State Council: Deepen the Implementation of the Healthy China Initiative and Promote the Revitalization and Development of Traditional Chinese Medicine

Deepening Medical and Health System Reform 2020

Key Tasks for the Second Half of the Year

In recent years, and especially since the Third Plenary Session of the 18th Central Committee of the Communist Party of China, China's medical and health system reform has continued to deepen, and the people's health status and the fairness and accessibility of basic medical and health services have continued to improve. Since the outbreak of the COVID-19 epidemic, the medical and health system has withstood the test and played an important role in winning the battle against COVID-19. In the second half of 2020, deepening medical and health system reform should be guided by Xi Jinping Thought on Socialism with Chinese Characteristics for a New Era, fully implement the spirit of the 19th National Congress of the Communist Party of China and the second, third, and fourth plenary sessions of the 19th Central Committee, implement the decisions and deployments of the Central Committee and the State Council of the Communist Party of China, adhere to the people-centered development philosophy, adhere to the principles of ensuring the basics, strengthening the grassroots level, and establishing mechanisms, comprehensively promote the deepening of medical reform and work related to the prevention and control of the COVID-19 epidemic, place greater emphasis on prevention, make up for shortcomings, plug loopholes, and strengthen weaknesses, continue to strive to shift from focusing on treatment to focusing on people's health, deepen the coordinated reform of medical treatment, medical insurance, and pharmaceuticals, continue to strive to solve the problems of difficulty and high cost of seeing a doctor, and provide strong support for winning the people's war, overall war, and decisive battle against the epidemic, and safeguarding the people's lives and health.

I. Strengthen Public Health System Construction

(1) Reform and improve the disease prevention and control system. Optimize and improve the functions of disease prevention and control institutions and improve the basic conditions for disease prevention and control. Improve the mechanism of medical and prevention coordination, strengthen the responsibilities of disease prevention and control in medical institutions at all levels, enhance the capacity of public hospitals to treat infectious diseases, and promote the integration of personnel, information, and resources between medical and prevention institutions. Strengthen the responsibilities of disease prevention and control in township hospitals and community health service centers, and establish a sound working mechanism for the linkage between disease prevention and control institutions and urban and rural communities. Strengthen the capacity building for infectious disease prevention and control at ports. (The National Health Commission and the General Administration of Customs are respectively responsible; the National Development and Reform Commission, the Ministry of Finance, the Ministry of Human Resources and Social Security, the National Administration of Traditional Chinese Medicine, etc., participate. Respectively responsible for each department to take the lead according to their respective responsibilities, the same below)

(2) Improve the infectious disease monitoring and early warning system. Implement the first-diagnosis responsibility system for infectious disease reporting, improve the monitoring mechanism for diseases of unknown cause and abnormal health events, promote the establishment of an intelligent early warning multi-point triggering mechanism, strengthen the communication of infectious disease monitoring and early warning information between the military and local areas and between departments, and promote the establishment of a multi-channel monitoring and early warning mechanism. (The National Health Commission, the General Administration of Customs, the National Administration of Traditional Chinese Medicine, the Health Bureau of the Central Military Commission's Logistics Support Department, etc., are respectively responsible, and relevant departments participate)

(3) Improve the public health emergency material guarantee system. Increase epidemic prevention and treatment medical facilities and mobile laboratories. Adhere to the integration of traditional Chinese and Western medicine, and strengthen the capacity building for the prevention and control of public health emergencies and emergency medical rescue for emergencies. Strengthen the reserves of medicines and medical protective materials, improve the nucleic acid testing capacity, promote the transformation of fever clinics in medical institutions, and promote the implementation of the "three zones and two corridors" requirements. Increase investment in the research and development of vaccines, drugs, and rapid testing technologies. (The National Development and Reform Commission, the Ministry of Science and Technology, the Ministry of Industry and Information Technology, the Ministry of Finance, the National Health Commission, the State-owned Assets Supervision and Administration Commission of the State Council, the General Administration of Customs, the National Administration of Traditional Chinese Medicine, etc., are respectively responsible, and relevant departments participate)

