新一轮医疗服务价格改革回顾与建议

Review and Suggestion of the New-round Medical Service Price Reform

2016年以来,医疗服务价格改革取得进展,但仍须向纵深推进。首先,总结新一轮医疗服务价格改革的两个特点,即承认现状、渐进的改革和与医保、财政做好衔接。其次,评价了新一轮改革:成效包括建立公立医院补偿新机制、价格初步体现技术劳务价值、放管结合、按病种收费,不足包括定价方法待改进、动态调整机制未涉及、医院补偿需完善。最后,提出了4点建议:一是综合考量,以成本监审为基础定价;二是建立动态调整机制;三是医保参与定价,发挥监管和控费效力;四是加强财政补偿、医院管理等配套措施。

Since 2016,medical service price reform has made a breakthrough,but it still needs to be advanced in depth. Firstly,the article summarizes two characteristics of the new-round reform：recognition of the status quo and the gradual reform,dealing well with the cohesion with medical insurance and finance. Then,this reform is evaluated.The results include the establishment of a new compensation mechanism for public hospitals,preliminary reflecting the value of technology and labor service,combination of deregulation and control in price,and collecting fees according to disease. The deficiencies are that the pricing methods need to be improved,and that the price dynamic adjustment mechanism is not involved,and that the hospital compensation needs to be improved. At last,the paper puts forward four suggestions：comprehensive consideration and building the medical service pricing mechanism on the basis of cost supervision and examination,establishing the dynamic adjustment mechanism,setting up the pricing mechanism for medical insurance participation,and giving full play to the effectiveness of supervision and cost reduction,strengthening the measures matching of financial compensation and hospital management.