General Office of the State Council on Printing and Distributing Deepening the Reform of the Medical and Health System
Notice of key work tasks in 2022
State Office issued No. 14 [2022]
The people's governments of all provinces, autonomous regions and municipalities directly under the Central Government, all ministries and commissions of the State Council, and all institutions directly under the Central Government:
The "Key Tasks for Deepening the Reform of the Medical and Health System in 2022" has been approved by the State Council and is hereby issued to you. Please organize and implement it carefully in light of the actual situation.
Office of the State Council
May 4, 2022
(This is a public release)
Deepen the reform of the medical and health system
Key tasks for 2022
The year 2022 is an important year for entering a new journey towards building a modern socialist country in an all-round way and towards the second centenary goal.
To deepen the reform of the medical and health system, we must adhere to the guidance of Xi Jinping Thought on Socialism with Chinese Characteristics for a New Era, fully implement the spirit of the 19th National Congress of the Communist Party of China and all previous plenary sessions of the 19th Party Congress, and earnestly implement the spirit of General Secretary Xi Jinping's important instructions and the decisions and arrangements of the Party Central Committee and the State Council. Promoting the construction of a healthy China, in-depth promotion of Sanming's medical reform experience, promoting the expansion and balanced distribution of high-quality medical resources, deepening the reform of medical care, medical insurance, and pharmaceutical linkages, and continuing to promote the transformation from medical treatment to people's health. , The problem of expensive medical treatment.
1. Accelerate the construction of a new pattern of orderly medical treatment and diagnosis and treatment
(1) Give full play to the leading and radiating role of national medical centers and national regional medical centers.
Relying on existing resources, accelerate the establishment and construction of national medical centers, carry out national regional medical center construction projects, deepen the reform of operation mechanism, and basically complete the planning and layout of national regional medical center construction projects nationwide within the year.
(The National Development and Reform Commission, the National Health and Health Commission, the Ministry of Education, the National Administration of Traditional Chinese Medicine, the National Bureau of Disease Control and Prevention, etc. and the local people's governments are responsible according to the division of responsibilities. The following are all responsible for the local people's government and will not be listed again)
(2) Give full play to the radiation-driven role of provincial high-level hospitals.
Relying on existing resources, guide local governments to build a number of provincial-level regional medical centers, improve systems and mechanisms, guide hospitals in provincial capital cities and central urban areas of super (super) large cities to support areas with weak resources, and promote the extension of high-quality medical resources to cities and counties.
(The National Development and Reform Commission, the National Health Commission, the State Administration of Traditional Chinese Medicine, etc. are responsible according to the division of responsibilities)
(3) Enhance the service capacity of city and county hospitals.
Each province conducts pilot projects of compact urban medical groups in 2-3 cities divided into districts, improves the system and mechanism, and implements grid layout and standardized management.
Support the sustainable, healthy and standardized development of socially-run medical institutions, and support socially-run medical institutions to take the lead in forming or participating in medical consortia.
Promote new models of clinical services and emergency first aid in the county.
Deeply promote the construction of a close county-level medical community and the reform of the system and mechanism, promote the overall management of administration, personnel, finance, business, medicine, and information systems within the medical community, strengthen monitoring and evaluation, and strengthen the application of evaluation results.
(The National Health Commission, the National Development and Reform Commission, the Ministry of Human Resources and Social Security, the State Administration of Traditional Chinese Medicine, etc. are responsible according to the division of responsibilities)
(4) Improve the level of primary medical and health services.
Implement and improve the guarantee and incentive policies for village doctors.
Promote the construction of healthy villages, and ensure full coverage of village-level medical and health services by means of inspections and dispatches.
Strengthen the health management services of primary medical institutions and family doctors (teams), promote long-term prescription services, and improve relevant medical insurance payment policies.
Orderly expand the source channels of family doctors and innovate service methods.
Optimize basic public health service projects and improve service quality.
