Guidance on reform of medical and health system

Tiandao City People's Government so100
The guiding opinions on the reform of the medical and health system are to further promote the development of medical and health care and improve the medical and health care of the people. According to the "Hebei Province-year urban workers basic medical insurance system and medical and health system reform work points" and the provincial health work conference The spirit, combined with the actual situation of the city, puts forward the following opinions on the reform of the medical and health system in the next phase of the city.
First, improve the basic medical insurance system for urban workers and continue to steadily expand the coverage of basic medical insurance. At the end of last year, on the basis of 80% of the number of people insured in the city, we will step up efforts to make new breakthroughs in the participation of central provincial units, difficult enterprises, individual and private economic organizations, and flexible employees. By the end of the year, the number of people participating in the city should reach 280,000, accounting for 88% of the number of people insured, and strive to break through 300,000.
Improve medical service management measures and expand the scope of medical services. Standardize the "two-set" management, quantify the assessment indicators, and implement the final elimination system. Intensify the inspection of designated medical institutions and designated pharmacies, and resolutely crack down on violations of laws and regulations. Adopt contractual management, refine the management agreement for fixed-point medical institutions, strengthen the binding mechanism of both parties, and jointly protect the rights and basic medical needs of the insured.
Strengthen the management of medical insurance funds. Improve the settlement method, implement the single-case settlement method on the basis of the segmented calculation of the accumulated payment, set the fees for some medical treatment projects of the designated medical institutions, and set the total control indicators for the medical insurance fund. Explore the scientific settlement method for implementing compound settlement. We will improve the agreement with designated medical institutions, sign agreements with medical institutions of different natures, and impose strict requirements on the use of “three rates” and new medical treatment projects to ensure the safe use of funds.
Further improve the medical insurance policy system and establish a multi-level medical insurance system. On the basis of the original policy, the "Regulations on Non-insurance Punishment for Enterprises and Institutions", "Measures on Participation of Minors", "Regulations on Establishing Health Archives System for Insured Workers", and "Measures for Medical Assistance" were issued. Policy measures such as "Opinions on Adjusting the Individual Burden of Insured Persons" to ensure the expansion of the insurance coverage and the further improvement of the medical insurance system.
According to different conditions in the county, classification guidance. In counties and districts with financial deficits, we will actively study new methods, work hard to solve the problem of arrears, and ensure the normal operation of the medical insurance system. For counties with good conditions, it is necessary to implement the civil service medical subsidy policy as soon as possible to ensure that funds are available in time.
Establish a medical insurance association. It is responsible for the medical insurance intermediary, consulting services, technical management training and self-discipline, making it a bridge and link between the government and medical insurance companies, designated hospitals, and designated pharmacies.
Second, accelerate the reform of the medical and health system to promote the transformation of the functions of health administrative departments at all levels. The main focus of the health administrative department is to focus on the regulation, guidance, planning, supervision, and regulation of the health industry, and gradually realize the fundamental transformation from “healing health” to “management health”. In accordance with the principles of “health supervision” and “disease prevention and control” institutions and functions, the municipal sanitation and epidemic prevention station and the municipal occupational disease prevention and treatment center will be integrated and separated, and the municipal health supervision office and the municipal disease prevention and control center will be established. Urban health supervision agencies exercise comprehensive health law enforcement powers, increase health administrative supervision, standardize medical and health market order, and create a favorable environment for all kinds of medical institutions to participate in market competition on an equal and orderly basis.
Accelerate the development and implementation of regional health plans. As soon as possible, the "Qinhuangdao City Regional Health Plan" will be introduced to re-integrate health resources. Gradually break the administrative affiliation and ownership boundaries of medical and health institutions, and implement the whole industry management of health work and health resources. Medical institutions are encouraged to form medical groups through joint and mergers. New health resources should be transferred to rural and community health services, to the training of health personnel, improvement of medical conditions, introduction of new technologies and new equipment, and gradually realize the transformation of the mode of health development from large-scale to quality-effective.
Continue to improve and implement the policy measures for the classification management of medical institutions. On the basis of the profitability and non-profitability of medical institutions, we will do a good job in the implementation of fiscal, taxation, and price policies for two types of medical institutions and the classified management of financial accounting systems, improve various management systems, and promote fair competition among medical institutions. And healthy development.
Actively promote the reform of the health investment and financing system. Standardize the corporate governance structure of public hospitals and gradually make the hospital a legal entity with independent operations. Strengthen the supervision of state-owned health investment, strive to improve investment efficiency, and ensure the preservation and appreciation of state-owned medical assets. In accordance with the requirements of the higher level of “promoting the separation of state-owned large and medium-sized enterprises, the separation and auxiliary business restructuring and separation and social functions”, the process of restructuring and separation of hospitals run by enterprises will be accelerated, and the burden on enterprises will be reduced. Encourage foreign capital and private capital to enter the medical field, encourage the development of private hospitals, and make them participate in market competition fairly. Conduct pilot projects for the reform of the property rights system of public hospitals, select 1-2 state-owned hospitals, auction or transfer their assets, and explore the reform model of public hospitals.
