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
按照"中医优势明显、临床路径清晰、诊疗效果确切、质量安全可控、病例数量充足、费用相对稳 定"的原则,试点地区结合本地实际和结算数据,通过收集病种、初步筛选、专家论证等流程,遴选确 定本地中医优势病种,实施动态调整。国家中医药管理局会同国家医疗保障局,将在各地已开展中医优 势病种按病种付费的目录基础上,结合已发布的中医治疗优势病种及中医优势病种,分批制定发布适宜 按病种付费的中医优势病种目录。试点地区原则上在国家统一明确的病种目录范围内开展按病种付费, 因地制宜增加试点病种的,应向国家报备。 各地可结合本地实际,以历史费用数据为基准,合理确定中医优势病种支付标准并实施动态调整, 反映中医技术劳务价值。原则上,试点后中医优势病种支付标准不低于试点前支付标准。综合考虑技术 劳务价值、物耗成本和医保基金使用绩效等因素,在保证疗效相当的基础上,针对外科类中医优势病种 可参照对应西医按病种(病组)支付标准,针对内科类中医优势病种可综合考虑历史费用数据以及对应 西医内科保守治疗按病种(病组)支付标准,合理确定适宜的支付标准。 人民网北京10月10日电 (记者乔业琼)据国家医保局官网消息,国家医保局、国家中医药局近日 联合发 ...
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]