Notice on carrying out some key work of the new rural cooperative medical system

(en.nhfpc.gov.cn)

Updated: 2014-07-30

3. Adjust paying regulation and support healthcare reform

Rural doctors will be allowed to increase their basic medical user fee, which should be no less than 5 yuan, by 1 yuan, paid by the new rural cooperative funds. Those medical institutions carrying out public hospital reforms should include the adjusted charge for medical staffs’ technical services (treatment costs, surgical charge, care service fee, etc.) into coverage of the new rural cooperative medical system. They should also increase medical expenditure on the technical services while controlling the coverage and ratio of payment on the use of drugs, value medical supplies and large medical equipment. Day surgery fees should also be included into the coverage of unified planning funds. New paying regulations should be researched and drafted to encourage the use of essential drugs and lower-cost drugs, guide medical institutions and medical personnel to save health service costs, rationalize prescription and reduce the financial burden of patients. Eligible village clinics, private hospitals and medical institutions within elderly care institutions shall be allowed to become a contract hospital for the new rural cooperative medical system.

4. To actively promote the establishment of a grading clinic system The grading clinic system utilizes the leverage and incentive role of the new rural cooperative medical system to guide people to visit primary care institutions for first diagnosis, to smooth dual referral paths, to split patient flow in accordance with their condition, and to encourage hospitals of different tiers to make joint efforts. By widening the gap of reimbursement rate between different hospitals, the system will lead patients to receive treatment in a rational order. Local authorities at all levels should publish first-diagnosis and referral regulations under the new rural cooperative medical system: to reimburse those patients who visit primary care institutions for first diagnosis; to reduce the reimbursement rate for those who do not follow the procedure; or to cancel their qualification of reimbursement step by step. Also, the referral path from superior hospitals to primary hospitals should be smoothened, and the deductible for the referral should either be lowered or canceled to guide patients in the chronic phase or recovery phase to primary hospitals. Medical treatment combinations are encouraged to explore service packages. Hospitals of different levels inside the combination should actively work together under a collaboration mechanism where they share common interests and responsibilities.