(The National Health and Health Commission, the Ministry of Human Resources and Social Security, the National Medical Insurance Administration, the National Rural Development Bureau, and the State Administration of Traditional Chinese Medicine are responsible according to the division of responsibilities)
(5) Continue to promote hierarchical diagnosis and treatment and optimize the order of medical treatment.
Organize the formulation of technical plans for disease classification diagnosis and treatment and admission and discharge standards, and guide orderly medical treatment.
Promote the total payment of the close county-level medical community, strengthen supervision and assessment, retain the surplus, reasonably share the overspending, and promote reasonable medical treatment in the region or medical consortium.
(The National Health and Health Commission, the National Medical Insurance Administration, and the State Administration of Traditional Chinese Medicine are responsible according to the division of responsibilities)
2. In-depth promotion of Sanming's medical reform experience
(6) Strengthen the promotion of Sanming's medical reform experience.
Track and evaluate the progress of in-depth promotion of Sanming's medical reform experience in various regions, promptly notify the lag of work and urge rectification.
Implement the "Notice of the General Office of the Central Committee of the Communist Party of China and the General Office of the State Council forwarding the "Several Opinions of the State Council Leading Group on Deepening the Reform of the Medical and Health System on Further Promoting the Experience of Deepening the Reform of the Medical and Health System" and other requirements, and promote the responsibility of local party committees and governments. The main responsible comrades serve as the leader of the medical reform leading group.
(The Secretariat of the Leading Group for Medical Reform under the State Council and the National Health Commission are responsible according to the division of responsibilities)
(7) Carrying out centralized and volume-based procurement of pharmaceutical consumables.
Expand the scope of procurement, and strive for a total of more than 350 generic names of drugs purchased by the state and local governments in each province.
At the national level, a batch of high-value spinal medical consumables has been purchased in a centralized manner.
For the pharmaceutical consumables with large consumption and high purchase amount other than the state-organized procurement, guide each province to implement or participate in the alliance procurement to implement at least one centralized procurement with volume, so as to improve the online procurement rate of drugs and high-value medical consumables.
Implement the policy of retaining the balance of medical insurance funds for centralized procurement of pharmaceutical consumables, improve the assessment of the retention of the balance, and incentivize the rational use of selected products.
Research and improve the rules and plans for the collection and use of specific drugs such as antibiotics.
Strengthen the price monitoring of medical consumables.
(The National Medical Insurance Administration, the Ministry of Finance, the Ministry of Human Resources and Social Security, the National Health Commission, the State Administration of Traditional Chinese Medicine, etc. are responsible according to the division of responsibilities)
(8) Promote the reform of medical service prices.
All provinces will issue documents related to the establishment of a dynamic adjustment mechanism for medical service prices by the end of June 2022, and transfer medical service prices to the catalogue of cost supervision and review and price hearing before the end of the year.
Guide local governments to scientifically set the starting conditions, triggering standards, and constraints for medical service price adjustments, conduct a price adjustment assessment once a year, and adjust prices in a timely manner when conditions are met.
Guide the five pilot cities of medical service price reform to explore supporting measures such as the rules for determining the total amount of price adjustment and the comprehensive evaluation index system for price adjustment.
(The National Medical Insurance Administration, the National Development and Reform Commission, the Ministry of Finance, the National Health and Health Commission, and the State Administration of Traditional Chinese Medicine are responsible according to the division of responsibilities)
(9) Promote the reform of medical insurance payment methods.
Implement a multi-complex medical insurance payment method based on payment by disease, and carry out the reform of payment by disease diagnosis-related group (DRG) or payment by disease score (DIP) in more than 40% of the country's overall planning areas. DRG payment or The medical insurance fund paid by DIP accounts for 30% of all eligible inpatient medical insurance fund expenditures.
Evaluate pilot cities that have entered the actual payment stage, and improve payment policies based on the evaluation results.
Advance the work related to outpatient pay per head, and improve relevant technical specifications.
(The National Medical Insurance Administration, the National Health Commission, the State Administration of Traditional Chinese Medicine, the Ministry of Finance, etc. are responsible according to the division of responsibilities)
(10) Deepen the reform of the personnel compensation system of public hospitals.