(4) Do a good job in the prevention and control of the COVID-19 epidemic in autumn and winter. Guide local areas to formulate specific plans in advance, strengthen personnel training and emergency drills, consolidate the "four-party responsibility," and do a good job in the "five guarantees and three strict requirements" (having protective guidelines, having prevention and control management systems and responsible persons, having protective materials and equipment, having medical and nursing support, having isolation and transfer arrangements, strictly managing the setting and management of fever clinics, strictly investigating epidemiology, and strictly preventing hospital-acquired infections) and other work. Establish and improve a tiered, layered, and diversionary mechanism for the treatment of major epidemics such as infectious diseases. Promote local areas to do a good job in providing long-term prescription services for patients with chronic diseases. (The National Health Commission, the National Development and Reform Commission, the Ministry of Finance, and the National Administration of Traditional Chinese Medicine are responsible. The first one is the leading department, the same below)

(5) Strengthen the construction of public health teams. Strengthen the construction of public health-related disciplines and the cultivation of reserve talents. Strengthen training on public health knowledge such as epidemiology for clinical doctors, including general practitioners. Pilot provinces and other places with conditions in the comprehensive medical reform should increase efforts to explore the improvement of the entry and use of public health personnel, treatment and protection, assessment and evaluation, and incentive mechanisms. (The Ministry of Education, the Ministry of Human Resources and Social Security, the National Health Commission, the National Administration of Traditional Chinese Medicine, and the Secretariat of the Leading Group for Medical Reform of the State Council are respectively responsible, and the Ministry of Finance, etc., participate)

II. Deepen the Implementation of the Healthy China Initiative

(6) Continuously improve the production and living environment and advocate a healthy and civilized lifestyle. Improve the mechanism for health science popularization. Carry out in-depth rural human settlement environment improvement. Improve the technical guidelines for COVID-19 prevention and control in farmers' markets. Promote the standardized construction of farmers' markets, standardize functional zoning and layout, and increase the intensity of standardized management and law enforcement. Promote the revision of the general rules for nutrition labeling of prepackaged foods. Formulate guiding documents for carrying out the new era patriotic health campaign in depth. (The Ministry of Ecology and Environment, the Ministry of Agriculture and Rural Affairs, the Ministry of Commerce, the National Health Commission, and the State Administration for Market Regulation are respectively responsible)

(7) Strengthen health promotion for key groups. Carry out national comprehensive prevention and control of myopia among children and adolescents evaluation and assessment. Comprehensively strengthen and improve school physical education, hygiene, and health education. Promote the expansion of pilot projects for mechanism innovation in maternal and child health care institutions. Formulate management guidelines for medical and elderly care institutions. Strengthen the work of providing home-based medical and health services for the elderly. Implement the community medical and elderly care integration capacity improvement project. (The Ministry of Education and the National Health Commission are respectively responsible, and the National Development and Reform Commission, the Ministry of Civil Affairs, the General Administration of Sport, and the National Administration of Traditional Chinese Medicine participate)

(8) Improve the prevention and control level of chronic diseases. Improve public health service projects. Taking the management of chronic diseases such as hypertension and diabetes as a breakthrough point, strengthen the combination of prevention and treatment at the grassroots level. Taking early screening and intervention of cardiovascular and cerebrovascular diseases, cancer, and pneumoconiosis as a starting point, promote the integration of business between disease prevention and control institutions and medical institutions. Formulate guidelines for cancer prevention and screening (popular science version). Promote pilot work on the construction of a social psychological service system. (The National Health Commission, the Ministry of Finance, and the National Administration of Traditional Chinese Medicine are responsible)

(9) Increase the intensity of prevention and control of infectious diseases, endemic diseases, and occupational diseases. Do a good job in the prevention and control of influenza in winter and spring. Achieve the goal of eliminating malaria, control and eliminate key endemic diseases such as Kashin-Beck disease and schistosomiasis, and basically control the prevalence of echinococcosis. Promote the work of occupational health experts. (The National Health Commission and the National Administration of Traditional Chinese Medicine are responsible)

