The National Health Commission and six other departments have issued 20 specific tasks on how to deepen medical reform and medical insurance in the second half of the year

Notice on Issuing the Key Work Tasks for Deepening the Reform of the Medical and Health System in the Second Half of 2023

Guo Wei Ti Gai Fa [2023] No. 23

The people's governments of various provinces, autonomous regions, and municipalities directly under the central government, the Xinjiang Production and Construction Corps, relevant ministries and commissions of the State Council, and relevant directly affiliated institutions:

The "Key Tasks for Deepening the Reform of the Medical and Health System in the Second Half of 2023" have been approved by the State Council and are now issued to you. Please organize and implement it seriously based on the actual situation.

National Health Commission National Development and Reform Commission

Ministry of Finance Ministry of Human Resources and Social Security

National Medical Insurance Administration National Food and Drug Administration

July 21, 2023

Deepen the reform of the medical and health system in the second half of 2023

Key work tasks

2023 is the beginning year for fully implementing the spirit of the 20th National Congress of the Communist Party of China.

1. promote the expansion of high-quality medical resources and regional balanced layout

We will promote the establishment and construction of national medical centers and national regional medical centers. According to the plan, the national medical center and the national regional medical center will be set up, and the mechanism of "unveiling the leader" and tracking the effectiveness will be established. Coordinate the layout of comprehensive, specialized, and Chinese medicine national medical center construction projects, carry out evaluation of the effectiveness of national regional medical center construction, and promote the establishment of a management system and operating mechanism compatible with national regional medical centers.

Continuously improve the medical level of cities and counties. Relying on existing resources, guide local governments to promote the construction of provincial-level regional medical centers. Promote the pilot construction of tight urban medical groups and strengthen the scientific and rational grid layout. Select several cities to pilot high-quality and efficient medical and health service systems. Continuously promote the work of matching tertiary hospitals to assist county-level hospitals. Encourage tertiary hospitals to explore cooperation mechanisms with county hospitals to achieve reasonable division of labor, complementary advantages, and shared benefits throughout the entire disease diagnosis and treatment chain. Organize the evaluation of medical service capabilities in county hospitals. Research and formulate guiding documents to promote the construction of a closely knit county-level medical community. Initiate the third batch of national hospice care pilot projects and implement a project to enhance hospice care service capabilities.

Strengthen the capacity building of community and rural medical and health services. Expand the service functions of rehabilitation medical care, medical and elderly care integration, and hospice care in township health centers, and reasonably develop community hospitals. Promote the high-quality development of family doctor signing services, promote effective signing and standardized performance, and promote the participation of general medical departments in grassroots family doctor signing services in comprehensive hospitals. Improve the mechanism for county-level mobile medical services and on-site services to ensure full coverage of rural medical and health services. Implement actions to enhance the ability of community medical and elderly care integration and demonstration projects for medical and elderly care integration. Deepen the application of "Internet plus medical health" in urban and rural community disease prevention and treatment and health management.

Improve the system and mechanism for promoting graded diagnosis and treatment. Explore the implementation of total medical insurance payment for close medical consortia, strengthen supervision and assessment, retain surplus, and reasonably share overspending. Encourage close medical consortia to establish a drug linkage management mechanism, and promote the connection of medication between upper and lower level medical institutions. In areas where conditions permit, medical and health institution personnel can be employed by counties and villages. Carry out performance evaluation of medical consortia. Promote the mutual recognition of examination and testing results in second level and above hospitals.

