中医药医保支付方式改革
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两部门联合发文 将开展中医优势病种按病种付费试点
Ren Min Wang· 2025-10-10 07:10
Core Viewpoint - The National Healthcare Security Administration and the National Administration of Traditional Chinese Medicine have jointly announced a pilot program for fee payment based on traditional Chinese medicine (TCM) advantages, selecting around 15 provinces or cities to implement this initiative over 2-3 years, with the aim of accumulating reform experiences for nationwide promotion [1][2]. Group 1: Pilot Program Implementation - The pilot regions must have local government support for healthcare and TCM development, have implemented version 2.0 of disease-based payment, and show a strong willingness to reform payment methods for TCM advantages [1][2]. - The selection of TCM advantage diseases will be based on principles such as clear clinical pathways, effective treatment outcomes, and stable costs, with local data collection and expert validation involved in the process [2]. Group 2: Payment Standards and Adjustments - Payment standards for TCM advantage diseases should reflect the value of TCM techniques and services, with standards not lower than those prior to the pilot [2]. - The payment standards will consider technical service value, material costs, and the performance of healthcare funds, with surgical TCM advantages referencing corresponding Western medicine payment standards [2]. Group 3: Reporting and Coordination - Pilot regions are required to regularly summarize progress and outcomes, submitting annual reports by December 31, detailing the disease catalog, payment standards, and implementation effectiveness [3]. - Medical institutions in pilot areas must designate personnel to coordinate the pilot work, ensuring data reporting and participation in training organized by healthcare departments [3].
医药行业支付迎连续变革,中药将开启按病种付费试点,行业业绩增速也有望环比好转
Xuan Gu Bao· 2025-10-09 23:32
Group 1 - The National Healthcare Security Administration and the National Administration of Traditional Chinese Medicine have initiated a pilot program for disease-based payment for traditional Chinese medicine (TCM) in approximately 15 provinces or cities, aiming to reform payment methods over 2-3 years and gradually promote nationwide [1] - Longjiang Securities indicates that the DRG/DIP payment reform represents a significant change from project-based payments, providing new strategic opportunities for the innovative development of TCM [1] - CITIC Securities notes that while the collection of traditional Chinese medicine is being comprehensively promoted, the overall price reduction aligns with expectations, particularly for exclusive TCM prescription drugs, which have seen moderate price declines [1] Group 2 - Zheshang Securities highlights that the TCM industry possesses attributes similar to the banking sector, characterized by ample cash flow, high dividends, and low profit volatility, with expectations of improved revenue and net profit growth in the second quarter of 2025 compared to the first quarter [1] - The company Sichuang Medical is actively engaging in the DRG/DIP field, leveraging its medical information intelligent open platform to assist healthcare institutions in reforming payment methods [1]