Liaoning solicits opinions on the resource allocation of medical insurance designated institutions a

*Source of the image: Official website of the Liaoning Provincial Medical Insurance Bureau

Good Dental News |Recently, the Liaoning Provincial Medical Insurance Bureau issued an announcement to solicit public opinions on the "Implementation Plan for the Resource Allocation Planning of Designated Medical and Pharmaceutical Institutions in Liaoning Province" (hereinafter referred to as the "Plan"). According to the "Plan", Liaoning Province will guide the scientific and reasonable allocation of resources of designated medical and pharmaceutical institutions and promote the high - quality development of designated medical and pharmaceutical institutions by planning the total amount, adjusting the existing quantity, optimizing the incremental quantity, and improving the quality.

The "Plan" proposes to plan and layout specialized hospitals such as children's, oncology, mental, and infectious disease hospitals and traditional Chinese medicine hospitals as needed. The number of designated institutions in sparsely - populated areas can be appropriately relaxed, and occupational disease and stomatological hospitals can be set up according to the actual needs of medical services. At the same time, it is necessary to orderly guide some hospitals to transform into specialized medical institutions for rehabilitation, nursing, mental diseases, occupational diseases, etc.

In terms of the allocation of designated medical institutions, the "Plan" proposes to reasonably allocate designated medical and pharmaceutical institutions in accordance with the principle of the "15 - minute medical insurance service circle". In principle, no designated medical institutions of the same type or the same level should be allocated within a service radius of 800 meters. If the number of beds per thousand people in a region reaches the regional health planning standard of this region, in principle, the number of designated medical institutions should only decrease and not increase. The total number of designated medical and pharmaceutical institutions within the year shall not exceed the annual total number of the regional medical resource allocation plan.

The "Plan" proposes to establish a management mechanism for medical insurance resources. The medical insurance administrative departments of each city need to form a working group for medical insurance resource management to compare and analyze the existing resources of designated medical and pharmaceutical institutions with the results of resource allocation calculations and regional health planning, and clarify the adjustment direction of resources of various types of designated medical and pharmaceutical institutions in the region.

When the calculated value is greater than the target value and the actual value, the focus should be on optimizing the incremental quantity. The application conditions should be refined, and eligible designated medical and pharmaceutical institutions should be included in the designated management in a timely manner; when the calculated value is less than the target value and the actual value, the focus should be on optimizing the existing quantity. Daily management should be strengthened to support the differentiated development of designated medical institutions.

In terms of implementation arrangements, the "Plan" follows the principle of "pilot first, then gradual promotion". It is proposed to select Shenyang and Dalian as the first - batch pilot cities, and other cities should speed up the start of relevant work to ensure that the medical insurance resource planning work in the whole province is fully completed during the "14th Five - Year Plan".