Promote the inheritance, innovation, and development of traditional Chinese medicine. Accelerate the construction of the National Traditional Chinese Medicine Inheritance and Innovation Center, National Traditional Chinese Medicine Epidemic Prevention and Control Base, Key Hospital with Traditional Chinese Medicine Characteristics, and Flagship Hospital for the Coordination of Traditional Chinese and Western Medicine, and promote the construction of the National Demonstration Zone for Comprehensive Reform of Traditional Chinese Medicine. Strengthen the construction of rehabilitation and geriatric medicine departments in traditional Chinese medicine hospitals, and rely on existing resources to build a number of traditional Chinese medicine rehabilitation centers. Strengthen the cultivation of traditional Chinese medicine characteristic talents, and provide traditional Chinese medicine knowledge and skills training for physicians in grassroots medical and health institutions and rural doctors. Promote the research and development of ancient classic formula formulations, accelerate the release of key information research and approval of new drugs.

2. Deepening the Reform of Public Hospitals Oriented by Public Welfare

Promote the reform of medical service prices and standardized management. We will promote the evaluation of the price adjustment of medical services in 2023 in all provinces, adjust prices in a timely manner within the scope of the total amount of qualified services, and give priority to the adjustment of treatment, surgery and some traditional Chinese medicine medical service items with the value of technical services. Continuous medical service price index compilation and related monitoring. Evaluate the price reform of five pilot cities, and launch the provincial pilot of medical service price reform.

Deepen the reform of the salary system in public hospitals. Guide local authorities to implement the autonomy of internal distribution in public hospitals. Within the approved total salary, public hospitals can adopt various ways of autonomous distribution, and tilt towards majors that are urgently needed by the public and have a shortage of talents based on actual needs. Reasonably determine the internal salary structure, pay attention to the stable income and effective incentives of medical personnel, and further leverage the guarantee function of the salary system. It is strictly prohibited to issue revenue targets to departments and medical staff, and the salary of medical staff shall not be linked to business income such as drugs, sanitary materials, inspection, and laboratory testing. Explore the implementation of an annual salary system for the main responsible persons in public hospitals.

Accelerate the high-quality development of public hospitals. Fully implement the dean's responsibility system under the leadership of the Party Committee. Carry out quality evaluation of party building work in public hospitals. Strengthen the operation and management of public hospitals with the integration of business and finance as the core, and continue to carry out performance evaluation work for public hospitals and maternal and child health institutions. Carry out high-quality development evaluation and promotion actions for public hospitals. Play a leading role in the pilot demonstration of high-quality development in public hospitals, and strengthen the management of public hospital reform and high-quality development projects. We will carry out a three-year campaign to promote information exchange and sharing among medical and health institutions nationwide, promote the construction and grading evaluation of smart hospitals, and pilot projects for "5G+healthcare", medical artificial intelligence, and "blockchain+healthcare". Carry out theme activities to improve medical experience and enhance patient experience. Support the high-quality development of medical institutions run by state-owned enterprises.

Comprehensively strengthen comprehensive supervision in the pharmaceutical industry. Guide party organizations in public hospitals to strengthen their main responsibility for comprehensively and strictly governing the party, and prevent risks of integrity. Develop guiding documents on deepening institutional and mechanism reforms and strengthening clean governance in the field of medicine and health. Continuously strengthen the construction of professional ethics, promote the construction of a long-term mechanism for addressing corruption in the pharmaceutical industry nationwide, and further purify the industry atmosphere. Carry out a special campaign to crack down on fraud and insurance fraud, and manage dental implant fees. Strengthen anti-monopoly and anti unfair competition supervision in the pharmaceutical industry. Standardize the development of private hospitals.

3. promotes orderly convergence of multi-level medical security

Consolidate and improve basic medical insurance for all. To guide the local establishment and improvement of the employee medical insurance outpatient co-help guarantee mechanism, to carry out general outpatient co-ordination, strengthen positive publicity and policy interpretation. Dynamically adjust the medical insurance drug catalog. Expand the scope of cross-provincial networking fixed-point medical institutions, the implementation of off-site medical settlement. Promote all qualified designated medical institutions to support the application of medical insurance electronic vouchers.

