A total of 77 medical institutions and hospitals in Wuhan, capital city of Central China's Hubei province, will adopt the diagnosis-related groups (DRG) payment system by the end of 2020, according to local media reports.
The DRG pilot program is a patient classification system designed to standardize medical insurance payments.
Patients will be categorized into DRGs with similar clinical symptoms and resource costs according to their age, gender, length of stay and clinical diagnosis. Medical fees and insurance payments will thus be based on DRG classification instead of the specific details of each patient.
The implementation of DRG will prompt hospitals and doctors to change unreasonable medical behaviors - such as using precious drugs, consumables and large-scale inspection equipment for patients.
In the second half of 2018, Wuhan city carried out a medical insurance DRG payment simulation calculation at three hospitals: Zhongnan Hospital of Wuhan University, Wuhan Hospital of Traditional Chinese and Western Medicine and the Central Hospital of Wuhan.
Through simulation calculations, the total medical insurance budget of the two hospitals decreased significantly compared with the current payment methods, and one of the hospitals reduced medical insurance expenditure by 111 million yuan ($16.76 million).
The pilot cities, including Beijing, Shanghai and Wuhan, are scheduled to start the new payment model in 2021 after a trial run in 2020.
In the future, Wuhan will further expand the scope of the pilot program, and fully implement the DRG payment system in designated medical institutions for medical insurance.
