广东推门诊打包付费：借力医保“强基层”

Core Viewpoint - Guangdong Province is the first in China to implement a "packaged payment" reform for outpatient medical services starting in 2026, which is expected to significantly impact the revenue structure of public hospitals and patient costs [1][2]. Summary by Sections Outpatient Payment Reform - The new policy will affect approximately 40% of the revenue structure of public hospitals in Guangdong, as the current outpatient to inpatient revenue ratio is about 4:6 nationwide [1]. - The reform aims to address issues of excessive outpatient medical services and the misallocation of healthcare resources, where hospitals have been incentivized to increase outpatient service volumes for profit [1][2]. Impact on Healthcare Institutions - The implementation of "packaged payment" is expected to change the operational logic of grassroots medical institutions, which have historically been viewed as lower quality, pushing patients towards larger hospitals [2]. - By providing more financial support to grassroots institutions, the reform encourages them to improve service quality and reduce unnecessary treatments, thus aligning their incentives with patient health outcomes [2][3]. Economic Leverage for Hospitals - For larger hospitals, the reform may lead to a shift from a "siphoning" model to an "empowering" model, where they invest in grassroots healthcare capabilities to access shared outpatient funding [3]. - The policy mandates that local governments enhance assessment metrics for outpatient services, linking these evaluations to funding settlements, which is crucial for compliance with the new payment structure [3]. Future Directions - The ultimate goal of the payment reform is to transition from a disease-centered approach to a health-centered approach, promoting preventive care and health management [4][5]. - Successful implementation could lead to a system where healthcare institutions are rewarded for keeping residents healthy, thereby reducing overall medical costs and improving public health outcomes [4][5].