Instruct the local government to make full use of the establishment resources according to the actual situation, and for the existing non-staff qualified professional and technical personnel who meet the conditions, they can explore the recruitment of the best through strict and standardized procedures such as open recruitment, and include them in the establishment management.
Implement the "two permits" requirements, implement a distribution policy oriented to increase the value of knowledge, strengthen public welfare attributes, improve the assessment mechanism, and guide local governments to deepen the reform of the salary system of public hospitals.
Guide qualified tertiary hospitals to carry out self-assessment of senior professional titles on a pilot basis.
(The Central Office, Ministry of Finance, Ministry of Human Resources and Social Security, National Health Commission, National Medical Insurance Administration, State Administration of Traditional Chinese Medicine, etc. are responsible according to the division of responsibilities)
(11) Strengthen comprehensive supervision.
Further promote the construction of a comprehensive supervision system for the medical and health industry, strictly implement the supervisory responsibilities of the industry competent authorities and the supervisory responsibilities within the responsibilities of relevant departments, and promote local governments to fully implement their territorial supervisory responsibilities.
Urge and guide local governments to standardize the charges and services of medical institutions, make rational use of drugs and standardize diagnosis and treatment as an important part of information disclosure by medical institutions, and publish them to the public on a regular basis.
Formulate management measures for the intelligent monitoring knowledge base and rule base of medical insurance funds, and promote the application of intelligent monitoring by local medical insurance departments.
Severely crack down on fraudulent acts of defrauding medical insurance funds.
Strengthen price supervision in the pharmaceutical sector.
Formulate measures for the supervision and administration of the quality of drug distribution and use, and measures for the supervision and administration of drug online sales.
Promote the construction of drug use monitoring information network and the application of drug coding, and strive to cover all second-level and above public medical institutions and 80% of government-run community health service centers and township health centers in 2022.
Solidly promote the dynamic maintenance and deepen application of the unified national medical insurance information business code.
(The National Health Commission, the State Administration for Market Regulation, the National Medical Insurance Administration, the National Administration of Traditional Chinese Medicine, the National Center for Disease Control and Prevention, and the State Food and Drug Administration are responsible according to the division of responsibilities)
3. Efforts to enhance the capacity of public health services
(12) Improve disease prevention and control capabilities.
Improve the disease prevention and control network, management system, and operating mechanism, improve the mechanism of combining prevention and control, joint prevention and control, and mass prevention and control, strengthen the construction of public health teams, and improve the ability to monitor and warn, trace the source of major epidemics, and respond to emergencies.
Do a good job in the reform of disease prevention and control institutions in a stable and orderly manner.
Promote the construction of public health committees of village (resident) committees.
(The National Health Commission, the National Center for Disease Control and Prevention, the Central Editorial Office, the Ministry of Civil Affairs and relevant departments are responsible according to the division of responsibilities)
(13) Strengthen medical and preventive coordination.
Promote the implementation of high-risk screening and intervention projects for major chronic diseases such as cancer, stroke, cardiovascular disease, and chronic obstructive pulmonary disease.
Promote the joint management of hypertension, hyperglycemia, and hyperlipidemia pilot projects, improve appropriate technologies and service models for chronic disease health management, and promote grass-roots chronic disease medical prevention and integrated management.
Promote the establishment of public health departments and other departments directly engaged in disease prevention and control in public medical institutions, and explore the establishment of full-time and part-time disease prevention and control supervisors in medical and health institutions.
Relying on general hospitals and specialized occupational disease hospitals, strengthen the construction of the diagnosis, treatment, and rehabilitation capacity for occupational diseases such as pneumoconiosis and chemical poisoning.
(The National Health Commission, the National Administration of Traditional Chinese Medicine, and the National Bureau of Disease Control and Prevention are responsible according to the division of responsibilities)
(14) Do a good job in the prevention and control of the new crown pneumonia epidemic.
