In 2019, local healthcare security administrations took over centralized procurement and medical insurance management (according to China's recruitment network statistics, at least 28 provinces have taken over the procurement and management). Some provinces have already held meetings on work deployment of healthcare security administrations or issued guidance documents which provide an insight into the work of China and local healthcare security administrations.
Gansu
Build a national pilot province for medical insurance informatization, and establish a unified provincial medical insurance information platform as soon as possible;
Continue to strengthen the special governance of health insurance fraud and the supervision of medical insurance funds, and establish a sound long-term mechanism for fund supervision;
Solidly promote the reform of the purchase and bidding system for drug consumables, the reform of medical insurance payment methods and management of high-value medical consumables.
Guangdong
Promote the procurement reform of pharmaceutical groups in an all-round way, expanding from the procurement of pharmaceutical groups to the procurement of medical consumables;
Improve the management mechanism for prices of medicines and regulate high-price medical consumables;
Continue to promote the payment and settlement mechanism based on the types of diseases, actively support the development of the medical treatment partnership system, and advance the construction of tiered diagnosis and treatment system.
Jiangsu
Prioritize the reform of the purchase and bidding system of drug consumables. In accordance with national practices, initiate pilot projects for centralized procurement with “amount and budget”.
The virtual-high price and overuse of medical consumables are also a major obstacle that must be surmounted as we deepen the reform for medical system.
Reform the price management mode of medical services, establish a dynamic adjustment mechanism encompassing price of purchase and bidding, control for inspection and examination cost and adjustment of medical service prices, and strengthen the linkage between price policies and payment of medical insurance.
Liaoning
Comprehensively promote the multiple medical insurance payment method, and continue to promote the reform of DRGs and point payment, as a way to reduce payment items.
Formulate a unified work plan for special governance of health insurance fraud throughout the province, and conduct random inspection and reexamination in the province.
Reform and improve the work mechanism for the approval of prices of new medical services, and complete the revision of the Measures for the Administration of Price of New Medical Services;
Reform and improve the centralized procurement mechanism for medicines, and release the “Implementation Plan for Centralized Procurement of Medicines in Medical Institutions of Liaoning Province”, and upgrade the centralized procurement mechanism for medicines with the payment of medical insurance as the leverage.
Shanxi
Based on the practice of procurement of drugs with target quantity in 4+7 Cities, initiate the pilot effort to utilize procurement of drugs with target quantity in Shanxi in a timely manner, strengthen the inter-provincial linkage adjustment of medical consumables, and deeply integrate Shanxi into the Belt and Road Initiative, and actively develop Shanxi with the Beijing-Tianjin-Hebei in coordinated manner;
Comprehensive implement the Ten Restrictions on Personnel of the Healthcare System, continue to prevent corruption of the governments, forge a better industry spirit, and strive to build a strong professional team.
Gansu
Build a national pilot province for medical insurance informatization, and establish a unified provincial medical insurance information platform as soon as possible;
Continue to strengthen the special governance of health insurance fraud and the supervision of medical insurance funds, and establish a sound long-term mechanism for fund supervision;
Solidly promote the reform of the purchase and bidding system for drug consumables, the reform of medical insurance payment methods and management of high-value medical consumables.
Guangdong
Promote the procurement reform of pharmaceutical groups in an all-round way, expanding from the procurement of pharmaceutical groups to the procurement of medical consumables;
Improve the management mechanism for prices of medicines and regulate high-price medical consumables;
Continue to promote the payment and settlement mechanism based on the types of diseases, actively support the development of the medical treatment partnership system, and advance the construction of tiered diagnosis and treatment system.
Jiangsu
Prioritize the reform of the purchase and bidding system of drug consumables. In accordance with national practices, initiate pilot projects for centralized procurement with “amount and budget”.
The virtual-high price and overuse of medical consumables are also a major obstacle that must be surmounted as we deepen the reform for medical system.
Reform the price management mode of medical services, establish a dynamic adjustment mechanism encompassing price of purchase and bidding, control for inspection and examination cost and adjustment of medical service prices, and strengthen the linkage between price policies and payment of medical insurance.
Liaoning
Comprehensively promote the multiple medical insurance payment method, and continue to promote the reform of DRGs and point payment, as a way to reduce payment items.
Formulate a unified work plan for special governance of health insurance fraud throughout the province, and conduct random inspection and reexamination in the province.
Reform and improve the work mechanism for the approval of prices of new medical services, and complete the revision of the Measures for the Administration of Price of New Medical Services;
Reform and improve the centralized procurement mechanism for medicines, and release the “Implementation Plan for Centralized Procurement of Medicines in Medical Institutions of Liaoning Province”, and upgrade the centralized procurement mechanism for medicines with the payment of medical insurance as the leverage.
Shanxi
Based on the practice of procurement of drugs with target quantity in 4+7 Cities, initiate the pilot effort to utilize procurement of drugs with target quantity in Shanxi in a timely manner, strengthen the inter-provincial linkage adjustment of medical consumables, and deeply integrate Shanxi into the Belt and Road Initiative, and actively develop Shanxi with the Beijing-Tianjin-Hebei in coordinated manner;
Comprehensive implement the Ten Restrictions on Personnel of the Healthcare System, continue to prevent corruption of the governments, forge a better industry spirit, and strive to build a strong professional team.