III. Deepen the Comprehensive Reform of Public Hospitals

(10) Improve the performance appraisal mechanism for medical and health institutions and medical personnel. Improve the performance appraisal of tertiary public hospitals, launch the performance appraisal of secondary public hospitals, and promote the performance appraisal of maternal and child health care institutions. Include disease prevention and control, public health emergencies, health promotion and education, etc., in the scope of assessment. Promote the public disclosure of economic operation information of public hospitals. Promote the establishment and improvement of pilot projects for the modern hospital management system, and carry out in-depth demonstration and performance evaluation work for comprehensive reform of public hospitals. Formulate policy documents to promote the high-quality development of public hospitals. (The National Health Commission and the National Administration of Traditional Chinese Medicine are respectively responsible, and the Ministry of Human Resources and Social Security, etc., participate)

(11) Establish and improve a dynamic adjustment mechanism for medical service prices. Guide various provinces to design a dynamic adjustment mechanism based on setting activation conditions, evaluating triggering implementation, adjusting prices both up and down, coordinating medical insurance payments, and conducting monitoring and assessment. Seize the opportunity presented by centralized procurement of drugs and consumables and the cancellation of surcharges on medical consumables to reduce the cost of drugs and consumables, conduct timely price assessments, and make adjustments in a steady and orderly manner when conditions are met. Promote the improvement of the access system for medical service items and accelerate the review of newly added medical service price items. Monitor the prices, costs, expenses, income distribution, and reform operation of medical services in public medical institutions as a basis for implementing dynamic adjustments to medical service prices. Strengthen cost accounting for medical services in public medical institutions. (National Health Commission, National Healthcare Security Administration, and National Administration of Traditional Chinese Medicine are respectively responsible.)

(12) Deepen reforms in the salary system and staff management. Implement the requirements of "two allowances," fully implement reforms in the salary system of public hospitals, guide local governments to improve the determination of total salary amounts, internal performance appraisal, and income distribution methods for public hospitals, and establish a sound operating mechanism for medical and health institutions that combines guarantees and incentives. Coordinate and make good use of staffing resources in the medical and health field, focusing on strengthening staffing in public hospitals, primary medical and health institutions, and public health institutions at all levels, such as disease prevention and control. (The Central Organization Department and the Ministry of Human Resources and Social Security are respectively responsible, with the Ministry of Finance, the National Health Commission, the National Healthcare Security Administration, and the National Administration of Traditional Chinese Medicine participating.)

(13) Implement government policies on investment in basic construction and equipment procurement for public hospitals that meet regional health planning requirements, and increase support for traditional Chinese medicine hospitals and infectious disease hospitals. Actively and steadily promote the resolution of legally compliant long-term debts of public hospitals, strictly prohibit debt-financed construction and above-standard decoration, and seriously hold accountable those involved in illegal debt-financing behavior by public hospitals. (The National Development and Reform Commission, the Ministry of Finance, the National Health Commission, and the National Administration of Traditional Chinese Medicine are respectively responsible.)

IV. Deepen Medical Security System Reform

(14) Improve the level of basic medical security. Increase the per capita government subsidy for urban and rural residents' medical insurance by 30 yuan, and steadily increase the individual payment standard. Improve the mechanism for guaranteeing medical treatment expenses for major epidemics. Carry out pilot programs for cross-provincial direct settlement of outpatient expenses. (National Healthcare Security Administration and Ministry of Finance are responsible.)

(15) Promote medical insurance payment method reform. Promote national pilot programs for payment based on diagnosis-related groups and per-case payment. Improve the consultation and negotiation mechanism between medical insurance agencies and medical institutions, reasonably determine and dynamically adjust the total budget indicators for medical insurance funds, and where conditions permit, increase the pre-allocation of revolving funds to reduce the pressure on medical institutions to make advance payments. Explore the implementation of total payment for close-knit medical consortia, strengthen supervision and assessment, and allow for retention of surpluses and reasonable sharing of overspending. Formulate guiding opinions on establishing medical insurance drug payment standards. (National Healthcare Security Administration, National Health Commission, and National Administration of Traditional Chinese Medicine are responsible.)