Adhere to the general strategy of "foreign defense against imports, internal defense against rebound" and the general policy of "dynamic clearing", adhere to the organic combination of normalized, scientific and precise prevention and control and local emergency response, implement the requirements of "four parties' responsibilities" and "four early days", and strengthen the source of the epidemic Control, focus on epidemic prevention and control in port areas, strictly implement closed-loop management of high-risk personnel, scientifically and accurately handle local epidemics, continue to do a good job in the vaccination of new coronaviruses, continuously optimize and improve prevention and control measures, and resolutely hold the bottom line of no large-scale rebound of the epidemic. Coordinate epidemic prevention and control and economic and social development, and strive to achieve the greatest prevention and control effect at the least cost.
Continue to help medical institutions in distress due to the epidemic.
(The National Health Commission, the National Center for Disease Control and Prevention and relevant departments are responsible according to the division of responsibilities)
(15) In-depth implementation of the Healthy China Action.
Solidly promote the Healthy China Action, further improve the working mechanism, and ensure the completion of the phased goals and tasks by 2022.
Continue to carry out in-depth patriotic health campaigns.
Promote the construction of performance appraisal mechanisms for medical institutions and medical staff to carry out health education and health promotion.
(The National Health Commission, the Ministry of Education, the General Administration of Sports, the State Administration of Traditional Chinese Medicine, the National Bureau of Disease Control and the relevant departments are responsible according to the division of responsibilities)
4. Promote the high-quality development of medicine and health
(16) Promote comprehensive reform and high-quality development of public hospitals.
The pilot provinces of comprehensive medical reform took the lead in exploring the model and path of high-quality development of public hospitals at all levels.
Local governments evaluate the high-quality development of public hospitals within their jurisdictions in accordance with the territorial principle.
Actively play a leading role in the high-quality development of high-level public hospitals.
Promote the establishment and improvement of the pilot project of the modern hospital management system.
Strengthen the performance appraisal of public hospitals and maternal and child health care institutions.
Deepen military-civilian integration in the medical and health sector.
(The National Health and Health Commission, the Ministry of Finance, the State Administration of Traditional Chinese Medicine, and the Health Bureau of the Logistics Support Department of the Central Military Commission are responsible according to the division of responsibilities)
(17) Give full play to the role of government investment in incentives.
Adhere to public welfare, implement the government's investment responsibility in the field of health and health, and guide local governments to implement the government's investment policy on public hospitals that conform to regional health plans.
Continue to support the comprehensive reform of public hospitals, implement demonstration projects for public hospital reform and high-quality development, and encourage and guide a group of prefectures and cities with reform enthusiasm to promote the experience of Sanming medical reform.
Select 10 prefectures and cities that have achieved remarkable results in deepening medical reform and give rewards.
(The Ministry of Finance, the National Health Commission, etc. are responsible according to the division of responsibilities)
(18) Promote the development of a multi-level medical security system.
Promote provincial-level coordination of basic medical insurance.
Improve the direct settlement method for cross-provincial and non-local medical treatment, and further expand the cross-provincial direct settlement of outpatient expenses. At least one designated medical institution in each county can provide cross-provincial direct settlement services for medical expenses including outpatient expenses.
Guide all localities to promote the overall planning of general outpatient medical insurance for employees, implement differentiated payment policies for medical treatment in primary medical and health institutions, and gradually include the general outpatient expenses for frequently-occurring and common diseases into the scope of payment of the overall fund.
Realize the basic unification of the scope of medicines in the national medical insurance.
We will deepen the pilot program of the long-term care insurance system, and summarize and promote experience in a timely manner.
Support commercial insurance institutions to develop commercial health insurance products linked to basic medical insurance, better cover expenses not paid by basic medical insurance, and explore and promote information sharing between medical insurance information platforms and commercial health insurance information platforms in accordance with regulations.
(The National Medical Insurance Administration, the Ministry of Finance, the National Health and Health Commission, the State Administration of Taxation, the China Banking and Insurance Regulatory Commission, the State Administration of Traditional Chinese Medicine, etc. are responsible according to the division of responsibilities)
(19) Strengthen the ability to guarantee the supply of medicines.
