青岛市11个中医优势病种“按疗效价值付费”新政省内率先落地

Core Viewpoint - Qingdao City has launched a pilot program for value-based payment for 11 traditional Chinese medicine (TCM) advantageous diseases, aiming to shift from "price-based" to "value-based" medical services, ensuring that TCM treatments achieve equivalent efficacy to Western surgical treatments [1][2] Group 1: Policy Implementation - The pilot program includes 11 TCM advantageous diseases, such as radial bone fracture and anal fistula, selected based on clear clinical pathways and confirmed efficacy [1] - Cases included in the program must meet both TCM and Western medical diagnostic standards, with TCM treatment costs accounting for at least 50% of total treatment costs [1][2] Group 2: Clinical Pathways and Standards - Medical institutions are required to adhere to strict admission criteria and inform patients about their rights regarding the value-based payment system [2] - A clinical pathway for the 11 pilot diseases has been established, with an execution rate target of over 80% for cases to qualify for evaluation and payment settlement [2] Group 3: Future Directions - The health and medical insurance departments will promote TCM diagnostic and treatment techniques to foster public trust and usage of TCM services [2] - The initiative aims to enhance the efficiency of medical insurance fund usage while meeting public demand for TCM services [2]