三湘都市报2月1日讯 2月1日，记者从湖南省医疗保障局了解到，《关于规范整合康复、精神治疗、美 容整形类医疗服务价格项目的通知》《关于规范整合呼吸和泌尿系统类医疗服务价格项目的通知》《关 于规范整合神经系统等3类医疗服务价格项目的通知》和《关于规范整合口腔等三类医疗服务价格项目 的通知》多个医疗服务价格项目立项指南执行文件印发。 规范湖南康复、精神治疗、美容整形、呼吸系统、泌尿系统、神经系统、耳鼻喉、体被系统、口腔、疝 （甲乳）和骨骼肌肉共11类医疗服务价格项目管理。 新增、废止多项医疗服务价格项目 经过梳理，新发文件新增康复类项目46项、精神治疗类项目16项、美容整形类项目202项；新增呼吸系 统类项目68项、修订现行呼吸类项目2项；新增泌尿系统类项目87项；新增神经系统类项目82项、耳鼻 喉类项目164项、体被系统类项目53项；新增口腔类医疗服务价格项目114项、疝（甲乳）类医疗服务价 格项目25项、骨骼肌肉类医疗服务价格项目109项。并同步明确相关项目的加收项、扩展项、基本物耗 等要素管理政策。 与此同时，废止现行康复类项目34项、精神治疗类项目30项、美容整形类项目23项；废止现行呼吸类项 目78项、 ...

Core Viewpoint - Public grassroots medical institutions are essential components of the basic medical service system, ensuring that residents can access medical services within 15 minutes, with their diagnosis and treatment volume accounting for over 50% of the total [1] Group 1: General Diagnosis Fee - The general diagnosis fee consolidates various costs such as registration, diagnosis, injection, and drug service costs into a single package, applicable only to public grassroots medical institutions [1] - The general diagnosis fee is designed to stabilize the income of grassroots medical institutions, which are limited in their technical capabilities and unable to perform many surgical procedures [1] Group 2: Pricing Determination - The pricing of general diagnosis fees is managed locally, with provincial health insurance bureaus and some city-level governments determining specific price levels, generally around 10 yuan [2] - As of 2024, 24 provinces have implemented the comprehensive diagnosis project guidelines, maintaining a stable price level around 10 yuan for the general diagnosis fee, which is included in the health insurance reimbursement scope [2] Group 3: Fee Collection Policies - General diagnosis fees and outpatient diagnosis fees cannot be charged simultaneously; the local health insurance department decides which fee to apply [3] - If a grassroots medical institution charges a general diagnosis fee, it cannot additionally charge for services included in that fee, such as injection or intravenous infusion fees [3] Group 4: Outpatient Diagnosis Fee Categories - Outpatient diagnosis fees can be categorized into several types, including general outpatient diagnosis, traditional Chinese medicine diagnosis, pharmaceutical outpatient services, and nursing outpatient services [4] - The guidelines also provide for a convenience outpatient diagnosis fee for follow-up patients needing prescriptions, and additional charges may apply for services provided by senior medical professionals [4]

Core Viewpoint - The article discusses the structure and pricing of general consultation fees in public grassroots medical institutions, highlighting the importance of these institutions in providing accessible healthcare services to the community [1][2]. Group 1: General Consultation Fee - General consultation fee is a bundled charge that includes registration, consultation, injection fees (excluding medication costs), and pharmaceutical service costs, aimed at stabilizing the income of grassroots medical institutions [1]. - The establishment of the general consultation fee was formalized in 2010 by the State Council, integrating various service fees into a single charge for public grassroots medical institutions [1]. Group 2: Pricing Levels - The pricing of general consultation fees is managed locally, with provincial health insurance bureaus and some city-level governments determining specific price levels, generally around 10 yuan [2]. - As of 2024, the National Health Insurance Administration will issue guidelines for comprehensive consultation projects, retaining the general consultation fee as a price item, with 24 provinces already aligning with these guidelines [2]. Group 3: Fee Collection Policies - Current policies stipulate that general consultation fees and outpatient consultation fees cannot be charged simultaneously; the local health insurance department decides which fee applies [3]. - If a grassroots medical institution charges a general consultation fee, it cannot additionally charge for services included in that fee, such as injection or intravenous infusion fees [3]. Group 4: Outpatient Consultation Fee Categories - Outpatient consultation fees can be categorized based on patient needs, including services for follow-up patients, and additional charges may apply for services provided by senior medical professionals [4]. - Specific categories of outpatient consultation fees include services from Western medicine, traditional Chinese medicine, pharmaceutical consultations, and nursing consultations [5].

