Core Insights - The National Healthcare Security Administration and the National Administration of Traditional Chinese Medicine have officially established 18 pilot regions for the payment by disease category for traditional Chinese medicine (TCM) [1] Group 1: Payment System - The payment by disease category system involves grouping or scoring diseases to implement a "bundled payment" model for medical institutions [1] - Pilot regions can determine payment standards for TCM advantage diseases based on historical cost data and implement dynamic adjustments to reflect the value of TCM services [1] Group 2: Pilot Regions - The identified pilot regions include: Beijing, Hebei Province, Tongliao City in Inner Mongolia, Shenyang City in Liaoning Province, Shanghai, Wuxi City in Jiangsu Province, Zhejiang Province, Wuhu City in Anhui Province, Shandong Province, Shaoyang City in Hunan Province, Guangdong Province, Guangxi Zhuang Autonomous Region, Chongqing, Panzhihua City in Sichuan Province, Qiandongnan Prefecture in Guizhou Province, Yunnan Province, Guyuan City in Ningxia Hui Autonomous Region, and Urumqi City in Xinjiang Uygur Autonomous Region [1] Group 3: Disease Categories - A recommended directory of 57 TCM advantage diseases has been established, covering conditions such as fractures, lumbar disc herniation, and strokes [1] - Pilot regions are encouraged to use this directory as a basis for local adjustments and announcements regarding the diseases [1] Group 4: Implementation and Progress - The document emphasizes the need for pilot regions to refine their implementation plans, detail work measures, clarify timelines and task divisions, and regularly summarize progress and outcomes [1] - The goal is to steadily advance the pilot program and accumulate experiences for the reform of TCM payment systems, with a view to gradually promoting it nationwide [1]

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].