The main contents of the reform of medical insurance payment methods are as follows: 1. Promote the classification reform of medical insurance payment methods and implement multiple composite payment methods. According to the characteristics of different medical services, we will promote the classification reform of medical insurance payment methods. In-patient medical services are mainly paid according to diseases and people related to disease diagnosis (DRGs), and long-term and chronic hospitalization medical services can be paid according to bed days; Primary medical services can be paid per head, and actively explore the combination of per head payment and chronic disease management; For complex cases and outpatient expenses that are not suitable for package payment, they can be paid according to the project.
Two, focus on the implementation of payment by disease.
For diseases with clear diagnosis and treatment plan, admission standard and mature diagnosis and treatment technology, in principle, payment by disease will be implemented, and day surgery and qualified outpatient treatment of traditional Chinese and western medicine will be gradually included in the scope of payment by disease. Reasonably determine the payment standard of Chinese and western medicine diseases.
Three, to carry out the pilot payment by disease diagnosis related groups (DRGs).
The fourth is to improve the payment methods such as per head and per bed day. To promote outpatient co-ordination and per capita payment, we can start with chronic diseases with clear treatment plan standards and evaluation indicators. For mental illness, hospice care, medical rehabilitation and other diseases that require long-term hospitalization and the average daily cost is relatively stable, you can pay by the bed day.
Netizens have expressed the hope that this reform will bring more benefits to the society and improve and solve the problem of difficult medical treatment.