On September 10, the Information Office of the State Council held a series of press conferences on the theme of "Promoting High-quality Development" in Beijing, at which Zhang Ke, Director of the National Health Security Administration, Li Tao, Deputy Director of the National Health Security Administration, and Yan Qinghui, Deputy Director of the National Health Security Administration, attended the briefing and answered questions from reporters. Photo by Xinhua News Agency reporter Pan Xu
How to better reduce the burden of medicine for the masses? How to make it more convenient and efficient to participate in insurance? How to keep the "money bag" of medical insurance? At a series of press conferences on the theme of "Promoting High-quality Development" held by the Information Office of the State Council on the 10th, the relevant person in charge of the National Health Insurance Administration responded to relevant hot issues.
Reduce the burden of medical treatment for the masses
Medical security is closely related to reducing the burden of medical treatment for the masses.
"We insist on deepening reform and improving the health and well-being of the people." Zhang Ke, director of the National Health Insurance Bureau, introduced that the National Health Insurance Bureau has institutionalized and normalized the centralized procurement of drug consumables, and has successively carried out 9 batches of state-organized drug centralized procurement and 4 batches of state-organized high-value medical consumables centralized procurement, and at the same time guided and promoted local centralized procurement for varieties other than national centralized procurement.
"One of the results of centralized procurement is to reduce the burden of drug use for the masses and improve the accessibility and quality of drug use." Yan Qinghui, deputy director of the National Health Insurance Administration, said that for example, the price of insulin has been greatly reduced after centralized procurement, and the proportion of third-generation insulin with better clinical performance has increased from 58% before centralized procurement to more than 70%. "The next step will continue to expand the coverage of centralized procurement, carry out new batches of centralized procurement of nationally organized drugs and high-value medical consumables, and include high-value medical consumables such as cochlear implants in the scope of centralized procurement." Yan Qinghui said.
"We also give full play to the advantages of medical insurance 'group buying' to guide the price of new drugs to return to reasonable." Li Tao, deputy director of the National Health Insurance Administration, said that the National Health Insurance Administration integrated the drug needs of more than 1.3 billion insured people to implement strategic purchases, improved the national drug negotiation and access mechanism, and many "noble drugs" were prescribed "civilian prices". In the six years since the establishment of the National Health Insurance Administration, the negotiated drugs have benefited 720 million insured patients, and multiple factors such as negotiated price reductions and medical insurance reimbursement have reduced the burden of the masses by more than 700 billion yuan.
Improve the quality of the connotation of protection
Consolidate and improve the level of hospitalization protection, carry out outpatient chronic disease protection, and comprehensively establish a mechanism for the overall planning of general outpatient medical insurance for employees and outpatient medication protection for hypertension and diabetes for urban and rural residents...... In recent years, the content and quality of medical insurance have been continuously improved.
Zhang Ke introduced that the National Health Insurance Administration has actively responded to the aging of the population and steadily promoted the pilot of the long-term care insurance system, which has covered 49 cities and 180 million people. At the same time, active fertility support measures have been implemented, and 20 provinces and the Xinjiang Production and Construction Corps have included IVF and other assisted reproductive technology projects in the scope of medical insurance payment.
Since the beginning of this year, the National Health Insurance Administration has integrated the concept of "doing one thing efficiently" into the medical insurance work, making the medical insurance service more convenient and beneficial to the people.
Yan Qinghui introduced, first of all, newborns from "settled to participate in insurance" to "landing that is", through data sharing, the local medical insurance departments have realized that newborns can be insured online with birth medical certificates, and the average time to participate in insurance payment has been reduced from 28.7 working days at the beginning of the year to 6.4 working days, and the newborn can be directly reimbursed for medical expenses when discharged.
Secondly, the personal account of employee medical insurance has changed from "personal exclusive" to "family sharing". From January to July this year, the amount of family mutual aid in the personal account of employee medical insurance reached 22.7 billion yuan, and it is expected that by the end of this year, all localities will realize the intra-provincial mutual aid of personal accounts, and will explore and promote cross-provincial mutual aid from next year.
"In particular, it should be emphasized that the number of outpatient chronic diseases directly settled across provinces has increased from 5 to 10." Yan Qinghui said that by the end of this year, there will be at least one medical institution in every district and county in the country that can provide cross-provincial direct settlement of new diseases.
In addition, the national unified medical insurance information platform makes medical insurance settlement more convenient. "The average daily settlement volume of the medical insurance information platform now exceeds 28 million person-times, and the average response time of the hospitalization fee settlement system is only 0.8 seconds, which effectively reduces the time for the masses to wait in line in the hospital." Li Tao introduced that a total of 1.17 billion people across the country have activated the medical insurance code, and the masses can use mobile phones or other electronic devices to activate the medical insurance code without carrying a physical card.
Strengthen the supervision of medical insurance funds
Recently, the National Health Insurance Administration has reported a number of cases of fraud and insurance fraud. How will the medical insurance department strengthen the supervision of the medical insurance fund and guard the "money bag" of the medical insurance?
"Up to now, a total of 432 designated medical institutions in 30 provinces have been inspected, and it is expected that the number of inspection institutions in the whole of this year will exceed the sum of the past five years." Yan Qinghui said.
According to reports, since the beginning of this year, the National Health Insurance Bureau has adhered to the strict crackdown and strict investigation, continued to increase the intensity of unannounced inspections, and paid more attention to the role of big data, and has verified and recovered nearly 60 million yuan of medical insurance funds through "glycosylated hemoglobin" screening clues, and recovered nearly 14 million yuan of medical insurance funds through "restricted gender diagnosis and treatment, examination, and medication" screening clues, realizing the "precise strike" under the combination of on-site inspection and big data.
"We insist on combining leniency and severity, and make good use of self-examination and self-correction." Yan Qinghui said that up to now, designated medical institutions at all levels have returned about 3 billion yuan of medical insurance funds.
It is reported that the National Health Insurance Administration has explored the establishment of management measures for medical insurance payment qualifications, and adopted a method similar to "driver's license deduction points" to score the relevant responsible persons; Improve the working mechanism of social supervisors of the medical insurance fund, and better mobilize all sectors of society to participate in the supervision of the fund.
Yan Qinghui said that the next step will be to conscientiously implement the decisions and arrangements of the Party Central Committee and the State Council, and never let the people's "money for medical treatment" and "life-saving money" become "Tang monk meat". (Xinhua News Agency reporter Xu Penghang)
丨Source丨CCTV News Client丨Production丨Pingliang Rong Media Center丨Review丨He Jun, Liu Yingna丨Editor丨Wu Peng