(16) Strengthen medical insurance fund management and improve the regulatory mechanism. Carry out big data-based intelligent monitoring of medical insurance, promote the application of technologies such as video monitoring and facial recognition, and explore provincial-level centralized monitoring. Promote "Internet + medical security," accelerate the construction of a national unified medical security information platform, and ensure its connection with the national integrated government service platform. (National Healthcare Security Administration is responsible.)

(17) Accelerate the development of commercial health insurance. Encourage commercial insurance institutions to provide comprehensive health insurance products and services covering multiple guarantees, including medical, disease, rehabilitation, care, and maternity. Actively introduce social forces to participate in medical security services. (National Healthcare Security Administration and the China Banking and Insurance Regulatory Commission are respectively responsible.)

V. Improve the Drug Supply Guarantee System

(18) Improve drug and consumable procurement policies. Orderly expand the scope of nationally organized centralized procurement and use of drugs, and conduct pilot programs for centralized procurement of high-value medical consumables. Encourage medical insurance agencies to directly settle drug payments with drug production or distribution companies. Guide local governments to fully implement policies on the procurement, distribution, and use of selected drugs and high-value medical consumables. Formulate policy documents on reforming and improving the drug procurement mechanism. Guide local governments to improve policies related to centralized procurement and medical insurance payments for novel coronavirus detection. (National Healthcare Security Administration and National Health Commission are respectively responsible, with the Ministry of Finance and the National Medical Products Administration participating.)

(19) Promote the rational use of drugs. Implement rational drug use monitoring, regularly publish monitoring results, promote medical institutions to optimize and standardize drug structures, promote the priority use of national essential drugs, and implement requirements such as "oral administration instead of intramuscular injection, intramuscular injection instead of intravenous infusion." Strengthen the construction of the national drug use monitoring platform. Promote clinical comprehensive evaluation of drugs and organize pilot programs for clinical comprehensive evaluation of essential drugs for major diseases. Formulate a second batch of encouraged generic drug catalogs. (National Health Commission and National Administration of Traditional Chinese Medicine are responsible.)

(20) Strengthen supervision of drug and consumable use. Gradually establish and improve an information-based traceability mechanism for drugs, implement "one product, one code" for vaccines and drugs that are nationally organized for centralized procurement and use, and select some key high-value medical consumables for the implementation of unique identification of medical devices. Construct a nationally unified and open centralized drug procurement market with unified standards and functional specifications, and promote the use of medical insurance drug codes. Gradually unify the national classification and coding of high-value medical consumables for medical insurance, and explore the coordinated application of standardized coding in the registration, procurement, and use of high-value medical consumables. (National Healthcare Security Administration and National Medical Products Administration are respectively responsible, with the National Health Commission, etc., participating.)

(21) Do a good job in ensuring the supply and stabilizing the prices of short-supply drugs. Promote the construction of a multi-source information collection platform and inter-departmental collaborative monitoring mechanism for short-supply drugs. Implement a production suspension reporting system and inventory management system for short-supply drugs. Establish and improve a normalized monitoring and early warning mechanism for drug and consumable prices, strengthen dynamic monitoring of domestic procurement prices and tracking of foreign prices. Increase the enforcement of monopoly violations involving raw materials, imported drugs, etc. (Ministry of Industry and Information Technology, National Health Commission, State Administration for Market Regulation, National Healthcare Security Administration, and National Medical Products Administration are respectively responsible, with the National Administration of Traditional Chinese Medicine participating.)

VI. Coordinate and Promote Related Key Reforms

(22) Continue to promote the construction of regional medical centers, promote the expansion and sinking of high-quality medical resources and balanced layout, and establish a management system and operating mechanism suitable for regional medical centers. (National Development and Reform Commission, National Health Commission, National Administration of Traditional Chinese Medicine, and the Secretariat of the State Council Leading Group on Medical Reform are respectively responsible.)