Improve the multi-level medical security system. Improve the system of major illness insurance and medical assistance, and establish a long-term mechanism for preventing and resolving poverty caused by illness. Continuously deepen the pilot of the long-term care insurance system, summarize and evaluate the pilot situation, and study and improve policy measures. Develop commercial medical insurance, with a focus on covering expenses that are not covered by basic medical insurance.

Deepen the reform of diversified and composite medical insurance payment methods. Carry out reforms to pay by disease diagnosis related grouping or by disease type score in no less than 70% of the overall planning areas. Promote the payment of long-term and chronic inpatient medical services based on bed days, and explore the implementation of payment based on disease types for advantageous diseases in traditional Chinese medicine. Guide various regions to establish and improve mechanisms for adjusting factors such as disease groups/types, weights/scores, coefficients, etc., and improve supporting mechanisms such as negotiation, surplus retention, special case negotiation, and fund supervision to improve the efficiency of medical insurance fund utilization.

4. Promoting Reform and Innovative Development in the Field of Medicine

Support drug research and development innovation. Clarify the shortcomings and support priorities of the pharmaceutical industry chain, guide and support enterprises to break through key technologies to achieve industrialization, and improve the level of supporting the pharmaceutical industry chain and supply guarantee capabilities. Continue to promote the priority review and approval work. Improve the price formation mechanism of new drugs. Continue to publish the list of drugs for children to encourage research and development and to encourage generic drugs.

Regularly carry out centralized and quantity based procurement of drugs and medical consumables. Carry out centralized and quantity based procurement of new batches of national organized drugs and medical consumables. Guide each province to carry out at least one batch of centralized quantity based procurement of drugs and medical consumables within the year, achieving a total of 450 national and provincial centralized procurement of drugs. Implement the policy of retaining surplus medical insurance funds for centralized procurement of drugs and medical consumables. Strengthen the rigid constraints on the quantity and implementation of centralized procurement and reporting in public medical institutions, improve the internal assessment methods and compensation mechanisms of medical institutions, and promote the rational and priority use of selected products. Improve the functions of the pharmaceutical centralized procurement platform and implement the pharmaceutical price monitoring project.

Strengthen drug supply guarantee and quality supervision. Continuously promote the priority allocation and use of essential drugs. Strengthen collaborative monitoring, early warning, and graded response for shortage of drugs. Explore and improve new formats and models of drug distribution, and accelerate the innovative development of the drug distribution industry. Carry out comprehensive clinical evaluation of drugs, improve the monitoring mechanism for drug use, and promote standardized and rational drug use. Conduct full coverage spot checks on selected products in the centralized procurement of drugs and medical consumables organized by the state, conduct full coverage patrols on vaccine production enterprises, and conduct spot checks on blood product production enterprises. Reasonably import necessary drugs and medical devices. Research and improve the policy measures related to the "two vote system".

5. a sound public health system

Promote the coordination and integration of medical prevention. Strengthen the monitoring and analysis of the new crown epidemic and virus variation, compact the "four-party responsibility", and do a solid job in the normal prevention and control of the new crown epidemic "Class B B tube. We will strengthen the production and supply of emergency medical materials, and enhance the ability to prevent, control and treat infectious diseases at the grass-roots level. Establish a list of public health responsibilities of public hospitals at all levels and types, clarify assessment and evaluation standards, and promote the establishment of disease prevention and control or public health departments in secondary and above medical institutions, clarify work functions, and allocate full-time personnel. To study and formulate measures for the management of disease prevention and control supervisors in medical institutions. Implementation of a system of chief experts in public health sub-fields. Strengthen the technical guidance and supervision and assessment of disease prevention and control work in medical institutions. Explore and promote the participation of professionals from disease control institutions in the work of medical consortia, and promote the coordinated development of county-level disease control institutions and county-level medical communities.

