Policy Interpretation of "Key Tasks for Deepening the Reform of the Medical and Health System in the Second Half of 2023"

Recently, with the approval of the State Council, the National Health Commission, the National Development and Reform Commission, the Ministry of Finance, the Ministry of Human Resources and Social Security, the National Medical Insurance Administration, and the National Medical Products Administration jointly issued the "Key Work Tasks for Deepening the Reform of the Medical and Health System in the Second Half of 2023" (hereinafter referred to as the "Tasks"), clarifying the key tasks and work arrangements for deepening the medical reform in the second half of 2023.

1、 Background of the promulgation of the "Task"

Currently, China has entered a stage of high-quality development, and the 20th National Congress of the Communist Party of China has made comprehensive arrangements for continuously deepening medical reform. Make good use of one lever to promote the coordinated development and governance of the three medical systems; Highlighting a key point, namely deepening the reform of public hospitals guided by public welfare, and continuously advancing the deepening of medical reform in depth.

2、 The main content of "Task"

The medical reform work in the second half of 2023 mainly includes six aspects and 20 specific tasks. One is to promote the expansion of high-quality medical resources and regional balanced layout. Promote the establishment and construction of national medical centers and regional medical centers, continuously improve the medical level of cities and counties, strengthen the construction of community and rural medical and health service capabilities, improve the system and mechanism for promoting hierarchical diagnosis and treatment, promote the inheritance and innovative development of traditional Chinese medicine, and promote the solution of "serious diseases can be solved in this province, general diseases can be solved in cities and counties, and headache and fever can be solved in townships and villages.". The second is to deepen the reform of public hospitals guided by public welfare. Promote the reform of medical service prices and standardized management, deepen the reform of the salary system in public hospitals, accelerate the high-quality development of public hospitals, standardize the development of private hospitals, comprehensively strengthen comprehensive supervision in the pharmaceutical industry, and create a clean and positive industry environment. The third is to promote the orderly connection of multi-level medical security. Consolidate and improve the basic medical insurance for all, improve the multi-level medical security system, deepen the reform of diversified and composite medical insurance payment methods, maximize the effects of various systems, and effectively reduce the burden of medical treatment for the public. The fourth is to promote reform and innovative development in the pharmaceutical industry. Support drug research and development innovation, normalize centralized and quantity based procurement of drugs and medical consumables, strengthen drug supply guarantee and quality supervision, and ensure the supply and use of good drugs. The fifth is to improve the public health system. Promote the collaboration and integration of medical and preventive measures, advance the reform of the disease prevention and control system, enhance the capacity of public health services, and work together from multiple aspects such as institutional improvement, talent team construction, evaluation and assessment to promote the construction and capacity enhancement of the public health system. Deepen the Healthy China Action and Patriotic Health Movement to continuously improve the health literacy of the people. Six is to develop and strengthen the medical and health workforce. Strengthen the cultivation of scarce professional and high-level talents, strengthen the construction of grassroots teams with a focus on general practitioners, implement the special plan for college student rural doctors, deepen reforms in grassroots salary and job settings, improve the enthusiasm of grassroots medical personnel, enhance the ability of grassroots medical and health services, and effectively focus work on communities and rural areas.

3、 The 20th National Congress of the Communist Party of China clearly proposed to deepen the reform of public hospitals guided by public welfare. What specific arrangements will be made next?

Public hospitals are the mainstay of China's healthcare service system, and the reform of public hospitals guided by public welfare is an important part of deepening healthcare reform. In September 2017 and at the end of 2019, drug and medical consumables bonuses were cancelled in public hospitals across the country. The old operating mechanism has been broken down, and the next focus is to continuously consolidate and improve the new operating mechanism. One is to implement the government's investment responsibility and consolidate the foundation of public welfare. Key efforts will be made to promote the implementation of investment in basic construction and equipment procurement of public hospitals that comply with regional health plans, development of key disciplines, talent cultivation, expenses for retired personnel that comply with national regulations, and policy based loss subsidies. Based on economic and social development, financial situation, and the health needs of the people, gradually increase government investment in health, strengthen government investment in basic medical security, and solidify the public welfare foundation of public hospitals. The second is to promote the reform and standardized management of medical service prices. The National Health Commission will continue to work with relevant departments to reform and standardize the management of medical service prices, so that medical service prices better reflect the value of technical labor, ensure the source of salaries for public hospital personnel, and promote the maintenance of public welfare. Promote the further implementation of price dynamic adjustment mechanisms in various regions, conduct annual price adjustment evaluations, and timely adjust prices that meet the conditions. On the basis of dynamic price adjustments, gradually clarify the price comparison relationship of medical services, reasonably reflect the technical labor value of medical personnel, and ensure that public hospitals achieve income and expenditure balance and sustainable development. Summarize and promote the experience of pilot cities in deepening the reform of medical service prices, evaluate, summarize and promote the reform of medical service prices in five pilot cities, launch provincial-level pilot projects for medical service price reform, establish and improve a medical service price formation mechanism that adapts to economic and social development, better plays the role of the government, fully participates in medical institutions, and reflects the value of technical labor. Promote centralized and quantity based procurement of drugs and consumables to improve quality and expand scope, timely carry out new batches of national organized procurement, cover more drugs and consumables, and continuously amplify the effect of reform. By the end of 2023, the total number of national and provincial collected medicinal products in each province will reach 450. The third is to deepen the reform of the personnel compensation system and mobilize the enthusiasm of medical personnel. We will promote relevant departments to further deepen the reform of the personnel and salary system in public hospitals, guide local authorities to implement the autonomy of internal distribution in public hospitals, reasonably determine the internal salary structure, pay attention to the stable income and effective incentives of medical personnel, play the guarantee function of the salary system, and enable medical staff to fully devote themselves to their work, interpreting public welfare with continuously improving medical service quality and level. The fourth is to strengthen performance evaluation guided by public welfare. Give full play to the role of the performance evaluation baton, continue to organize and do a good job in the performance evaluation of second level and above public hospitals, coordinate and carry out public welfare oriented assessment and evaluation work, focus on assessing medical quality, operational efficiency, sustainable development, satisfaction, etc. The assessment results are linked to hospital level evaluation, medical insurance payment, total salary, etc., guiding public hospitals to adhere to public welfare and implement functional positioning, Promote the reform and development of public hospitals in the correct direction of public welfare.