赋能医疗机构高质量发展 医保按病种付费新规出台

Core Viewpoint - The National Healthcare Security Administration (NHSA) has released the "Interim Measures for Disease-Specific Payment Management," aiming to reform the medical insurance payment system to establish a unified, efficient, and standardized mechanism that supports the high-quality development of medical institutions [1] Summary by Relevant Sections Payment System Reform - The new measures focus on disease-specific payment as a key aspect of the medical insurance payment reform [1] - The goal is to create a nationwide unified payment mechanism that is effective and collaborative [1] Budget Management - The measures emphasize the importance of total budget management, requiring reasonable expenditure budget preparation and establishing a rigid total for disease-specific payments [1] Grouping Scheme - The measures specify the formulation and adjustment of grouping schemes, detailing the responsible parties, framework, supporting data, and adjustment content, with a principle of biennial adjustments [1] Core Elements and Supporting Measures - The measures clarify the definitions of key elements such as weight, rate, and payment standards, mandating that the NHSA collaborates with medical institutions to reach consensus [1] - It also standardizes supporting measures related to medical insurance payments, including special case negotiations, advance payments, opinion collection, negotiation, and data publication to enhance the scientific level of medical insurance payments [1]