Policy review: how provincial medical insurance policies inject new momentum into the development of traditional Chinese medicine

 The reform of medical security is a major measure to meet the needs of the people for multi-level and diverse medical security and health servic.
Chinese medicine is a treasure of Chinese civilization and plays an important role in the health of the whole peop.
Under the background of the country's comprehensive deepening of medical insurance reform, how to promote the "three medical linkage" Chinese medicine reform, so that Chinese medicine can better serve the health of the whole people? In December 2021, the National Medical Security Administration and the National Administration of Traditional Chinese Medicine jointly issued the "Guiding Opinions on Medical Insurance Supporting the Inheritance, Innovation and Development of Traditional Chinese Medicine" (hereinafter referred to as the "Opinions.
Shanghai, Zhejiang, Anhui, Guangdong, Sichuan, Gansu and other relevant departments have also successively issued relevant polici.
Hangzhou Tanggu Information Technology .
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has been focusing on the digitalization of the traditional Chinese medicine industry for a long ti.
It has participated in the sunshine platform project for the supervision of the procurement and distribution of traditional Chinese medicine pieces in Shanghai, and has paid close attention to the medical insurance reform policies related to traditional Chinese medici.
After analyzing and researching the policies of medical insurance to support the inheritance, innovation and development of traditional Chinese medicine issued by various provinces in recent years, we have summarized the following six aspec.
Support the construction of TCM donors, and the medical insurance budget is tilted toward the grassroo.
The medical community is led by county-level hospitals to build a county-level and rural three-level medical service network, so as to realize an orderly division of labor among a county-level hospital, a township health center, and a village clin.
A county-level medical and health community for information exchange and benefit shari.
Among the medical insurance policies issued by the above-mentioned provinces, all support the construction of a TCM medical community with county-level traditional Chinese medicine hospitals as the lead.
Zhejiang Province also clearly stated that the proportion of medical insurance reimbursement should be tilted towards grass-roots medical institutions, and guide insured personnel to seek medical treatment at the grass-roots lev.
The purpose of building a community of traditional Chinese medicine is to promote high-quality traditional Chinese medicine medical and health services to sink to grass-roots medical and health institutions, and to improve the ability of grass-roots traditional Chinese medicine servic.
As the medical insurance budget is tilted towards the medical community, grassroots people can not only see traditional Chinese medicine at their doorsteps, but even enjoy a higher proportion of medical insurance reimburseme.
Driven by the medical community and the medical insurance policy, traditional Chinese medicine pharmaceutical services such as the distribution of traditional Chinese medicine decoction and medication guidance will also be further improved, so that ordinary people can use traditional Chinese medicine with confidence and convenien.

In recent years, driven by the needs of epidemic prevention and control and favorable policies, "Internet +" traditional Chinese medicine services have become one of the important contents of traditional Chinese medicine inheritance and innovati.

It has become the consensus of various provinces and cities to encourage TCM medical institutions to carry out "Internet +" diagnosis and treatment services, and to incorporate "Internet +" TCM services that meet the regulations into the scope of medical insurance payme.

Zhejiang Province emphasizes on cultivating the emerging business form of "Internet + Chinese medicine" service, and actively builds a Chinese medicine service ecosystem of online TCM follow-up, online payment, offline dispensing of decoctions, and distributi.

Establish a medical insurance TCM prescription circulation platform, explore the online bidding and distribution mechanism, and optimize the medical treatment experience of insured personn.

Gansu Province proposed to promote the development of "smart Chinese pharmacies", improve the level of pharmaceutical services such as TCM decoction pieces and formulations, and realize the integration of TCM decoction pieces procurement and storage, prescription circulation, medical insurance settlement, preparation and decoction, centralized distribution, and quality management in medical institutio.

Development, improve the convenience of traditional Chinese medicine services, and facilitate the mass.

"Internet +" Chinese medicine services are included in the scope of medical insurance payment, which will help medical institutions to accelerate the improvement of their information management level, and meet the growing health needs of the people with diversified Chinese medicine servic.

Encourage medical institutions to purchase authentic medicinal materials and explore the formation mechanism of high-quality and high-price TCM decoction piec.

The "Opinions" proposes to strengthen the price management of TCM services, clarifying that public medical institutions purchase TCM decoction pieces from formal channels and sell them in strict accordance with the actual purchase pri.

On the basis of requiring medical institutions to implement the state-specified addition policy for Chinese herbal pieces, some provinces and cities have put forward regulations to explore the mechanism of high-quality and better-price Chinese herbal piec.

On the basis of the existing 23 varieties of authentic Chinese herbal decoction pieces that have been negotiated and purchased on the Internet, Gansu Province has further expanded the procurement catalogue of Chinese herbal decoction piec.

The whole process of traceability of traditional Chinese medicinal materials should be traced, and relevant price and procurement policies should be improved to encourage and guarantee the supply of high-quality traditional Chinese medicinal materials; Zhejiang Province emphasized the need to promote medical institutions to establish a mechanism for determining the procurement price based on the quality of traditional Chinese medicin.

