2.0版DRG/DIP方案：优化支付标准、规范医保支付

Investment Rating - The report maintains an "Outperform" rating for the industry, indicating a positive outlook compared to the broader market [5]. Core Insights - The introduction of the 2.0 version of the DRG/DIP payment scheme aims to optimize payment standards and regulate medical insurance payments, promoting healthy and stable development in the pharmaceutical industry [1]. - The 2.0 version has adjusted grouping to better align with clinical realities, increasing the number of ADRG groups from 376 to 409, resulting in a total of 634 disease diagnosis-related groups [2]. - The policy allows for a special case negotiation mechanism for complex cases and new drugs, enabling medical institutions to self-declare special cases, which can account for up to 5% of total DRG or DIP cases [3]. - As of the end of 2023, over 90% of coordinated areas in the country have implemented DRG/DIP payment reform, indicating initial success in the reform process [4]. Summary by Sections Industry Events - On July 23, the National Healthcare Security Administration issued a notice on the 2.0 version of the grouping scheme, which is expected to enhance payment standards and regulate medical insurance payments [1]. Policy Adjustments - The 2.0 version includes a comprehensive list of diseases and surgical operations, optimizing the structure of core disease categories and reducing the total number of categories from 11,553 to 9,520 [2]. Supportive Policies - The report highlights the importance of improving the efficiency of medical insurance fund settlements and encourages prepayment to alleviate pressure on medical institutions [3]. Investment Recommendations - The report draws parallels with the U.S. Medicare system, noting that after the introduction of the DRG payment method in 1983, per capita spending growth decreased significantly, suggesting potential cost savings in the current context [5]. - Companies involved in minimally invasive procedures and day surgeries are expected to benefit, along with those in healthcare information technology [5].