Core Viewpoint - The article discusses the issuance of the "Guidelines for the Pricing of Surgical and Treatment Auxiliary Operations" by the National Medical Insurance Administration, which aims to standardize and categorize auxiliary surgical operations within the medical insurance system, enhancing transparency and adaptability to new technologies [2][3]. Policy Background - The introduction of a unified pricing guideline addresses structural challenges in China's medical service pricing system, such as regional disparities and the lack of standardized pricing for auxiliary operations [3]. - The guidelines represent the first systematic classification of auxiliary operations in surgery, covering advanced technologies like 3D imaging, navigation systems, and remote surgery [3][4]. Key Components of the Guidelines - The pricing project consists of seven core elements: project name, service output, price composition, additional charges, expansion items, pricing units, and pricing explanations [4]. - The guidelines include 36 auxiliary operations categorized into six systems based on service output attributes, facilitating understanding across disciplines [5][6]. Categories of Auxiliary Operations - **3D Technology Chain**: This category includes operations related to 3D reconstruction, modeling, and printing, which enhance pre-surgical planning and individualization of treatment [6][8]. - **Tracing and Imaging Enhancement**: This category focuses on technologies that improve intraoperative information clarity, such as tracers and advanced imaging techniques [7][9]. - **Energy Instrument Assistance**: This category includes various energy devices used in surgery, emphasizing the separation of technical costs from device usage [10][11]. - **Intraoperative Imaging Guidance**: This category standardizes the pricing of imaging guidance during surgery, enhancing its role in risk management [12][13]. - **Surgical Path Navigation**: This category includes navigation systems that provide real-time tracking and positioning during surgeries [14][15]. - **Surgical Robotics and Remote Surgery**: This category recognizes the role of robotic assistance and remote surgery as significant advancements in surgical capabilities [16][18]. Understanding the Pricing System - The guidelines emphasize that "service output" is the sole basis for establishing pricing projects, allowing for flexibility in technical paths as long as the output remains consistent [20]. - The guidelines allow for existing projects to accommodate technological improvements without the need for new pricing applications, reducing barriers to innovation [21][22]. Implications for Hospitals and Enterprises - The new pricing framework is expected to lead to a comprehensive restructuring of cost management, quality control, and payment mechanisms within hospitals [26][30]. - Hospitals will be better equipped to assess the real costs and values of auxiliary operations, promoting transparency and accountability in surgical practices [30][31]. - Enterprises will need to shift their focus from equipment-centric models to service output-oriented strategies, enhancing their data capabilities to comply with new regulatory requirements [36][38]. Observations on Systemic Evolution - The guidelines represent a significant shift from fragmented technical approaches to a cohesive capability system, facilitating clearer communication of technological value [44][45]. - The formal recognition of independent pricing for capabilities, such as robotic assistance, aligns with international trends towards technology-neutral and capability-oriented regulatory frameworks [46]. - The requirement for data retention and reporting will transform surgical practices from experience-based to data-driven methodologies, supporting future research and clinical improvements [47][48].

Core Viewpoint - The National Healthcare Security Administration (NHSA) has announced the continuous update of the national medical service price "overview table" to enhance the management of medical service prices and promote reasonable pricing across regions [1] Group 1: Policy Changes - The NHSA's notification emphasizes the need for provincial healthcare departments to consider local economic development, medical technology advancements, and the financial capacity of stakeholders when managing medical service prices [1] - Provincial healthcare departments are required to conduct regular assessments of dynamic adjustments to medical service prices [1] Group 2: Price Management - The notification prohibits price increases in medical services when there is rapid growth in medical expenses or when the healthcare fund is in deficit [1] - The NHSA aims to facilitate horizontal comparisons and regional collaboration to maintain reasonable pricing across different provinces [1]