guiding Opinions on Medical Insurance Supporting the Inheritance, Innovation and Development of Traditional Chinese Medicine", which pointed out that "TCM medical institutions may temporarily not implement DRG payment.
In areas where points are paid, the coefficients and points of TCM medical institutions and TCM diseases should be appropriately increased
.
" The release of this opinion made the TCM industry companies at that time relieved, plus the release of favorable policies, TCM concept stocks Once high
.
However, "not temporarily" does not mean that it has not been implemented.
At the end of November 2021, the "Notice of the Three-Year Action Plan for the Reform of DRG/DIP Payment Methods" issued by the National Medical Insurance Administration has made it clear that in 2024, all co-ordination areas in the country will carry out DRG/DIP.
Payment reform; by 2025, all diseases and medical insurance funds will be basically covered
.
At present, many places have already started relevant actions
.
For example, on January 17, the Zhejiang Provincial Medical Insurance Bureau issued a notice on further implementing the "Implementation Opinions on Supporting the Inheritance and Innovation of Traditional Chinese Medicine", which pointed out that the "Zhejiang Medical Insurance Bureau's Implementation Opinions on Supporting the Inheritance, Innovation and Development of Traditional Chinese Medicine" ” has been implemented since January 1, and one of the main contents includes DRG payment of TCM medical institutions: In the DRG payment and settlement work in 2021, all localities should fully implement a positive incentive mechanism linking the treatment rate of TCM medical institutions and medical insurance payment
.
The rate of traditional Chinese medicine treatment refers to the proportion of the total income of TCM medical institutions in hospitalized TCM decoction pieces, TCM medical service items, and Chinese patent medicines in the inpatient medical income
.
On January 12, the Guangdong Provincial Medical Insurance Bureau also made it clear at a press conference that it will organize the selection of TCM dominant diseases in batches, implement DRG/DIP payment, and carry out the reform of the TCM service medical insurance payment system
.
It is understood that there are currently 23,000 TCM medical institutions and 192 TCM hospitals in Guangdong Province, of which there are 36 and 72 TCM hospitals at the third and second level, respectively
.
Under the plan of the provincial medical insurance bureau, all municipal TCM hospitals will be established as tertiary hospitals, and all county TCM hospitals with a permanent population of more than 300,000 will be established as second-class hospitals
.
In addition, on January 5 this year, Nanjing City also launched the interim measures for medical insurance on DRG/DIP payment.
The interim measures also piloted TCM grouping for some TCM dominant diseases.
It is clear that the disease group included in TCM DIP has a low benchmark point.
For the corresponding western medicine disease group, adjust according to the western medicine disease group
.
From the perspective of the industry, traditional Chinese medicine DRG has become the general trend
.
Under this model, enterprises in the traditional Chinese medicine industry will face some challenges.
For example, DRG and DIP payment emphasize the quality and efficiency of diagnosis and treatment methods, while the current medical capabilities of traditional Chinese medicine enterprises are relatively weak
.
Kaiyuan Securities once pointed out that although there are currently more than 9,000 varieties of traditional Chinese medicine in China, with nearly 60,000 Chinese medicine approval numbers, there seems to be no shortage of traditional Chinese medicine varieties, but from the current clinical needs, there are still Chinese patent medicines with high clinical value.
lack
.
In the long run, under the TRG model of traditional Chinese medicine, it is expected that TCM and traditional Chinese medicine will be further linked in the future, which will benefit the development of the traditional Chinese medicine industry
.
The industry believes that, on the whole, it will be beneficial to bid farewell to the stage of barbaric growth of the traditional Chinese medicine industry, make the industry develop in the direction of standardization and high quality, and bring more good news to patients
.
.
On December 30, 2021, the National Medical Insurance Administration and other two departments jointly issued the "Guiding Opinions on Medical Insurance Supporting the Inheritance, Innovation and Development of Traditional Chinese Medicine", which pointed out that "TCM medical institutions may temporarily not implement DRG payment.
In areas where points are paid, the coefficients and points of TCM medical institutions and TCM diseases should be appropriately increased
.
" The release of this opinion made the TCM industry companies at that time relieved, plus the release of favorable policies, TCM concept stocks Once high
.
However, "not temporarily" does not mean that it has not been implemented.
At the end of November 2021, the "Notice of the Three-Year Action Plan for the Reform of DRG/DIP Payment Methods" issued by the National Medical Insurance Administration has made it clear that in 2024, all co-ordination areas in the country will carry out DRG/DIP.
Payment reform; by 2025, all diseases and medical insurance funds will be basically covered
.
At present, many places have already started relevant actions
.
For example, on January 17, the Zhejiang Provincial Medical Insurance Bureau issued a notice on further implementing the "Implementation Opinions on Supporting the Inheritance and Innovation of Traditional Chinese Medicine", which pointed out that the "Zhejiang Medical Insurance Bureau's Implementation Opinions on Supporting the Inheritance, Innovation and Development of Traditional Chinese Medicine" ” has been implemented since January 1, and one of the main contents includes DRG payment of TCM medical institutions: In the DRG payment and settlement work in 2021, all localities should fully implement a positive incentive mechanism linking the treatment rate of TCM medical institutions and medical insurance payment
.
The rate of traditional Chinese medicine treatment refers to the proportion of the total income of TCM medical institutions in hospitalized TCM decoction pieces, TCM medical service items, and Chinese patent medicines in the inpatient medical income
.
On January 12, the Guangdong Provincial Medical Insurance Bureau also made it clear at a press conference that it will organize the selection of TCM dominant diseases in batches, implement DRG/DIP payment, and carry out the reform of the TCM service medical insurance payment system
.
It is understood that there are currently 23,000 TCM medical institutions and 192 TCM hospitals in Guangdong Province, of which there are 36 and 72 TCM hospitals at the third and second level, respectively
.
Under the plan of the provincial medical insurance bureau, all municipal TCM hospitals will be established as tertiary hospitals, and all county TCM hospitals with a permanent population of more than 300,000 will be established as second-class hospitals
.
In addition, on January 5 this year, Nanjing City also launched the interim measures for medical insurance on DRG/DIP payment.
The interim measures also piloted TCM grouping for some TCM dominant diseases.
It is clear that the disease group included in TCM DIP has a low benchmark point.
For the corresponding western medicine disease group, adjust according to the western medicine disease group
.
From the perspective of the industry, traditional Chinese medicine DRG has become the general trend
.
Under this model, enterprises in the traditional Chinese medicine industry will face some challenges.
For example, DRG and DIP payment emphasize the quality and efficiency of diagnosis and treatment methods, while the current medical capabilities of traditional Chinese medicine enterprises are relatively weak
.
Kaiyuan Securities once pointed out that although there are currently more than 9,000 varieties of traditional Chinese medicine in China, with nearly 60,000 Chinese medicine approval numbers, there seems to be no shortage of traditional Chinese medicine varieties, but from the current clinical needs, there are still Chinese patent medicines with high clinical value.
lack
.
In the long run, under the TRG model of traditional Chinese medicine, it is expected that TCM and traditional Chinese medicine will be further linked in the future, which will benefit the development of the traditional Chinese medicine industry
.
The industry believes that, on the whole, it will be beneficial to bid farewell to the stage of barbaric growth of the traditional Chinese medicine industry, make the industry develop in the direction of standardization and high quality, and bring more good news to patients
.
