成都市医疗保险谈判绩效分析

Performance Analysis of Medical Insurance Negotiation in Chengdu

截至目前,成都市已与全市定点医疗机构和94家药企先后开展了7次药品谈判,谈判药品共458个品规,团购价格在四川省药招挂网价基础上最高降幅达30%,平均降幅6.5%左右,累计减少医保基金支出上千万元,减轻参保人员医疗负担近7000万元。通过谈判,建立了平等合作的医保契约管理关系,促使医药供方主动控制成本,实现了医疗保险从行政管理向协商谈判转变。

Up to now, Chengdu Municipal Government has carried out 7 pharmaceutical negotiations with the city＇s designated medical institutions and 94 pharmaceutical companies, involving a total of 458 drug product regulations. The group rates have decreased a maximum of 30% on the basis ,of the online prices of the centralized procurement of pharmaceuticals on the management platform in Sichuan province, with an average reduction of about 6.5%. The cumulative reduction of medical insurance fund has mounted up to over 10 million Yuan, and the medical expenditure of insured personnel has been mitigated to nearly 70 million Yuan. Through negotiations, an equal and cooperative relation of Medicare contract management has been established, urging the medicine suppliers to take the initiative to control costs, and thus has realized the transformation of medical insurance from administrative management to consultative negotiation.