Promote the reform of the disease prevention and control system. Establish and improve the system for monitoring, risk assessment, and early warning of infectious diseases, research and develop guiding documents for establishing a sound intelligent multi-point triggering infectious disease epidemic monitoring and early warning system, and promote the construction of infectious disease monitoring and early warning and emergency command information platforms. Develop guiding documents for the high-quality development of disease prevention and control systems. Promote the implementation of disease prevention and control system reform plans in local areas, and complete all reform tasks by the end of the year.

Enhance the capacity of public health services. Adhere to prevention as the main focus, deepen the Healthy China Action and Patriotic Health Movement, and continuously improve the health literacy of the masses. Strengthen the management of major chronic diseases, enhance mental health and mental health work, and continuously promote occupational health protection actions. Strengthen the public health service capacity of grassroots medical and health institutions, improve national basic public health service projects and major infectious disease prevention and control projects. Strengthen food safety standards and risk monitoring and assessment.

6. development and expansion of medical and health team

Strengthen the shortage of professional and high-level personnel training. Promote medical colleges to strengthen the construction of general medicine disciplines, and generally establish general medicine teaching organizations. Strengthen the standardization of geriatric medicine. Support vocational colleges to add elderly health services, old-age services related professional. Strengthen the training of professionals in spirit, critical care, geriatrics, pediatrics, anesthesia, public health, etc., and compound talents combined with prevention and treatment. Implementation of high-level medical talent plan. Strengthen the management expertise training of hospital managers. Guide all localities to strengthen the construction of professional nurses, elderly care workers, and medical care workers for the elderly, and organize professional training for nurses in primary medical and health institutions on common diseases, frequently-occurring diseases and psychological care for the elderly.

Strengthen the construction of grassroots teams with a focus on general practitioners. Mainly focusing on "5-year college education+3-year standardized training", combined with various methods such as job transfer training and targeted undergraduate medical student training in rural areas, we aim to strengthen the team of general practitioners. Implement the registration or annotation of the scope of practice for general practitioners who have received training and passed the assessment according to regulations. Ensure the salary and benefits of general practitioners are in line with the salary level of clinical physicians in local county-level public hospitals under the same conditions. Optimize the structure of professional and technical positions in grassroots medical and health institutions, with a focus on general practitioners. Carry out training programs to enhance the capacity of rural health talents in counties. Implement the special plan for rural doctors among college students. Guide local authorities to ensure the participation of rural doctors in basic pension insurance.

All relevant departments in various regions should attach great importance to deepening medical reform work, effectively strengthen organizational leadership, strengthen propaganda and guidance, respond to social concerns in a timely manner, and gather consensus on reform. Pilot provinces of comprehensive medical reform should further explore innovation and play a demonstrative and driving role. The National Health Commission should strengthen the overall coordination of medical reform work, work together with relevant departments to strengthen supervision, guidance, monitoring and evaluation, and ensure that all reform tasks are implemented and effective.

Policy Interpretation of "Key Tasks for Deepening the Reform of the Medical and Health System in the Second Half of 2023"

Recently, with the approval of the State Council, the National Health Commission, the National Development and Reform Commission, the Ministry of Finance, the Ministry of Human Resources and Social Security, the National Medical Insurance Administration, and the National Medical Products Administration jointly issued the "Key Work Tasks for Deepening the Reform of the Medical and Health System in the Second Half of 2023", clarifying the key tasks and work arrangements for deepening the medical reform in the second half of 2023.