Deepen the reform of the internal management system and operational mechanism of public medical institutions. Accelerate the reform of the personnel distribution system, fully implement the personnel recruitment system, set up posts on demand, and choose in both directions. Allow and standardize the social part-time work of public hospital employees, engage in second professional behavior, and encourage the provision of medical services to grassroots and rural areas. Expand the autonomy of internal distribution of medical and health units, determine the distribution of wages according to the performance of the post, and open the distribution grade. The annual salary system can be implemented for hospital administrators and key business backbones. Strengthen the economic management of public medical and health institutions and implement cost accounting.
Continue to promote medical reform. In accordance with the principle of total control and structural adjustment, we will further standardize and improve the management methods for the two lines of drug revenue and expenditure, and reduce the proportion of drugs in hospital revenue. Continue to implement and improve the centralized bidding and procurement of medicines and disposable medical and hygienic products, and curb the excessive increase in medical expenses. The amount of medicines purchased by the hospitals at the second level or above must reach more than 80% of the total amount of medicines purchased. Strict implementation of new medical service prices, hospitals above the second level fully implement the "one-day list of hospitalization expenses", medical service price disclosure and information management measures to enhance the transparency of medical service charges.
Vigorously develop community health services. Strengthen the standardized management of community health service institutions and work hard on connotation construction. If the existing community health service institutions are re-examined and accepted, if they fail to meet the basic requirements, they will be disqualified from conducting community health services. Encourage large and medium-sized medical institutions to carry out community health service work, and guide and support social forces to organize community health service institutions. Adopt public bidding, choose to identify community health service institutions, and gradually establish a structural optimization, rational layout, and science

A standardized community health service network. By the end of the year, the city's community health service street coverage rate should reach 60%.
Promote the reform of the rural medical and health system. In accordance with the "CPC Central Committee, xx decision on further strengthening rural health work" and the requirements of the provincial health work conference, the establishment of a new rural cooperative medical care system as a breakthrough, comprehensively promote the rural health system reform work. Pilot work on the new rural cooperative medical care system was carried out in Tuanlin Township of Changli County and Yubo Township of Lulong County.
Third, continue to deepen the reform of the pharmaceutical production and circulation system to increase the intensity of gmp certification for pharmaceutical production enterprises and gsp certification for circulation enterprises. According to the provincial requirements, by the end of the year, 12 pharmaceutical production enterprises in the city must complete gmp certification. For the gmp certification work of each enterprise, it is necessary to strengthen the tracking and supervision, speed up the certification process, and strive for all the acceptances at the end of the year. Enterprises that fail to pass the gmp certification within the time limit will be resolutely eliminated, and the withdrawal of the municipal drug distribution enterprises will also speed up the gsp certification work, and must be resolutely shut down if the standards are not met within the prescribed time limit.
Supporting and strengthening the company and optimizing the structure of pharmaceutical production. Promote the expansion of production technology and new product development of advantageous pharmaceutical production enterprises to enhance market competitiveness. Help qualified medical production enterprises take high-tech industries as a breakthrough, seize the technical commanding heights, and cultivate new growth points. Accelerate the pace of mergers, mergers, and restructuring of pharmaceutical manufacturers, and establish pharmaceutical groups to enhance their ability to resist risks.
Support the merger expansion and chain operation of advantageous pharmaceutical distribution enterprises. On the basis of the restructuring of pharmaceutical circulation enterprises, we will vigorously promote new marketing methods such as chain operation and online purchase and sales to reduce operating costs.
Continue to promote the reform of the drug price management system. We will improve the organizational system of government pricing, establish a monitoring mechanism for drug market prices, implement drug price reporting and complaint systems, and gradually implement measures to print retail prices for drug packaging, and promote the establishment of a market-based drug price mechanism.
Fourth, strengthen leadership, do a good job of propaganda, strengthen leadership, and improve organization. Strengthen the work of the municipal medical and health system reform leading group and its office, establish and improve the regular meeting system and other work systems, strengthen the coordination and supervision of medical and health reform, and implement various medical reforms.
Strengthen the propaganda work on the reform of the medical and health system. Relevant departments and news media should adopt various methods to vigorously publicize the progress of medical reform policies and medical reform work, continuously improve the awareness and support of the general public on medical reform, and promote the smooth development of medical reform.