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江西医改大动作!公立医院全部取消药品加成

2017-09-09 佚名 上高网

刚刚公布!重大利好!9月9日起江西省公立医院综合改革实现全覆盖9月底,全省所有公立医院全部取消药品加成(中药饮片除外)、挂号费并入诊查费……

刚刚公布!重大利好!

9月9日起江西省公立医院综合改革实现全覆盖9月底,全省所有公立医院全部取消药品加成(中药饮片除外)、挂号费并入诊查费、年底实行按病种收费的病种数不少于100个……持续半个多世纪的“以药补医”政策将在江西彻底终结!

以2型糖尿病伴慢性并发症的患者为例,一年治疗用药费用约为6000元,按20%计算加成率,取消药品加成后药费约为5000元。


9月7日上午,江西省政府新闻办、省医改办联合召开的江西省全面推开公立医院综合改革新闻发布会在南昌召开。记者从会上获悉,从9月9日零时,江西省所有公立医院将全面推开综合改革,持续半个多世纪的“以药补医”政策将在江西彻底终结,这在江西省医疗卫生事业发展历程中具有里程碑意义。

看点一:取消药品加成 挤压耗材虚高价格

据悉,江西省在全面推开公立医院综合改革上,取消药品加成,全面破除医院“以药补医”机制,综合考虑药品保管、贮存、损耗以及中西药加成率等因素,全省县及县以上公立医院按20%计算药品综合加成率。

挤压药品和耗材虚高价格、规范医疗服务。通过药品耗材集中招标采购腾出的空间,主要用于调整医疗服务价格,调增部分按规定纳入医保报销。同时,按照“保基本”原则,调增的门诊诊查费以普通门诊新增价格额度为报销定额,纳入医保统筹基金报销。规范医疗服务行为,挤压过度医疗水分。

看点二:下调部分检查检验项目价格 加大财政投入

按照“总量控制、结构调整、有升有降、逐步到位”的原则,逐步理顺医疗服务价格,上调体现医务人员劳务价值的医疗服务项目价格,下调部分大型设备项目价格,下调部分检查检验项目价格。

加大财政投入。届时,省财政对省直医疗机构取消药品加成部分按10%比例予以补助。另外,对经价格调整后仍然产生政策性亏损的省直单体医疗机构,省财政按取消药品加成金额的5%为上限安排补助经费,低于5%的据实补助;对补助后仍有缺口的全额补助事业单位予以补足。

看点三:年底前实现基本医保全国联网和异地就医直接结算

据了解,此次改革将深化医保支付方式改革,针对不同医疗服务特点,对住院医疗服务,主要按病种、按疾病诊断相关分组付费,长期、慢性病住院医疗服务可按床日付费;对不宜打包付费的复杂病例和门诊费用,可按项目付费;在全省城市公立医院全面推行按病种付费,实施病种不少于100个,到2020年覆盖所有医疗机构和所有医疗服务。同时,加快推进临床路径管理,确保医保支付制度既控医疗费用过快增长,又保障好服务质量。

健全重特大疾病保障机制,提高大病保险对困难群众支付的精准性,推动商业健康保险发展,鼓励和支持商业健康保险机构参与医保经办服务,推动形成多元化竞争格局。

加快建立异地就医直接结算机制,年底前实现江西省基本医保全国联网和异地就医直接结算,满足群众合理的异地就医需求方便群众看病结算。

看点四:推行药品购销“两票制” 提升医务人员薪酬待遇

据了解,江西省在全面推开公立医院综合改革上,2017年在城市公立医院推行药品购销“两票制”,2018年在全省各级公立医院全面推开,进一步减少中间环节,降低药品虚高价格。

会上,省卫生计生委主任、省医改办主任丁晓群表示,广大医务人员是公立医院综合改革的主力军,是推进卫生与健康事业改革发展的中坚力量。江西省将从提升薪酬待遇、发展空间、执业环境、社会地位等方面入手,调动广大医务人员的积极性、主动性、创造性。

此外,江西省将选择若干省直医院试点,解决城市公立医院岗位设置和职称晋升问题,同时积极推行政府购买岗位,变“养人办事”为“办事养人”,实现同岗同薪同待遇。

看点五:监管对象由医疗机构延伸至医务人员

会上,记者还了解到,在省直医院调价项目内,南昌市调整了903项医疗服务项目,包括综合医疗服务类58项,医技诊疗类104项、临床诊疗类671项、中医类70项,调价项目总数占南昌市已开展项目数的31%左右。也就是说,南昌市还有69%的医疗服务项目价格是保持稳定不变的。

在调整的903项医疗服务项目中,上调801项,下调102项,做到了“有升有降”,其中部分大型医用设备检查、检验项目价格有所下降,而体现医务人员技术劳务价值的医疗服务价格有所提升。