(23) Promote tiered diagnosis and treatment and the construction of medical and health informatization. Fully promote the construction of community hospitals, refine and implement family doctor contract services, improve the capacity of urban and rural community medical services, improve the tiered diagnosis and treatment system, and strengthen primary-level health prevention and control. Deepen comprehensive medical reform in counties, promote pilot programs for close-knit county-level medical consortia, and promote "county-township integration, village-village integration." Promote the implementation of multi-channel subsidy policies for the service income of rural medical and health personnel. Accelerate the development of "Internet + medical health," improve the national health information platform, promote the application of new generation information technology in the medical and health field, and promote the reshaping of medical and health management and service models. Support the sustained, healthy, and standardized development of privately-run medical institutions. Provide support for medical institutions affected by the epidemic. Formulate opinions on the comprehensive establishment of a high-quality and efficient medical and health service system with Chinese characteristics. (National Development and Reform Commission, Ministry of Finance, Ministry of Human Resources and Social Security, National Health Commission, National Healthcare Security Administration, National Administration of Traditional Chinese Medicine, and the Secretariat of the State Council Leading Group on Medical Reform are respectively responsible.)

(24) Promoting the Revitalization and Development of Traditional Chinese Medicine. Vigorously promote the integrated traditional Chinese and Western medicine medical model in comprehensive hospitals, infectious disease hospitals, and specialized hospitals, and incorporate the implementation situation into hospital grading assessments and performance evaluations. Accelerate the construction of evidence-based medicine centers for traditional Chinese medicine, launch the construction of national traditional Chinese medicine centers and regional traditional Chinese medicine medical centers, carry out pilot projects for classic traditional Chinese medicine wards, improve the emergency response and treatment capabilities of traditional Chinese medicine hospitals, and give full play to the unique role of traditional Chinese medicine in the treatment of major epidemics. Select and release a batch of advantageous diseases and treatment projects of traditional Chinese medicine, and encourage and guide medical and health institutions to provide traditional Chinese medicine services. Strengthen the capacity building and team building of county (city) traditional Chinese medicine medical services, and promote full coverage of county-run traditional Chinese medicine medical institutions. When adjusting medical service prices, give priority consideration to medical service prices that reflect the value of technical labor services, and support the inheritance and innovative development of traditional Chinese medicine. Formulate policies and measures to accelerate the characteristic development of traditional Chinese medicine. (The National Administration of Traditional Chinese Medicine, the National Development and Reform Commission, the National Health Commission, and the National Healthcare Security Administration are respectively responsible.)

(25) Doing a Solid Job in Health Poverty Alleviation. Comprehensively address the prominent issue of basic medical security, and strengthen policy support for the training of health personnel and the improvement of technical capabilities in poverty-stricken areas. Carry out medical security work for rural impoverished populations according to regulations. Increase guidance and support for deeply impoverished areas such as the "Three Regions and Three Prefectures," and strengthen efforts to combat major infectious diseases and endemic diseases. Improve problems such as malnutrition in impoverished areas. (The National Health Commission, the National Development and Reform Commission, the Ministry of Education, the Ministry of Finance, the National Healthcare Security Administration, the National Administration of Traditional Chinese Medicine, and the State Council Poverty Alleviation Office are responsible.)

(26) Improving the Comprehensive Supervision, Coordination, and Oversight Mechanism for the Medical and Health Industry. Carry out pilot projects for "credit + comprehensive supervision." Formulate policy documents on the accountability and oversight mechanisms for comprehensive supervision in the medical and health industry. Formulate several regulations to strengthen the construction of the health and health supervision system, and promote the standardized construction of supervisory institutions. Further standardize medical practices and promote reasonable medical examinations. (The National Health Commission and the National Administration of Traditional Chinese Medicine are responsible.)

All localities and relevant departments should strengthen the concept of "big health," effectively strengthen systematic planning and organizational leadership for deepening medical reforms, and include the completion of medical reform tasks as an important part of government target management and performance evaluation, and coordinate the work of normalized epidemic prevention and control and deepening medical reforms. Further promote the experience of medical reform in Fujian Province and Sanming City. Establish an evaluation and adjustment mechanism for pilot provinces in comprehensive medical reform. The Secretariat of the State Council Leading Group for Medical Reform should strengthen overall coordination, conduct monitoring and evaluation, establish a task ledger and report quarterly, and conduct an evaluation of the "Thirteenth Five-Year Plan" medical reform plan. Strengthen publicity and guidance on medical reform, timely interpret policies and measures, and build consensus on reform.