Background of the 1. "Mission"

Since the 18th National Congress of the Communist Party of China, the Party Central Committee with Comrade Xi Jinping at the core has placed the protection of people's health in the strategic position of priority development, incorporated the deepening of medical reform into the comprehensive deepening of reforms, and promoted the transformation of "treatment-centered" to "people" Health-centered ", focusing on solving the two key and difficult problems of" difficult medical treatment "and" expensive medical treatment ", launched a series of important reform measures, and achieved remarkable results. At present, China has entered a stage of high-quality development, and the 20th National Congress of the Communist Party of China has made comprehensive arrangements for the continuous deepening of medical reform. 2023 is the first year to fully implement the spirit of the Party's 20th National Congress. Deepening medical reform must fully implement the spirit of the Party's 20th National Congress, guided by Xi Jinping's new era of socialism with Chinese characteristics, and firmly grasp the main features of Chinese modernization. Features and major principles, accurately grasp the new requirements of the new stage of high-quality development in which the deepening of medical reform is located, adhere to "one center", that is, people's health as the center ", that is to promote the coordinated development and governance of the" three medical services "; highlight the" one key point ", that is, deepen the reform of public hospitals oriented by public welfare, and continue to deepen the medical reform.

2. the main contents of the task

The medical reform work in the second half of 2023 mainly includes 20 specific tasks in six areas. First, to promote the expansion of high-quality medical resources and regional balanced layout. We will promote the establishment and construction of national medical centers and national regional medical centers, continuously improve the medical level of prefectures, cities and counties, strengthen the capacity building of medical and health services in communities and rural areas, improve the system and mechanism for promoting hierarchical diagnosis and treatment, and promote the inheritance and innovative development of traditional Chinese medicine. We will promote "serious diseases and serious diseases can be solved in this province, general diseases can be solved in cities and counties, and headaches and brain fever can be solved in towns and villages". The second is to deepen the public welfare-oriented reform of public hospitals. Promote the reform of medical service prices and standardized management, deepen the reform of the salary system of public hospitals, accelerate the high-quality development of public hospitals, standardize the development of private hospitals, comprehensively strengthen the comprehensive supervision of the pharmaceutical field, and form a clean and healthy industry environment. The third is to promote the orderly convergence of multi-level medical security. We will consolidate and improve the basic medical insurance for all, improve the multi-level medical security system, deepen the reform of diversified and compound medical insurance payment methods, maximize the effects of various systems, and effectively reduce the burden of medical treatment for the masses. The fourth is to promote reform and innovative development in the field of medicine. Support drug research and development innovation, normalize the centralized procurement of drugs and medical consumables, strengthen drug supply security and quality supervision, and ensure "good medicine" and "good medicine". Fifth, improve the public health system. We should promote the coordination and integration of medical and prevention, promote the reform of disease prevention and control system, improve the ability of public health services, and make joint efforts to promote the construction and capacity improvement of public health system from the aspects of system improvement, talent team construction, evaluation and assessment. Deeply carry out the Healthy China Action and the Patriotic Health Campaign to continuously improve the health literacy of the masses. Six is to develop and strengthen the medical and health team. Strengthen the training of scarce majors and high-level talents, strengthen the construction of grassroots teams focusing on general practitioners, implement a special plan for college students and rural doctors, deepen the reform of grassroots salaries and job settings, increase the enthusiasm of grassroots medical staff, and improve grassroots medical and health services Ability to effectively focus work on communities and rural areas.

3. the 20th National Congress of the Communist Party of China clearly proposed to "deepen the reform of public hospitals oriented to public welfare". What are the specific arrangements for the next step?

