National Health Insurance Bureau like: only 11 hospitals 432 drugs, save more than 90 million!

Read: Three places were first praised by the NHS.
recently, the state health insurance bureau officials micro-public the first batch of local health care bureau management efficiency typical cases for the provincial health care bureau to learn, three places by the national health insurance bureau the first batch of praise.
provinces are Hebei Province, Inner Mongolia Autonomous Region and Zhuhai City, Guangdong Province.
, Hebei Province and the pharmaceutical market are closely related.
According to the State Health Insurance Administration, Hebei Province, through data analysis of the province's centralized drug procurement platform, found that there is a large gap between different medical institutions in the procurement of drugs of the same name, some medical institutions to purchase high-priced drugs, procurement of low-cost drugs and other anomalies.
In order, Hebei Provincial Health Insurance Bureau set up a special class to the province's 11 medical institutions as the starting point, through the convening of a gas conference, letter inquiries and other forms of drug procurement anomalies in some medical institutions to remind, require written explanation, regulate drug procurement behavior.
11 medical institutions in Hebei Province, on the basis of ensuring clinical needs and rational use of drugs, actively regulate drug procurement behavior by negotiating price reductions with pharmaceutical companies, replacing them with high-quality and low-priced drugs, and eliminating some drugs.
rectification norms, enterprises take the initiative to reduce the price of 151 drugs, medical institutions reasonable replacement of drugs 241, stop the procurement of 40 drugs.
according to the 2019 procurement volume forecast, can save procurement funds of more than 90 million yuan per year.
the contrast between the figures behind this is striking.
according to statistics from the Science and Technology Development Center of the Chinese Pharmaceutical Society, in the first half of 2019, the total number of drug varieties used in third-tier hospitals was 2,122.
Hebei Province, the 11 hospitals should belong to the third-level hospitals, under the supervision of the Hebei Provincial Health Insurance Bureau, 423 drugs have been adjusted, but from the results, a year can save more than 90 million yuan, an average of more than 8 million hospitals.
believe that the National Health Insurance Administration's praise, on the one hand, Hebei Province's hospitals, not only these 11 hospitals will be hands-on drugs, on the other hand, other provinces will actively learn from Hebei Province's practices.
what makes Hebei's approach unique? On April 24, hebei Provincial Health Insurance Bureau issued a "Notice on the establishment of fixed-point medical institutions, medical expenses indicators abnormal growth warning system", the notice said, on the basis of big data, the health insurance intelligent system listed 11 indicators for real-time monitoring of hospital medical expenses, early warning, if the hospital must be given a description, and indicate the specific department and responsible person.
if re-offenders have to submit rectification reports, rectification is not qualified, hospitals, including individual doctors will be suspended from medical insurance eligibility.
9 of the 11 early warning indicators are drug-related: if alerted, hospitals must submit analytical reports within 10 working days.
that there is still an abnormal growth in the medical cost index for 2 consecutive months after the reminder, the interview reminder mechanism is initiated.
interview is still specific to the individual - the medical insurance director of the pharmaceutical institutions, the person in charge of medical insurance and related responsible persons.
medical institutions should complete the rectification on time according to the contents of the interview, effectively curbing unreasonable cost growth.
medical institutions that have continued to increase abnormally in the relevant cost indicators after the interview, the Hebei Provincial Health Insurance Bureau sent a letter of supervision to initiate the listing supervision procedure.
, the pharmaceutical institutions received the listing supervision letter, within 5 working days to the provincial health insurance bureau to submit the rectification plan, in accordance with the rectification plan deadline to complete the rectification.
Medical institutions, departments or individuals (physicians) who have not completed the rectification within the time limit shall, at the end of the year, appropriately deduct the security deposit and give the suspension of medical insurance services for 3 to 6 months;
, these 11 hospitals are the ones that have undergone early warning and rectification after being supervised by big data.
the hebei Provincial Health Insurance Bureau's use of big data regulation is clearly extremely useful.
Last June, the National Health Insurance Administration issued guidance on standardization of health care, in July, the National Health Insurance Administration launched the drug and supplies coding work, in October, the National Health Insurance Administration launched the scope of medical insurance reimbursement for some diseases, surgical operations, medical services and doctors, nurses code.
Public information did not find out whether the Hebei Provincial Health Insurance Bureau's big data supervision is built on the National Health Insurance Bureau's big data system, but no doubt, Hebei's pilot can see is a bull's-knife test of big data supervision, the future big data supervision will certainly play an increasingly powerful role.
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