今年下半年，东北地区一家三级专科医院的医保科主任，陷入了对现金流的焦虑。 6月上旬，他所在医院的省份印发了一则"关于医保基金与医药企业直接结算"的文件，一改从前"医保给 医院结算，医院再给企业回款"的模式，变成由当地医保部门每月代医院向集采药品企业结清货款。理 论上，这能把医院给下游企业的回款周期，压缩至一个月内。 让他焦虑的是，经历了过去数年的医保支付方式改革、医疗服务价格调整，医院的收入本就下滑，账面 上的现金流早已局促紧张，有的医院工资发放也出现困难。 以前，医保结算给医院的这笔回款，至少是医院现金流很重要的一部分，"如果再把这笔现金流截断， 医疗机构会更加艰难。" 这位医保科主任的焦虑并非空穴来风。近几年来，自各地医保局开始探索执行"医保直接结算"的政策 起，这种对现金流的忧虑，在各家医院内部已非常普遍。 2017年起，福建就曾率先开始实行医保直接结算。谈起医院的焦虑，接近当地医保的相关人士向健闻咨 询透露，一开始经常有医院反馈类似的担忧，"工作初期会遇到一些困难，因为改变了医院的工作模 式，重塑了财务流程，难免会有意见。但运行几年后，医院也形成了习惯。" 福建当地的另一位医保人士也道出关键，延长账期 ...

Group 1 - The biopharmaceutical ETF (159657.SZ) has seen a 0.48% increase, with the associated index, Vaccine Biotech (980015.SZ), rising by 0.53% [1] - Major constituent stocks such as Changchun High-tech, Fosun Pharma, and Tigermed have shown positive performance, with increases of 1.11%, 0.88%, and 4.91% respectively [1] - The National Healthcare Security Administration reports that 77% of coordinated areas have achieved instant settlement between medical insurance and medical institutions, with a total of 300.1 billion yuan allocated to cover 361,800 designated medical institutions [1] Group 2 - Guotai Junan Securities indicates that the vaccine industry will experience a significant increase in inventory in 2024, influenced by demand fluctuations and channel inventory adjustments [2] - The overall sentiment in the vaccine sector is under pressure due to centralized procurement policies and regional political factors [2] - The industry strategy report from Guoxin Securities highlights that the NDA/IND applications for innovative drugs remain active, with progress on products like the HPV vaccine potentially supporting industry sentiment [2]