Public hospitals are the main body of China's medical and health service system, and the reform of public hospitals oriented by public welfare is an important part of deepening medical reform. In September 2017 and at the end of 2019, public hospitals across the country canceled the addition of drugs and medical consumables respectively. The old operating mechanism has been broken. The next step is to continue to consolidate and improve the new operating mechanism. The first is to implement the responsibility of government investment and consolidate the foundation of public welfare. We will focus on promoting the implementation of investment in the capital construction and equipment purchase of public hospitals in line with regional health planning, the development of key disciplines, personnel training, the expenses of retirees in line with national regulations, and policy loss subsidies. According to the economic and social development, financial situation and people's health needs, we should gradually increase the government's health investment, strengthen the government's investment in basic medical security, and consolidate the public welfare foundation of public hospitals. The second is to promote the reform of medical service prices and standardized management. The National Health Commission, together with relevant departments, will continue to do a good job in the reform and standardized management of medical service prices, so that the prices of medical services can better reflect the value of technical services, ensure the source of salaries for public hospital personnel, and promote the maintenance of public welfare. We will promote all localities to further implement the dynamic price adjustment mechanism, carry out price adjustment evaluation every year, adjust prices in a timely manner if they meet the requirements, gradually straighten out the price comparison relationship of medical services on the basis of dynamic price adjustment, reasonably reflect the technical labor value of medical personnel, and ensure that public hospitals achieve a balance of payments and sustainable development. Summarize and promote the experience of deepening the reform of medical service prices in pilot cities, evaluate, summarize and promote the reform of medical service prices in five pilot cities, launch provincial-level pilots for medical service price reform, and establish and improve a medical service price formation mechanism that adapts to economic and social development, better plays the role of the government, and medical institutions fully participate in and reflect the value of technical labor services. Promote the centralized procurement of pharmaceutical consumables with quantity and quality expansion, timely carry out new batches of national organization collection, cover more drugs and consumables, and continue to amplify the effect of reform. By the end of 2023, the total number of national and provincial drugs collected in each province will reach 450. The third is to deepen the reform of the personnel compensation system and mobilize the enthusiasm of medical staff. Relevant departments will be promoted to further deepen the reform of the personnel salary system in public hospitals, guide local governments to implement the autonomy of internal distribution in public hospitals, reasonably determine the internal salary structure, pay attention to the stable income and effective incentives of medical staff, and give full play to the guarantee function of the salary system, so that medical staff can devote themselves to work and interpret public welfare with the continuous improvement of the quality and level of medical services. Four is to strengthen the public welfare oriented performance appraisal. Give full play to the role of the performance appraisal baton, continue to organize the performance appraisal of public hospitals at level 2 and above, and coordinate the development of public welfare-oriented appraisal and evaluation related work, focusing on the assessment of medical quality, operational efficie

What is the progress of the work related to promoting the high-quality development of public hospitals in 4.? What are the specific arrangements for the "Task?

In May 2021, the General Office of the State Council issued the Opinions on Promoting the High-Quality Development of Public Hospitals. In order to implement the decision-making and deployment of the Party Central Committee and the State Council, we have adopted a point-by-point approach to promote the high-quality development of public hospitals. First, the province as a unit to guide the 11 comprehensive medical reform pilot provinces to take the lead in promoting the high-quality development of public hospitals. Guide all provinces to issue implementation plans for the high-quality development of public hospitals, establish an evaluation mechanism for the high-quality development of public hospitals, evaluate the promotion of high-quality development of public hospitals in each province, and feedback evaluation opinions to each province one by one, requiring all localities to consolidate and expand in a timely manner. Research and analyze the existing problems and deficiencies, improve the improvement measures and implement them. Second, the city as a unit, the implementation of public hospital reform and high-quality development demonstration projects. Through competitive review, a group of cities with high enthusiasm for reform and innovation and good basic conditions are selected to implement public hospital reform and high-quality development demonstration projects. According to a three-year cycle, the central government of each city will subsidize 0.5 billion yuan to encourage and guide reform and innovation, Take the lead in forming high-quality development experience of city and county-level public hospitals. Two batches of 30 cities have been selected. The third is to carry out pilot projects in 14 large-scale high-level public hospitals in 9 provinces. Through the way of joint construction of committees and provinces, the central and local governments will work together to break through policy barriers, integrate high-quality resources, promote the upgrading of medical technology and hospital management, overtake in corners, and create a model for the high-quality development of public hospitals and a modern hospital management system. template. At present, all pilot hospitals have formulated implementation plans, and the committees, provinces, and hospitals have worked together to strengthen the party's overall leadership, build high-level clinical disciplines, carry out cutting-edge scientific and technological innovation, build a high-quality talent team, and implement scientific and refined management., Provide first-class medical services and other six aspects to implement the joint construction agreement.

