Enterprises Are Cautiously Optimistic About The New Medical Insurance Policy And Expect More Details To Be Implemented

In the public view, "Internet medicine", which seems to have been "silent" for a period of time, became active again during the COVID-19 epidemic.

According to incomplete statistics of public data, as of February 2020, more than 10 Internet medical platforms nationwide launched online consultation columns during the epidemic, and more than 200 public hospitals carried out free Internet diagnosis and treatment or online consultation of COVID-19.

At the same time, from February to March, the central and local governments introduced policies to encourage and supervise Internet health care, and the Internet medical services discussed for a long time were also included in the medical insurance payment. This is undoubtedly good for the Internet medical industry, which has been developing for ten years and is still on the verge of loss. However, for medical institutions, Internet medical enterprises, retail pharmacies, etc., there are different levels and rhythms of how to benefit from policy dividends. To really "eat" this dividend, More supporting policies and detailed rules need to be implemented.

The epidemic pushed Internet medicine to the foreground

The frequent occurrence of favorable policies is inseparable from the performance of "Internet+medical care" during the epidemic.

"During the epidemic, a large number of demands for Internet medical services were generated. The main operational indicators of some of the leading enterprises of Internet consultation and pharmaceutical e-commerce, including the number of visits, new registered users, activity, number of visits, number of visits, and drug sales, achieved a significant increase. In the case that public hospitals only provide limited medical services, Internet medicine has played a more positive and positive role, and has been highly recognized by relevant national departments. ”Tang Zhengye, head of consumer health consulting business of IQVIA (Ai Kunwei), pointed out in an interview with the 21st Century Economic Report.

"In the short term, a large number of online diagnosis and treatment and drug purchase are changing the access mode of consumers and patients to medical service demand to a certain extent. In the long run, Internet medicine, which has been developed for many years, is gradually moving towards the front stage, and the policy has accelerated the development of the industry for three years. In the future, in the medical supply side reform, Internet medicine will further change all aspects of the whole industry chain and value chain of the medical service system, and improve the operation and production efficiency of the whole system. "

The core essence of the Internet is to obtain traffic and its realization. Different industries are spending money to build barriers to traffic, while the traffic in the medical industry is doctor resources, patient resources, etc. The epidemic has helped to obtain traffic and build barriers to a certain extent.

"Online consultation has developed for many years, but a preliminary user education was completed during the epidemic, and most users know online consultation and its value for the first time." Li Tiantian, founder and chairman of DXY, told the 21st Century Economic Report, "During the epidemic, the problems received from online consultation mainly focused on judging whether the symptoms were pneumonia caused by COVID-19, mask related selection and wearing methods, low heat treatment methods, and maternal related protection consultation. These demands accounted for about 50%, and doctors on the online consultation platform could completely solve these basic needs through online answers. For hospitals, assist in shunt, reduce pressure and avoid cross infection; For Internet hospitals, user education can be completed. "

"Because of the convenience brought by the Internet medical service during the epidemic, the policy gradually tends to encourage the development of Internet medicine." 1 Yu Gang, co-founder and executive chairman of Drugstore, said in an interview with the 21st Century Economic Report reporter, "From the user side, many users have not dared to use the Internet for medical treatment before. First, they are not used to it, and second, they do not trust it. The epidemic has given everyone a chance to try, and these customers will settle down. The user scale and penetration rate of Internet medical health will be greatly improved. "

During the epidemic, the role played by Internet medicine was also recognized by pharmaceutical enterprises. Tang Zhengye believed that "it is very likely that pharmaceutical enterprises will put some high-value drugs, such as drugs that are out of the procurement in quantity, original patented drugs, new drugs, etc., on the Internet medicine platform for sale or as a major sales channel in the future."

Be cautious about Internet medical access to medical insurance

From OTC drug online sales pilot, telemedicine service, online registration and consultation, prescription drug online sales prohibition to deregulation, and Internet hospital landing, Internet medical development has ushered in many acceleration nodes in the decade.

However, under the "Internet+healthcare" model, there are many different types of enterprises and segmentation models, and their demands and interactions for policies are also different.

Take the new policy of bringing Internet medical services into medical insurance settlement, "the whole is more beneficial to the industry, but not necessarily to the enterprises. The first problem to be solved is the settlement of medical insurance in different places. For example, DXY's Internet hospitals are registered in Yinchuan and Heilongjiang, but if a patient in Shanghai goes to the DXY's Internet hospital for medical treatment, it turns out that medical insurance cannot be used, because it is a off-site medical treatment. According to the current policy, patients in Shanghai can only be reimbursed after consulting on the online Internet platform of a hospital in Shanghai. In fact, this greatly limits the advantage of the Internet's "borderless service", because as an Internet company, it is unlikely to build an Internet hospital platform in every region and hospital in the country. ”Li said every day.

Li Tiantian believes that for Internet medical access to medical insurance, "we should be cautious and not too optimistic. At present, it is still difficult for the platform to connect with medical insurance in various regions, and there are too many departments involved in medical insurance, and the policies in each region are different. It is necessary to get through the medical insurance electronic system in various regions, and communication and coordination are difficult. It is suggested to further optimize the supporting relationship between private Internet medical institutions and offline physical medical institutions, further liberate the productivity, and 'loosen the tie' for the private Internet medical industry. "

There are also many difficulties in communicating with local governments on how to connect medical insurance. "The local governments at all levels are still unclear about the specific implementation of national policies. For example, what are the detailed rules for the implementation of Internet medical insurance? What drugs can be allowed to be covered through online medical insurance? How to monitor? How to connect the systems? The detailed rules have not yet been released. For example, there is no clearer implementation rules for prescription drugs sold online at present, and we mainly adopt the mode of taking and delivering drugs from online bookstores. ”Yu Gang said that under the promotion of national policies, "in the future, we need to further expand the service ecology, and will pay more attention to the sinking market in the 3-6 tier cities, where there is a larger population base, but medical services are seriously inadequate. In addition, we will make more attempts and exploration in insurance payment and medical insurance payment."