丁晓群表示,此次改革将强化公立医院医疗费用监管,分类确定区域和单体公立医院的医疗收入增幅控制目标;强化药品和医用耗材招标采购监管,跟踪监测重点监控品种、超常使用药品、高值医用耗材;强化医保定点机构、医保定点药店和医生的监管,完善医疗保险对医疗服务的监控机制,将监管对象由医疗机构延伸至医务人员。

看点六:挂号费并入诊察费 医疗服务价格纳入医保报销范围

记者从会上获悉,这次改革会对群众就诊费用产生一定影响。经测算分析,群众的负担总体不增加。本次调整的医疗服务价格按规定纳入医保报销范围,同时通过药品“双信封”集中采购,压低了药品价格,让利群众。但就患者个体而言,受每位患者在就诊疾病、治疗方案、治疗周期等方面存在个性差异会有不同影响。如对于一次诊疗过程以药物治疗为主,或较多涉及CT、核磁检查的患者,其就医费用一般会有所下降;若诊疗过程中以技术劳务治疗项目为主,则患者诊疗费用会有所增加。

调价后的1279项医疗服务项目,仍按原来的医保目录属性纳入医保基金支付范围,按政策规定予以报销。也就是说,医保报销额度随着医疗服务项目价格调整按规定比例调增。

此外,在医保支付政策方面,为了调价后不增加百姓就医负担,所有调整的医疗服务项目均在医保目录范围内,按规定纳入医保报销。调增的门诊诊察费以普通门诊新增价格为报销定额,纳入医保统筹基金报销,其中三级综合改革公立医院支付标准为13元/每人.每次,二级综合改革公立医院支付标准为9元/每人.每次,一级综合改革公立医院支付标准为4元/每人.每次。南昌市还增加了门诊特殊慢性病病种数,年最高限额也有不同程度提高。除了设立便民门诊外,对在同一科室48小时内重复就诊的门诊患者只收一次诊察费,切实做到了便民惠民。

看点七:贫困家庭10种大病继续免费救治 个人自付比例降至10%以下

据悉,此次改革对全省贫困家庭10种大病继续实施免费救治并实行长效管理,按每人每年不低于90元标准,为全省346万建档立卡的贫困人口购买大病补充保险,建立完善基本医保、大病保险、补充保险、医疗救助“四道医疗保障线”,使个人自付比例降至10%以下。

覆盖全人群,统筹推进城乡、区域、不同人群的公共卫生和计划生育工作,将流动人口纳入当地基本公共服务范围,提高均等化水平。覆盖全过程,逐步将健康管理从特定生命阶段延伸到整个生命周期,并对高血压糖尿病抗生素耐药、儿童肥胖等健康问题进行有针对性地干预,加快从“治已病”向“治未病”转变。

此外,江西省在此次深化改革力争达到今年全省二级以上公立医院医师参与家庭医生签约服务团队要达到10%,城市公立医院给予一定比例的专家号、预留床位等,方便签约居民优先就诊和住院,确保年底实现家庭医生(团队)签约服务率达到30%以上,重点人群签约服务覆盖率达到60%以上。

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    2017-09-11 tidiq
  3. [GetPortalCommentsPageByObjectIdResponse(id=1681757, encodeId=c6881681e5769, content=<a href='/topic/show?id=11258e373b8' target=_blank style='color:#2F92EE;'>#药品加成#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87373, encryptionId=11258e373b8, topicName=药品加成)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b8e927859734, createdName=longerg, createdTime=Wed Aug 01 10:14:00 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1286816, encodeId=c086128681605, content=<a href='/topic/show?id=ebac3442063' target=_blank style='color:#2F92EE;'>#医改#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=34420, encryptionId=ebac3442063, topicName=医改)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b3e9205, createdName=tidiq, createdTime=Mon Sep 11 06:14:00 CST 2017, time=2017-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=242267, encodeId=680f24226eac, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Sat Sep 09 20:33:45 CST 2017, time=2017-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=242213, encodeId=96ab242213ef, content=9月9日起江西省公立医院综合改革实现全覆盖9月底.全省所有公立医院全部取消药品加成(中药饮片除外).挂号费并入诊查费.年底实行按病种收费的病种数不少于100个--持续半个多世纪的[以药补医"政策将在江西彻底终结!, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Sat Sep 09 16:21:18 CST 2017, time=2017-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=242206, encodeId=d94124220647, content=我们这儿都取消了5年了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=625c1320083, createdName=fcbgyb, createdTime=Sat Sep 09 15:43:29 CST 2017, time=2017-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=242202, encodeId=3a9124220205, content=好事.取消药加成.惠顾于民.只是苦了医院., beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Sep 09 15:27:39 CST 2017, time=2017-09-09, status=1, ipAttribution=)]
    2017-09-09 131****1460

