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《甘肃省深化医药卫生体制改革2019年重点工作任务》出台 高血压糖尿病等门诊用药纳入医保报销

2019-07-23 00:00:00 智能朗读:

????【本报讯】(兰州日报社全媒体记者赵万山)省政府办公厅近日印发《甘肃省深化医药卫生体制改革2019年重点工作任务》(以下简称《工作任务》)?!豆ぷ魅挝瘛分赋?,完善医保药品目录动态调整机制,将基本药物目录内符合条件的治疗性药品按程序优先纳入医保目录范围。把高血压、糖尿病等门诊用药纳入医保报销。

????支持县乡医疗机构扩大分级诊疗病种数量

????《工作任务》指出,巩固和完善分级诊疗制度。明确不同级别和类别医疗机构的职责和功能定位,建立分工协作机制。对现有500种分级诊疗病种进行评估、调整,合理调整分级诊疗病种支付标准,支持县乡医疗机构扩大分级诊疗病种数量。鼓励各市州研究细化不同级别医疗机构医疗服务价格、医保支付等政策,拉开报销比例,引导合理就医。所有分级诊疗病种均实行临床路径管理。

????年底前开展5个专科联盟和5个技术联盟试点

????《工作任务》明确,以学科建设为重点,提升18家以上县医院和24家县中医院综合能力。推动三级医院主动调整门诊病种结构,积极开展日间手术。引导医疗共同体有序发展,2019年年底前,开展5个专科联盟和5个技术联盟试点。参与国家城市医疗联合体试点的城市所在地要建成1个有明显成效的医联体,各县市区区域内至少建成1个有明显成效的医疗共同体。鼓励包括社会办医疗机构在内的各级各类医疗机构平等参与和适度竞争,促进优质医疗资源下沉,避免大医院“跑马圈地”“虹吸”患者等问题。

????在省人民医院等地开展国家现代医院管理制度试点

????《工作任务》指出,持续深化公立医院综合改革,继续开展示范和效果评价工作。统筹推进区域综合医改试点工作,加强医疗、医保、医药及公共卫生等改革集成创新。在省人民医院、省妇幼保健院、庆阳市人民医院、酒泉市人民医院开展建立健全国家现代医院管理制度试点,遴选45个公立医院开展省级现代医院管理制度试点。完善公立医院政府投入政策。根据公立医院综合改革评价结果等因素分配中央财政相关补助资金。

????《工作任务》要求,巩固完善国家基本药物制度,并逐年提高基本药物使用金额比例和品规比例,建立优先使用激励和约束机制。完善医保药品目录动态调整机制,将基本药物目录内符合条件的治疗性药品按程序优先纳入医保目录范围。把高血压、糖尿病等门诊用药纳入医保报销。对临床必需、易短缺、替代性差等药品,采取强化储备、统一采购、定点生产等方式保障供应。

????逐步扩大长期护理保险制度试点

????《工作任务》指出,加快推进医保支付方式改革,开展按疾病诊断相关分组付费试点,继续推进按病种为主的多元复合式医保支付方式改革。按照国家医保局统一安排,逐步扩大长期护理保险制度试点。加快发展商业健康保险,完善商业健康保险监管制度。抓紧落实和完善跨省异地就医直接结算政策,尽快使符合条件的异地就医患者在所有定点医院能持卡看病、即时结算,切实便利流动人口和随迁老人。

????取消建档立卡贫困人口大病保险封顶线

????《工作任务》指出,深入实施健康扶贫。相关资金和政策进一步向深度贫困地区倾斜。贫困人口大病集中救治病种扩大到25个,取消建档立卡贫困人口大病保险封顶线,鼓励地方研究提出对收入水平略高于建档立卡贫困户的群众的支持政策。加强贫困地区县医院能力建设和城乡医院对口帮扶,支持鼓励通过农村订单定向医学生免费培养、全科医生特岗计划、“县管乡用”“乡聘村用”等方式,着力解决一些乡镇卫生院和村卫生室缺乏合格医生的问题。

????《甘肃省人民政府办公厅关于完善国家基本药物制度的实施意见》出台

????完善医保支付政策减少患者药费支出

????【本报讯】(兰州日报社全媒体记者赵万山)《甘肃省人民政府办公厅关于完善国家基本药物制度的实施意见》(以下简称《意见》)近日出台?!兑饧分赋?,完善医保支付政策,将国家基本药物目录药品优先纳入城镇职工和城乡居民医保目录报销范围或优先调整甲乙分类。在保证药效前提下在慢性病管理中优先使用基本药物,减少患者药费支出。鼓励各地试点探索老年人高血压、糖尿病等重点慢性疾病基本药物特殊保障政策。

????《意见》指出,按照《甘肃省药品集中采购诚信管理办法》,加强生产和配送企业行为监管,落实生产企业供应配送的第一责任,保障偏远、交通不便地区的药品配送。因企业原因造成用药短缺的,给予诚信及积分违约处罚。

????《意见》指出,鼓励省内企业对已纳入基本药物目录的仿制药开展一致性评价。省级药品采购机构对通过一致性评价的仿制药开辟阳光挂网“绿色通道”,并在省药品采购平台上进行标识,提示医疗机构优先采购。

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