（来源：中国改革报） 转自：中国改革报 医保按病种付费是指通过对疾病诊疗进行分组或折算分值，实行医保对医疗机构的"打包付费"。各试点 地区可结合本地实际，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。 这些试点地区为：北京市、河北省、内蒙古自治区通辽市、辽宁省沈阳市、上海市、江苏省无锡市、浙 江省、安徽省芜湖市、山东省、湖南省邵阳市、广东省、广西壮族自治区、重庆市、四川省攀枝花市、 贵州省黔东南州、云南省、宁夏回族自治区固原市、新疆维吾尔自治区乌鲁木齐市。 此前，《适宜按病种付费的中医优势病种推荐目录》遴选了57种中医优势病种，覆盖骨折类、腰椎间盘 突出症、中风类等。试点地区可以以推荐病种目录为基础，结合本地实际，因地制宜做好病种发布和调 整。 文件明确，中医优势病种按病种付费试点地区要进一步完善试点实施方案，细化工作举措，明确时间节 点和任务分工，定期总结工作进展及成效，积极稳步推进试点工作，积累一批中医药医保支付改革经 验，并逐步向全国推广。 本报讯 记者荆文娜报道 国家医保局、国家中医药局日前发布文件，正式确定了18个中医优势病种按病 种付费试点地区。 ...

Core Viewpoint - The National Healthcare Security Administration and the National Administration of Traditional Chinese Medicine have jointly announced a pilot program for fee payment based on traditional Chinese medicine (TCM) advantages, selecting around 15 provinces or cities to implement this initiative over 2-3 years, with the aim of accumulating reform experiences for nationwide promotion [1][2]. Group 1: Pilot Program Implementation - The pilot regions must have local government support for healthcare and TCM development, have implemented version 2.0 of disease-based payment, and show a strong willingness to reform payment methods for TCM advantages [1][2]. - The selection of TCM advantage diseases will be based on principles such as clear clinical pathways, effective treatment outcomes, and stable costs, with local data collection and expert validation involved in the process [2]. Group 2: Payment Standards and Adjustments - Payment standards for TCM advantage diseases should reflect the value of TCM techniques and services, with standards not lower than those prior to the pilot [2]. - The payment standards will consider technical service value, material costs, and the performance of healthcare funds, with surgical TCM advantages referencing corresponding Western medicine payment standards [2]. Group 3: Reporting and Coordination - Pilot regions are required to regularly summarize progress and outcomes, submitting annual reports by December 31, detailing the disease catalog, payment standards, and implementation effectiveness [3]. - Medical institutions in pilot areas must designate personnel to coordinate the pilot work, ensuring data reporting and participation in training organized by healthcare departments [3].