There is another piece of news today that needs to be paid attention to:
On the news side, the National Health Insurance Administration held a press conference this morning to introduce the reform of medical insurance payment methods, and released the "Payment by Disease Group (DRG) and Disease Type Score (DIP) Version 2.0 Grouping Plan"
It is clarified that from 2025, all co-ordinating regions will uniformly use the grouped version, and explore the inclusion of remote medical expenses in the scope of DRG/DIP management.
What is DRG?
DRG and DIP are two Medicare payment reform strategies. All of them are important strategies for medical payment reform, aiming to promote the transformation of the operating mechanism of medical institutions and improve the efficiency and quality of medical services through packaged pricing.
DRG refers to the division of patients into a certain number of disease groups according to the severity of the disease, the complexity of the treatment method and the degree of resource consumption, each group has a unified charging price, and the medical insurance will pay according to the payment standard of the DRG that the patient enters, and no longer pay to the medical institution according to the actual cost of the patient in the hospital, so as to avoid the increase in the medical cost of the patient due to more medication and more examination.
DIP is paid according to the value of the disease, which means that each disease diagnosis is grouped according to the different treatment methods, and the medical insurance department will determine the payment standard for each disease according to the total amount of medical insurance funds that should be paid each year, which has the advantage of being able to better reflect the actual cost of disease treatment and is conducive to improving the efficiency and quality of medical services.
Just remember one sentence:
The demand for information system transformation brought about by the reform of DRG/DIP payment methods includes two parts: the local end and the hospital side, of which the local transformation has been centralized bidding since 2019, and about 73% of the medical institutions at the hospital end have not yet completed the transformation, and the corresponding market space is nearly 10 billion yuan, which is expected to be released in 23-25 years.
In addition, most medical IT companies are involved in data elements in the medical field, and the confirmation of data element rights is clearly proposed by the "Decision" of the Third Central Committee of the People's Republic of China, "to accelerate the establishment of data property rights attribution identification, market transactions, rights and interests distribution, and interest protection systems". Therefore, there are also many policy catalysts for follow-up medical data elements.
The core beneficiary companies of DRG/DIP are sorted out as follows:
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