Health and Family Planning Commission refines multi-channel financial compensation mechanism for basic medical reform

Source: on October 17, 2014, in order to deepen the reform of medical and health system and consolidate the new mechanism of grass-roots operation, the state health and Family Planning Commission and the Ministry of Finance jointly carried out the work of key contact points for comprehensive reform of grass-roots health for three years On October 16, the general office of the national health and Family Planning Commission sent a message that according to the implementation plan of the key contact points of the comprehensive reform of local grass-roots health reported by 34 contact points, such as Xicheng District of Beijing, Chifeng City of Inner Mongolia and Tieling City of Liaoning Province, the regulatory ministries will guide and refine them from the macro policy level The detailed contents include: striving to break through the key links of the reform, such as the establishment of a stable and long-term multi-channel compensation mechanism, the purchase of basic medical and health services, the deepening of personnel and distribution system reform, the improvement of an effective performance appraisal system, and the adjustment of the price of technical services for medical personnel, so as to form a reform mode with local characteristics Under the above policy requirements, the reporter combed the implementation plan of key contact points of comprehensive health reform at multiple grassroots level and found that "multi-channel compensation mechanism" was frequently included in the key projects of local reform In April this year, the reform of 34 basic level contact points was launched After the recommendation of relevant provinces and the review of experts, the regulatory ministries and commissions determined 34 basic level areas as key contact points nationwide, including Xicheng District and Pinggu District of Beijing, Cangzhou City of Hebei Province, Chifeng City of Inner Mongolia, Tieling City of Liaoning Province, Jilin City of Jilin Province, Changning District of Shanghai and Pudong New Area The key task of the selected contact points is to promote the implementation of the grass-roots medical reform policy, carry out reform and innovation around the key issues in the implementation of the grass-roots medical reform policy, and strengthen the construction of reform capacity in the contact point areas, and carry out evaluation, summary and promotion Taking Liaoning Province as an example, Tieling City was finally shortlisted after layers of application and selection The reporter learned from the provincial government that Tieling was shortlisted because the basic medical and health service network in urban and rural areas has been basically sound, the service function of basic medical and health institutions is relatively perfect, the basic drug system has been fully implemented and the comprehensive reform of basic health has been carried out, and the compensation mechanism, personnel distribution system, performance appraisal system and other policies have been well implemented The central government will grant a special fund of 1 million yuan per year to each contact point to carry out the comprehensive reform of grass-roots health, so as to explore new models and establish new mechanisms At present, Tieling City has set up a leading group of key contact points for comprehensive health reform at the grass-roots level, which is studying and refining the implementation plan based on the local actual situation On June 11, the provincial health and Family Planning Commission and the Department of finance also held the launch and seminar of the key contact point project of comprehensive health reform at the grassroots level in Tieling to jointly implement the reform In addition to Tieling, the key contact points for the comprehensive reform of basic health in Xicheng District of Beijing have started the data collection of the buyer's family health survey, and the basic level office of Inner Mongolia health and Family Planning Commission has also completed the selection work before June this year Among them, the reform plan of key contact points in Inner Mongolia is to establish a stable and long-term multi-channel compensation mechanism, financial subsidies and revenue and expenditure management system, establish a mechanism for purchasing basic public health services, improve an effective performance appraisal system, and deepen the reform of personnel and distribution system On October 16, the national health and Family Planning Commission officially issued a voice to clarify the next operation path of key contact points in various regions The next step is to establish a stable and long-term multi-channel compensation mechanism, implement financial compensation funds, improve revenue and expenditure management, standardize the management of basic public health service funds, give full play to the compensation role of medical insurance funds, purchase basic medical and health services, deepen the reform of personnel and distribution systems, and improve the incentive and effective performance appraisal system Some breakthroughs have been made in the key links of the reform, such as adjusting the price of technical services for medical personnel, and a reform model with local characteristics has been formed In fact, the issue of financial compensation in the comprehensive reform at the grassroots level has been discussed for a long time According to the information learned by the reporter, although in 2012, the central finance once granted subsidy funds to 311 county (city) public hospital reform pilot units in 18 provinces in accordance with the standard of 3 million yuan per county (city), but the actual part of the subsidy is not enough to alleviate the pressure on the grass-roots level Taking Shandong Province as an example, for a long time, the grass-roots financial pressure in Shandong Province is large, the long-term medical reform funding guarantee mechanism has not been established, and the part that needs local compensation and supporting has exceeded the burden capacity of local finance Moreover, due to the historical debt, there are many problems such as low starting point, poor ability, backward infrastructure conditions and lack of technical personnel in the basic health institutions The reporter learned that the decision-making level had said that when promoting the new health care reform at the grassroots level, it was required to complete the debt clearing and resolution work of the grassroots medical and health institutions by September 2013 But up to now, the problem of grass-roots debt has not been eradicated How to find a breakthrough on this issue? Cai Jiangnan, director of the center for health management and Policy Research of CEIBS, suggested that on the premise that the decision-making level has liberalized the price of medical services in non-public hospitals, we should also try to adjust the price of services such as outpatient and inpatient services Because there is no supplement of medical service fees, we can even retain part of "medical support" at the grass-roots level