在消费降级阴云的笼罩下，今年太原北城的闭店率很高。 有一次，晋观君路过胜利街某条街巷，此前那条街巷不算繁华，但也不至于很冷清。 但前段时间过去，路边的店铺关了不少，加之冬天天冷还有关门的早，整个街巷显得更凄凉了。 那条小巷里有4个药店，有2个关门了，还有两个亮着灯还在营业，但消费者较少，门可罗雀。 药店都会倒闭？ 查了一下数据，好像近几年药店倒闭的还不少，各个城市都有，不单单是太原。 中康数据显示，2024年全国零售药店关店数量约3.9万家，闭店率达到5.7%，平均每天有107家药店倒闭。。 进入2025年前三季度，全国药店关闭超4万家，关店规模逐季扩大，有业内人士预测，2025年预计有5万至10万家药店关门。 尤其是那些位置一般，消费力以老年人为主的街道或小巷，闭店率更是不忍直视，几乎达到了50%以上。 如果仔细观察的话会发现，在那些闭店的店铺里，首次出现了药店闭店的情况。 在人们的认知中，药店是暴利行业，药店还能闭店？ 这一下子，药店生意为何就不好做了呢？ 晋观君之见，大致有三方面原因： 其一，市场饱和了 关于太原有多少家药店，并没有公开的具体的数据。 依据市场监管局2022年发布的数据显示，全市共有药品 ...

青海坚持医保药品目录动态调整，将更多新药、好药纳入医保支付范围。387种国家医保谈判药品、竞 价药等纳入"双通道"保障，提高患者用药可及性。在国家892种中药饮片的基础上，增加150种藏医用中 药饮片纳入医保支付范围，在全国率先出台并不断优化藏蒙医院制剂医保目录，目前共531种3200个。 加大对民族医特色优势医疗服务项目的政策倾斜力度，将499项民族医诊疗项目纳入医保支付范围，纳 入占比达到88%。将127项手术纳入医保日间手术结算范围，不设起付线，按住院政策报付。将项痹、 面瘫等6个中藏医优势病种纳入中藏医日间病房医保结算范围，住院不收取床位费，护理费用按照三级 护理标准的50%收取，持续降低参保群众就医负担。 本报讯 （记者 郭靓） 1月4日，记者从青海省医疗保障局了解到，"十四五"期间，省医保局立足省情实 际，通过打好医药管理"组合拳"，持续提升参保群众获得感、幸福感。 强化与卫健部门协调联动，通过"一体化"管理，将村卫生室纳入医保定点，截至目前，全省村卫生室 4469家，纳入医保定点管理4343家，基本覆盖所有行政村。同时，强化定点医药机构管理，明确属地管 理责任，取消省内定点机构互认，一处纳入全省 ...

齐鲁晚报·齐鲁壹点 孙文丽 据悉，"十四五"时期，德城区医保局坚持以人民健康为中心，紧紧围绕"保基本、可持续、惠民生、促 改革"的主线，锐意进取，扎实工作，人民群众的医保获得感、幸福感、安全感显著增强。 聚焦监管强化与风险防控，医保基金监管构建新格局。德城区医疗保障局始终将维护医保基金安全作为 首要政治任务和底线红线。监管体系日益完善，建立健全医保基金监管联席会议制度和社会监督员制 度，形成了政府监管、社会监督、行业自律、个人守信相结合的综合监管格局。监管的法治化、规范化 水平不断提升。基金监督保持高压态势，综合运用智能监控、专项检查、飞行检查、联合执法等多种手 段，保持打击欺诈骗保的高压态势。"十四五"期间，累计对146家违法违规定点医药机构作出严肃处 理，包括中止或解除服务协议、行政处罚等，并通过自查自纠、检查核查累计追回违规使用的医保基金 844.28万元、拒付19.61万元。坚决守住了人民群众的"看病钱""救命钱"。相关监管工作经验被省医保局 聚焦制度健全与全民覆盖，"公平医保"基石更加稳固。德城区医疗保障局始终致力于构建覆盖全民、公 平适度的医疗保障体系。参保覆盖持续巩固，深入实施全民参保计划，精准 ...