Granules are included in the scope of medical insurance fund payme.

Under the guidance of the high-quality and high-price policy, all entities in the traditional Chinese medicine industry chain will take more proactive measures to ensure quality, and actively cooperate with relevant departments to carry out the full-process traceability of authentic medicinal materials and traditional Chinese medicine pieces, so as to promote the formation of a high-quality and high-price mechani.

Allowing medical institutions to implement independent pricing for preparations and prepared decoction pieces The "Opinions" not only require medical institutions to add TCM decoction pieces, but also support the implementation of independent pricing for TCM decoction pieces prepared and prepared by medical institutio.

Provinces have also actively responded to the call to include Chinese medicinal preparations and Chinese medicinal decoction pieces from eligible medical institutions into the scope of local medical insurance paymen.

Most of the traditional Chinese medicine preparations in medical institutions come from the contracted parties of the famous old Chinese medicine practitioners in the hospit.

They are the wisdom crystallization of the academic thinking and diagnosis and treatment experience of famous old Chinese medicine doctors, and the inheritance carrier of clinical thinking and medication rul.

It is safe, effective and convenient to u.

It is a powerful means of competition for hospitals based on "differentiated service.

Under the policy dividend of independent pricing of traditional Chinese medicine preparations and inclusion of medical insurance, medical institutions will mobilize more enthusiasm to participate in preparation research, and promote the development of traditional Chinese medicine preparations from the hospital to the region, so that more people can benefit from it, and it will also open up more opportunities for traditional Chinese medicine preparatio.

development spa.

Strengthen information-based supervision and ensure the implementation of medical insurance-related policies In order to promote the implementation of policies for medical insurance to support the inheritance, innovation and development of traditional Chinese medicine, some provinces have made clear regulations to strengthen the supervision of medical insurance fun.

Among them, the information construction with the goal of supervision attracts attenti.

Gansu Province proposes to vigorously promote joint law enforcement, information sharing and interconnection between medical insurance departments and relevant departments to form a synergy of supervision; Shanghai proposes to comprehensively improve the informatization level of traditional Chinese medicine medical institutions and further improve the service characteristics of traditional Chinese medici.

The medical insurance intelligent monitoring rule base and knowledge base promote the application of medical insurance intelligent monitoring, and realize the whole-process supervision of pre-event reminder, in-event early warning, and post-event revi.

Although the intelligent supervision of medical insurance for traditional Chinese medicine services is complicated to a certain extent, the intelligent supervision of medical insurance still relies on the information level of medical institutions in essen.

Therefore, TCM medical institutions should strengthen the information management of TCM diagnosis and treatment process and the construction of smart TCM pharmacies, and promote the in-depth integration of information technologies such as the Internet of Things, big data, and blockchain with TCM services, which will help to further improve the efficiency of intelligent supervision of medical insuran.

Supporting medical institutions to carry out suitable technology of traditional Chinese medicine and characteristic services The suitable technology of traditional Chinese medicine has unique advantages in health care, medical rehabilitation, e.

, and allowing suitable technology of traditional Chinese medicine to sink to the grassroots level is of great significance to promoting the health of the whole peop.

To this end, Anhui Province supports the inclusion of qualified traditional Chinese medicine techniques into the settlement of day-bed admission and treatment of diseases in primary medical institutio.

In exploring the per-capita payment mechanism for some chronic diseases, support and guide grassroots medical institutions to provide appropriate traditional Chinese medicine servic.

Guangdong Province supports grass-roots medical institutions to carry out traditional Chinese medicine services such as chronic diseases and medical rehabilitation, and prioritizes the inclusion of appropriate traditional Chinese medicine and traditional Chinese medicine diagnosis and treatment items into the scope of outpatient drugs and treatments for specific diseases, and explores the implementation of payment by disea.

The quality of appropriate technology and characteristic services of traditional Chinese medicine is closely related to the service level of medical sta.

In the measures to promote the price reform of traditional Chinese medicine services, Sichuan Province focuses on increasing the price of traditional Chinese medicine medical service items that reflect the value of traditional Chinese medicine technical labor services, stimulates the enthusiasm of medical staff to provide traditional Chinese medicine diagnosis and treatment services, and allows the appropriate technology of traditional Chinese medicine to better serve the health of the grassroots peop.

In addition to the above, there are some points worth paying attention to in the medical insurance support policies of various provinces, such as promoting the DRG grouping of traditional Chinese medicine, and paying for management of DRG points; Included in the payment of medical insurance funds; on the basis of provincial or inter-provincial regional alliances, the procurement of Chinese patent medicines with volume is carried o.

Under the call of national policies, other provinces will also successively introduce relevant medical insurance support polici.

The implementation of these policies will surely promote the inheritance, innovation and development of traditional Chinese medicine to a new lev.