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 article discusses a long-term reform in China's medical service pricing system, which aims to unify the vast discrepancies in medical service pricing across different regions, ultimately leading to a standardized national pricing system [1][4][14]. Group 1: Reform Background and Objectives - The reform has been ongoing for 25 years, with multiple changes in management and reform plans [1]. - The goal is to consolidate the 5,000 to 23,000 medical service pricing items across various regions into a consistent national pricing system [1][6]. - The National Healthcare Security Administration (NHSA) has initiated a new round of medical service pricing reform since 2021, with significant acceleration noted in 2024 [1][2]. Group 2: Implementation Challenges - Hospitals are experiencing considerable pressure due to the accelerated pace of the reform, with the complexity of the new guidelines expected to surpass previous reforms like DRG/DIP [3][13]. - The existing chaos in medical service pricing, with over 30,000 items lacking standardization, has led to significant management challenges and confusion in pricing relationships [4][6]. - The NHSA has issued 28 batches of "Project Establishment Guidelines," which include around 1,200 main projects and over 500 additional items, aiming to standardize the pricing structure [8][12]. Group 3: Future Directions and Considerations - The NHSA plans to release all "Project Establishment Guidelines" by 2025, with ongoing efforts to address the complexities of integrating new and existing projects [2][12]. - The new guidelines emphasize the separation of technical costs and consumables, which raises questions about how to charge for new technologies and materials [10][17]. - There are concerns regarding the balance between reflecting clinical labor value, ensuring the sustainability of the healthcare fund, and considering patient affordability [16].