    学习了受益匪浅

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1681757, encodeId=c6881681e5769, content=<a href='/topic/show?id=11258e373b8' target=_blank style='color:#2F92EE;'>#药品加成#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87373, encryptionId=11258e373b8, topicName=药品加成)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b8e927859734, createdName=longerg, createdTime=Wed Aug 01 10:14:00 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1286816, encodeId=c086128681605, content=<a href='/topic/show?id=ebac3442063' target=_blank style='color:#2F92EE;'>#医改#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=34420, encryptionId=ebac3442063, topicName=医改)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b3e9205, createdName=tidiq, createdTime=Mon Sep 11 06:14:00 CST 2017, time=2017-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=242267, encodeId=680f24226eac, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Sat Sep 09 20:33:45 CST 2017, time=2017-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=242213, encodeId=96ab242213ef, content=9月9日起江西省公立医院综合改革实现全覆盖9月底.全省所有公立医院全部取消药品加成(中药饮片除外).挂号费并入诊查费.年底实行按病种收费的病种数不少于100个--持续半个多世纪的[以药补医"政策将在江西彻底终结!, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Sat Sep 09 16:21:18 CST 2017, time=2017-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=242206, encodeId=d94124220647, content=我们这儿都取消了5年了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=625c1320083, createdName=fcbgyb, createdTime=Sat Sep 09 15:43:29 CST 2017, time=2017-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=242202, encodeId=3a9124220205, content=好事.取消药加成.惠顾于民.只是苦了医院., beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Sep 09 15:27:39 CST 2017, time=2017-09-09, status=1, ipAttribution=)]
    2017-09-09 有备才能无患

    9月9日起江西省公立医院综合改革实现全覆盖9月底.全省所有公立医院全部取消药品加成(中药饮片除外).挂号费并入诊查费.年底实行按病种收费的病种数不少于100个--持续半个多世纪的[以药补医"政策将在江西彻底终结!

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1681757, encodeId=c6881681e5769, content=<a href='/topic/show?id=11258e373b8' target=_blank style='color:#2F92EE;'>#药品加成#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87373, encryptionId=11258e373b8, topicName=药品加成)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b8e927859734, createdName=longerg, createdTime=Wed Aug 01 10:14:00 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1286816, encodeId=c086128681605, content=<a href='/topic/show?id=ebac3442063' target=_blank style='color:#2F92EE;'>#医改#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=34420, encryptionId=ebac3442063, topicName=医改)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b3e9205, createdName=tidiq, createdTime=Mon Sep 11 06:14:00 CST 2017, time=2017-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=242267, encodeId=680f24226eac, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Sat Sep 09 20:33:45 CST 2017, time=2017-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=242213, encodeId=96ab242213ef, content=9月9日起江西省公立医院综合改革实现全覆盖9月底.全省所有公立医院全部取消药品加成(中药饮片除外).挂号费并入诊查费.年底实行按病种收费的病种数不少于100个--持续半个多世纪的[以药补医"政策将在江西彻底终结!, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Sat Sep 09 16:21:18 CST 2017, time=2017-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=242206, encodeId=d94124220647, content=我们这儿都取消了5年了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=625c1320083, createdName=fcbgyb, createdTime=Sat Sep 09 15:43:29 CST 2017, time=2017-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=242202, encodeId=3a9124220205, content=好事.取消药加成.惠顾于民.只是苦了医院., beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Sep 09 15:27:39 CST 2017, time=2017-09-09, status=1, ipAttribution=)]
    2017-09-09 fcbgyb

    我们这儿都取消了5年了!

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1681757, encodeId=c6881681e5769, content=<a href='/topic/show?id=11258e373b8' target=_blank style='color:#2F92EE;'>#药品加成#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87373, encryptionId=11258e373b8, topicName=药品加成)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b8e927859734, createdName=longerg, createdTime=Wed Aug 01 10:14:00 CST 2018, time=2018-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1286816, encodeId=c086128681605, content=<a href='/topic/show?id=ebac3442063' target=_blank style='color:#2F92EE;'>#医改#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=34420, encryptionId=ebac3442063, topicName=医改)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b3e9205, createdName=tidiq, createdTime=Mon Sep 11 06:14:00 CST 2017, time=2017-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=242267, encodeId=680f24226eac, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Sat Sep 09 20:33:45 CST 2017, time=2017-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=242213, encodeId=96ab242213ef, content=9月9日起江西省公立医院综合改革实现全覆盖9月底.全省所有公立医院全部取消药品加成(中药饮片除外).挂号费并入诊查费.年底实行按病种收费的病种数不少于100个--持续半个多世纪的[以药补医"政策将在江西彻底终结!, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Sat Sep 09 16:21:18 CST 2017, time=2017-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=242206, encodeId=d94124220647, content=我们这儿都取消了5年了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=625c1320083, createdName=fcbgyb, createdTime=Sat Sep 09 15:43:29 CST 2017, time=2017-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=242202, encodeId=3a9124220205, content=好事.取消药加成.惠顾于民.只是苦了医院., beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Sep 09 15:27:39 CST 2017, time=2017-09-09, status=1, ipAttribution=)]
    2017-09-09 1e0f8808m18(暂无匿称)

    好事.取消药加成.惠顾于民.只是苦了医院.

    0

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map
Baidu
map