Three Departments Issue Guidance Opinion Allowing Grassroots Level to Issue Long-Term Prescriptions of Up to 12 Weeks

Recently, the National Healthcare Security Administration, the National Development and Reform Commission, and the National Health Commission jointly issued the “Guiding Opinions on Supporting the Development of Primary Healthcare Services” (hereinafter referred to as the “Guiding Opinions”). Focusing on “strengthening grassroots, consolidating foundations, and ensuring basic services,” the document promotes policy innovations in medical insurance payments, pricing management, and drug security to establish a comprehensive policy system that supports the development of primary healthcare services.

The “Guiding Opinions” propose optimizing the total payment policy for tightly integrated county medical communities and exploring per capita outpatient payments for chronic diseases. They aim to coordinate the total expenditure of employee and resident medical insurance, covering outpatient, hospitalization, and both local and cross-region medical expenses within the county, promoting the integration of county medical resources. Surplus funds will be increasingly directed to grassroots facilities, incentivizing medical communities to decentralize resources and services. The policy encourages linking per capita payments for family doctor contract services with outpatient medical insurance funds, guiding grassroots medical staff to proactively provide chronic disease follow-up, medication guidance, and health monitoring. Long-term prescriptions for chronic disease patients, with a maximum duration of 12 weeks, are permitted at the grassroots level, and these prescriptions will not be included in the average cost assessment, allowing doctors to develop reasonable treatment plans based on patient conditions.

The “Guiding Opinions” state that within the scope of general outpatient expenses covered by employee medical insurance, the reimbursement ratio should not be less than 50%. Outpatient pooling for resident medical insurance will mainly rely on grassroots healthcare institutions, with a reimbursement ratio of no less than 50%. These measures economically guide people to prefer primary care and significantly improve the convenience of medical services.

For grassroots healthcare institutions, increasing the allocation of new medical insurance funds to grassroots facilities, decentralizing surplus funds, and reducing the monthly settlement period to within 20 working days will effectively ease cash flow pressures. Unifying drug catalogs at county, township, and village levels and fully including procurement drugs into grassroots facilities will greatly alleviate the problem of drug shortages at the grassroots.

(Reported by CCTV Correspondent Wen Yongyi and Long Xiaoqin)

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