中医优势病种诊疗服务
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两部门联合发文 将开展中医优势病种按病种付费试点
Ren Min Wang· 2025-10-10 07:10
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].