Continue to deepen the reform of the review and approval system, and accelerate the launch of innovative drugs with clinical value.
Continue to promote the quality and efficacy consistency evaluation of generic drugs.
Optimize the national essential drug list and improve the list management mechanism.
Improve the policy of prioritizing the allocation and use of essential drugs in public medical institutions, encourage urban medical groups, county medical associations, etc. to establish a drug linkage management mechanism, and promote the connection between lower and lower medical institutions.
Improve the drug coordination monitoring mechanism and strengthen the grading response to drug shortages.
Strengthen the construction of centralized production bases for small-variety drugs (drugs in short supply).
Strengthen the protection of drugs for rare diseases.
Improve the working mechanism and standards for comprehensive clinical evaluation of drugs, and use the evaluation results as an important basis for the selection of medical institutions' drug catalogues and the connection between superiors and subordinates.
Promote the implementation of unique identification of medical devices by category, and deepen the connection and application of unique identification in supervision, medical care, medical insurance and other fields.
Explore and improve new formats and models for drug distribution.
(The Ministry of Industry and Information Technology, the Ministry of Commerce, the National Health Commission, the National Medical Insurance Administration, and the State Food and Drug Administration are responsible according to the division of responsibilities)
(20) Promote the revitalization and development of traditional Chinese medicine.
Promote the comprehensive reform of traditional Chinese medicine.
Carry out a pilot program to promote the inheritance, innovation and development of traditional Chinese medicine by linking medical care, medical insurance, and medicine.
Select some regions to carry out medical insurance to support the development of traditional Chinese medicine, and promote the payment of traditional Chinese medicine characteristic and advantageous diseases according to the disease.
Promote the construction of "flagship" hospitals for TCM and Western medicine collaboration and pilot projects for TCM and Western medicine clinical collaboration for major and difficult diseases.
Strengthen the capacity building of traditional Chinese medicine services in grass-roots medical and health institutions, and strive to realize that all community health service centers and township health centers are equipped with traditional Chinese medicine halls and equipped with traditional Chinese medicine doctors.
(The State Administration of Traditional Chinese Medicine, the National Development and Reform Commission, the Ministry of Finance, the National Health Commission, the National Medical Insurance Bureau, etc. are responsible according to the division of responsibilities)
(21) Coordinate the promotion of reforms in related fields.
Implement the action to improve the ability of the community to combine medical care and elderly care.
Carry out demonstration projects for the integration of medical care and elderly care.
Promote the pilot program of standardized management of clinical research and expand the scope of the pilot program.
During the year, 35,000 general practitioners and 100,000 residents (including professional master students) were trained and trained through various channels such as rural order-oriented free medical student training. tilt.
Implement the two policies related to the equal treatment of resident physicians in standardized training.
Support vocational colleges to add "one old and one small" and other related majors in the health service industry.
Deeply promote the "Internet + Medical Health" and "Five Ones" service actions, and promote the exchange and sharing of information among medical and health institutions across the country.
Promote telemedicine services to cover 95% of the country's districts and counties, and gradually extend to the grassroots.
(The Ministry of Education, the Ministry of Public Security, the Ministry of Civil Affairs, the Ministry of Human Resources and Social Security, the National Health Commission, the National Medical Insurance Administration, the National Administration of Traditional Chinese Medicine, and the National Bureau of Disease Control are responsible according to the division of responsibilities)
All localities and relevant departments should effectively strengthen organizational leadership and continue to deepen medical reform.
Comprehensive medical reform pilot provinces should further play a leading role in demonstration.
The Secretariat of the Medical Reform Leading Group of the State Council and the leading coordinating agencies of the medical reform leading groups at various places shall, together with relevant departments, strengthen overall coordination, supervision and evaluation, carry out medical reform monitoring, establish task ledgers, and strengthen regular scheduling and reporting.
Strengthen publicity and guidance, respond to social concerns in a timely manner, and build consensus on reform.