Core Viewpoint - The National Healthcare Security Administration (NHSA) has issued a notice to strengthen monitoring and handling of the "dual pricing" issue in retail pharmacies, which harms the interests of insured patients [1][2]. Group 1: Issue of "Dual Pricing" - "Dual pricing" refers to the practice where the same medication is sold at different prices to insured and uninsured individuals, often resulting in higher costs for insured patients [1]. - Some pharmacies justify this practice by citing long reimbursement cycles and financial pressures, leading to a transfer of costs to insured patients [1]. - The existence of "dual pricing" reflects speculative behavior among certain operators, exacerbated by limited information transparency and weak penalties for violations [1]. Group 2: Regulatory Measures - The NHSA aims to shift from passive detection to proactive monitoring using big data, intelligent pricing systems, and anomaly warning models to identify and punish violations promptly [1]. - There is a need for simultaneous optimization of the reimbursement mechanism to alleviate financial burdens on small pharmacies, alongside incentives for compliant pharmacies [2]. - Establishing a reporting reward mechanism and price comparison platforms will empower patients to advocate for their rights and enhance social oversight [2]. Group 3: Public Engagement - The public plays a crucial role as both stakeholders and supervisors in addressing the "dual pricing" issue [2]. - As of now, 29 provinces have launched price comparison mini-programs, allowing citizens to check real-time prices and differences between pharmacies, promoting transparency in healthcare spending [2].

Core Viewpoint - The recent cases of abnormal data in the healthcare system highlight the critical importance of data quality in ensuring the effective operation of medical insurance funds, which are essential for public health [1][5]. Group 1: Data Quality Issues - Numerous bizarre medical practices, such as a 73-year-old woman undergoing "painless egg retrieval" and male patients having hysteroscopy billing records, were identified as results of poor data quality management [1][5]. - The National Healthcare Security Administration (NHSA) has utilized a unified medical insurance information platform to identify and address these abnormal data cases, showcasing the empowering role of data in regulatory oversight [1][5]. Group 2: Implications of Data Errors - Errors in medical insurance data can trigger regulatory alarms and lead to on-site inspections, resulting in increased management costs for both regulatory bodies and medical institutions [5][7]. - The integrity of medical insurance funds, which are considered "lifesaving money" for the public, relies heavily on the quality of data management by designated medical institutions [5][7]. Group 3: Responsibilities and Recommendations - Designated medical institutions are urged to take primary responsibility for data quality, ensuring accurate reporting and ongoing verification to eliminate data risks at the source [7]. - Healthcare departments are encouraged to enhance their technical capabilities, implement intelligent monitoring and cross-verification mechanisms, and increase penalties for violations to ensure the proper functioning of medical insurance funds [7].

Core Viewpoint - The article emphasizes the importance of regular supervision of medical insurance funds to ensure their safe operation, improve usage efficiency, standardize medical service behaviors, and reduce the burden on patients seeking medical care. Traditional regulatory methods are inadequate in addressing new types of violations arising from reforms in medical insurance payment methods, necessitating a shift towards intelligent auditing using big data and smart technologies [1][2][3]. Group 1: Development of Intelligent Auditing - The development of intelligent auditing has been guided by policies since 2018, with significant milestones including the promotion of real-time monitoring and strict regulation of medical behaviors [2]. - By 2023, the National Medical Insurance Administration aims to implement a nationwide intelligent monitoring system, with a goal of establishing a standardized and scientific auditing framework by the end of 2025 [2][3]. Group 2: Features of Intelligent Auditing System - The intelligent auditing system features a layered architecture that integrates diverse data sources, enabling real-time analysis and monitoring of medical expenses [4]. - A dynamic and flexible rule engine is central to the system, allowing for the adaptation of auditing rules based on evolving medical policies and practices [5]. Group 3: Impact on Medical Insurance Regulation - The intelligent auditing system significantly enhances the efficiency of medical insurance regulation, processing over 20 million cases daily with an accuracy rate exceeding 92% [7]. - It establishes unified standards and objective rules, improving the credibility and authority of medical insurance oversight [7]. Group 4: Governance and Collaboration - The system promotes a shift from external control to internal motivation for compliance among medical institutions, encouraging proactive adherence to regulations [8]. - It fosters a collaborative governance model where feedback from medical institutions can lead to the dynamic updating of rules, enhancing the system's accuracy and inclusivity [8]. Group 5: Enhancing Service Quality - Intelligent auditing improves settlement efficiency for insured individuals, enhancing their sense of satisfaction and security regarding medical services [10]. Group 6: Future Outlook - There is a need for improved policy interpretation and training for medical staff to ensure a better understanding of auditing rules and standards [11]. - Emphasis on data security and privacy protection is crucial, given the sensitive nature of medical insurance data [13]. - The establishment of relevant laws and regulations is necessary to support the legal and compliant application of intelligent auditing technologies [14].