The reform of traditional Chinese medicine medical insurance payment methods has accelerated, and many places have ushered in new breakthroughs

In recent years, in order to further deepen the reform of medical insurance payment, promote the high-quality development of traditional Chinese medicine, and better meet people's needs for traditional Chinese medicine services, the state has issued a series of policies to improve the medical insurance support policies
of traditional Chinese medicine.
For example, at the end of 2021, the "Guiding Opinions of the National Medical Security Bureau and the State Administration of Traditional Chinese Medicine on Medical Insurance to Support the Innovative Development of Traditional Chinese Medicine" put forward 15 measures to promote medical insurance to support the innovative development of
traditional Chinese medicine.
At present, under the impetus of national policies, the reform of traditional Chinese medicine medical insurance payment methods in various places has also begun to accelerate, and ushered in new breakthroughs
.
For example, at the performance evaluation report of the DRG payment reform of Guangxi medical insurance on September 28, it was revealed that the reform of the medical insurance payment method of traditional Chinese medicine in Guangxi has made new breakthroughs, and in the future, when residents use traditional Chinese medicine to treat diseases, they are expected to get more and more standardized medical insurance protection
.
Guangxi is one of the two provinces in the country that have promoted the reform of
DRG payment methods.
In 2021, the Medical Security Bureau of the Autonomous Region launched the pilot project of "Payment Methods Suitable for the Characteristics of Traditional Chinese Medicine under the Comprehensive Reform of Medical Insurance DRG Payment" in Liuzhou, and the reform path mainly includes payment for the dominant diseases of traditional Chinese medicine, payment according to the value of curative effect, and payment
according to the diagnosis of Western medicine in the dual diagnosis into the DRG group.
Mainly in Liuzhou Traditional Chinese Medicine Hospital
.
It is understood that in the pilot exploration, Liuzhou City has improved the standard of traditional Chinese medicine paying according to the value of curative effect, so that traditional Chinese medicine can achieve the same effect and the same price payment; 32 diseases with obvious advantages in traditional Chinese medicine are selected and paid
according to the number of disease points.
From May to August 2022, Liuzhou City carried out 338 cases of curative value payment, saving about 1 million yuan in medical insurance fund expenditure, reducing the consumption of medical resources by nearly 2 million yuan, of which about 400,000 yuan was reduced by the burden of medical treatment for the masses, and about 1.
6 million yuan was rewarded by the balance of medical institutions; 3997 cases of payment for dominant diseases in traditional Chinese medicine were carried out, and through the reform of medical insurance payment, medical insurance payment was inclined to traditional Chinese medicine by nearly 3 million yuan
.
In addition, Taiyuan City, Changzhi City, and Datong City in Shanxi Province have included the outpatient treatment costs of cupping and Tuina as appropriate techniques for traditional Chinese medicine into the scope of
medical insurance payment.
It is understood that Taiyuan City will include the outpatient treatment costs of appropriate TCM technology into the scope of medical insurance payment, and the outpatient treatment costs within the scope can be reimbursed
at 60%.
All personnel who participate in the basic medical insurance of employees or residents of Taiyuan City can enjoy the outpatient treatment guarantee treatment
of appropriate technology of traditional Chinese medicine.
At present, Shanxi Provincial Hospital of Traditional Chinese Medicine, Affiliated Hospital of Shanxi University of Traditional Chinese Medicine, Shanxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Shanxi Provincial Acupuncture Hospital, and Taiyuan Hospital of Traditional Chinese Medicine have taken the lead in carrying out this service
.
It is worth mentioning that, according to the Datong Municipal Medical Security Bureau, since September 1, Datong insured persons who need to use appropriate traditional Chinese medicine technology to receive treatment in outpatient clinics after being diagnosed by traditional Chinese medicine physicians with deputy senior titles or above in designated medical institutions of level two or above can also enjoy corresponding medical insurance treatment
in accordance with regulations.
In addition, some time ago, the "14th Five-Year Plan" for the Development of Traditional Chinese Medicine (hereinafter referred to as the "Plan") issued by Chongqing Municipality also pointed out that during the "14th Five-Year Plan" period, the price and medical insurance policies of traditional Chinese medicine will be improved, and the price formation mechanism of
traditional Chinese medicine medical services will be explored.
Among them, independent pricing
is implemented for traditional Chinese medicine tablets and traditional Chinese medicine preparations used by medical institutions.
At the same time, the "Plan" also pointed out that eligible TCM diagnosis and treatment projects, TCM tablets and TCM hospital preparations will be included in the scope of payment of
the basic medical insurance fund.
On the other hand, Chongqing will also explore the same effect of traditional Chinese medicine and Western medicine with the same effect and the same price in accordance with the relevant provisions of the
national medical insurance payment.
Disclaimer: Under no circumstances does the information herein or the opinions expressed in this article constitute investment advice
to any person.