Medical network - on March 10, fujian medicine crisis will recruit! Prior to the rhythm of the pig into the circle and then a sharp sword to kill pig, cut the mess! History take the shortest fujian medical insurance payment settlement price based medicine joint procurement price sunshine, officially released in March 7, the pharmaceutical joint limit sunlight procurement directory (first batch) and health care the highest selling price and payment settlement price notice, received notice said after released to hang the net "complaints and qualification of materials submitted by enterprises further audit, adjusted the part of the net drug, fix the highest part of the health care sales price, check and ratify the province medical insurance payment settlement price at the same time.
After read through the notice, medicine for insiders and began to doubt sound, meng question, mystery, their ears shall not steal the bell... Have medicine to recruit people said: I announced on the last catalog, how do this? I pay the sale price for health care to be raised or lowered, payment and settlement accounting out the price? ... Actually, I write here is also a confused, in all its fujian the sunlight procurement plan and rules very can understand people thinking, should belong to jin yong's novels in "giant" "epee front, big qiao don't workers", has reached the highest realm of drug centralized purchasing: "no rules, there are rules in the heart, recruit and adjustment, recruit and fixed. Real don't like, and to not move!"
But, through its release about the word "price" involving drugs or carried on the thorough analysis accounting system design! The simple statistics, the original notification of the communist party of China covers six drug "the price" noun - "1, the highest selling price; 2, medicine health care payment settlement price; 3, platform hanging net net price of the drug; 4, the highest purchase price of medical institutions; 5, the actual purchase price of pharmaceuticals, 6 drugs sale price.
The author notification and understanding to the simple explanation:
A, medicine health care the highest selling price: according to the drug general "four principles", according to the net enterprise final offer, considering related price information (e.g., the minimum purchase price, ports, factory name, etc.) to determine the health medical establishment that decide A dot the highest selling price. The highest selling price does not point to any specific companies, specific products.
B - medicine health care payment settlement price: integrated pharmaceutical properties (treatment, auxiliary, nutrition), approved by the drug prices and funds to bear ability in medical insurance to pay limits of settle accounts of expense of drug standards.
C - platform hanging net net price of the drug, should be understood as a production enterprise finalists condition platform showed final net price;
D - the highest purchase price of medical institutions, drug purchasing behavior occurs in provincial platform should not exceed the highest purchase limit value;
E - drug purchase price, should be understood as a drug in the provincial platform purchasing behavior of the actual transaction occurring in the dynamic, concrete, real, clearing drugs payment market transaction price.
F - sale price: to understand the price for the sales of medical institutions to disease (should pay the price of the patients with theory, according to the insurance reimbursement percentage share of this article do not distinguish)
See this, the reader is dizzy? Anyway, I'm almost fainted! In fact, in the ideal situation, A can be equal to B, C can equal to D, E can equal to C and D, the F can be equal to B. The scene, the author want to poetry: that's what ABCDEFG, the medicine recruit not how. Burning brain heartburn tear flow, the purchase price which seek to... To detoxify the turn of the uncertain relation between the price, have to actuarial mathematics is a great god! In fact, the price is not so complicated, only need to grasp the three core price...
Take a chestnut
Such as some production enterprise in fujian netting a drug coverage, system condition of the competition the actual net price 20 yuan, health care is highest sales price of 22 yuan, medical insurance payment settlement price is 15.4 yuan. If the district, district cities negotiation price negotiation to 16 yuan, in the process of the transaction; Production enterprises, patients, medical institutions and health care payer each paid or how much profit?
Manufacturer:
This is obvious: according to the actual amount of the transaction price negotiations 16 yuan settlement drug payment!
Patient:
Balance at the current under the basic principles of medical institutions, the author analyzed the possibility of large medical institutions in medical care is the highest sales price of 22 yuan to patients, in this case, the patient you just need to pay 6.6 yuan.
Medical institutions:
First of all, if a medical institution with 22 yuan still foreign sales, so the hospital profits will be 6 yuan. Foreign sales, of course, if a medical institution to 20 yuan, so the hospital profits will be 5.4 yuan. That is to say, in this case, simple to lower the price of foreign sales, the higher price bargaining for medical institutions is not cost-effective. As a result, most likely is: prefecture-level negotiations further reduce and maintain a relatively high sales price. If this is the case, or the above rules, the actual net price and the payment settlement price is changeless, the prefecture level negotiations prices down further, for example: if the prefecture level to negotiate the price down to $10, foreign sales is still 20 yuan, so, on the basis of symbolic to lower the price of foreign sales and has carried on the substantive area after bargaining, medical institutions will be 11.4 yuan of bumper profits.
Bargain as a result, the next step of fujian province area, the authors speculated that will be more cruel. Nine target area bargaining from fuzhou (provincial), the bargain area where to begin? Similarly, today I received a message like this: xiamen drug centralized purchasing leading group published a notice today, the city will according to the implementation of medical insurance payment settled in fujian province on the basis of drug joint limit sunlight procurement rules and the catalog of joint limit sunlight procurement organization with the amount of negotiation of medical institutions, medical institutions, please combined with the actual situation, put forward reasonable Suggestions, and submitted on 9 March 2017 in day shift. Print affix the seal of the unit to send xiamen city xiamen, health and family planning commission drug centralized purchasing leading group office.
Provincial level (the net, medicare payments) end at the same time, the area be far behind? ! |