Next, we will guide pilot demonstration projects to increase reform and exploration efforts, and solidly promote the high-quality development of public hospitals. Initiate the evaluation of high-quality development of public hospitals in 2023 and make good use of the evaluation results. Research and develop management methods for demonstration projects, performance evaluation rules for demonstration projects, and explore special performance evaluation for high-quality development pilot hospitals. Coordinate and promote the implementation of the provincial co construction agreement in pilot hospitals for high-quality development, sort out the problems in the implementation of the agreement, and organize relevant departments to conduct special research and promote the implementation of the agreement. Summarize the implementation of the operational mechanism and policy list of regional medical centers, provide timely feedback and evaluation results to local authorities, and guide rectification and improvement. Summarize and evaluate the pilot work of modern hospital management system.

What is the current progress of relevant work in building an orderly new pattern of medical treatment and diagnosis and treatment in 5.? What are the specific considerations and initiatives for the next step?

In 2021, when General Secretary Xi Jinping inspected the Sha County General Hospital in Sanming City, Fujian Province, he gave important instructions on deepening the reform of the medical and health system, emphasizing the need to balance the layout of high-quality medical resources, so that serious illnesses and serious illnesses can be solved in the province, and general diseases are solved in cities and counties. Headache and brain fever are solved in towns and villages. General Secretary Xi Jinping's important instructions have pointed out the direction and provided fundamental guidance for us to speed up the establishment of a hierarchical diagnosis and treatment system and build a new pattern of orderly medical treatment and diagnosis and treatment. In recent years, the National Health Commission and relevant departments have continuously promoted and deepened reforms, continuously improved the medical and health service system, increased high-quality medical resources, and improved medical and health service capabilities at different levels, effectively meeting the needs of the people for medical treatment. The first is to build a national medical peak and a provincial medical highland. We will promote the planning, setting and layout construction of national medical centers and national regional medical centers, and concentrate our efforts on tackling key technical problems in the diagnosis and treatment of difficult and critical diseases. Up to now, 13 categories of national medical centers have been set up, including cardiovascular, pediatric, and respiratory; five batches of 125 national regional medical center construction projects have been determined to achieve the goal of covering all provinces. The construction of provincial-level regional medical centers was carried out in an orderly manner. The second is to enhance the Junior College capacity of municipal and county hospitals. Focus on key diseases and Junior College, layout of provincial-level regional medical centers, and narrow the gap between the level of diagnosis and treatment of key diseases in prefectures and cities and provincial capitals. At the same time, increase the city hospital counterpart support efforts, continue to promote the construction of county-level hospital Junior College, to make up for the shortcomings. In 2022, 87.71 percent of county-level hospitals nationwide will meet the basic standard of medical service capacity. The third is to improve the primary medical and health service system. We will strengthen the construction of township health centers and community health service institutions, develop community hospitals, and carry out in-depth activities of "quality service at the grass-roots level. By the end of 2022, more than 30000 township health centers and community health service centers have reached the service capacity standard. Fourth, to carry out the county medical community and urban medical group construction pilot. Strengthen the integrated management of human, financial, material and technology, and take chronic diseases such as hypertension and diabetes as the starting point to smooth the two-way referral mechanism. Establish a Junior College alliance to expand the radiation surface of high-quality Junior College resources. At present, 15000 medical consortia of various forms have been established nationwide, which provides strong support for homogeneous medical services through the integration and sharing of regional high-quality resources. In 2022, the number of two-way referrals will reach 29.847 million, and the two-way referral structure will be optimized. Fifth, the development of Internet diagnosis and treatment and telemedicine services. Improve the management of Internet diagnosis and treatment, and promote the healthy development of Internet hospitals. Improve the province-city-county-township-village five-level telemedicine service network, improve the level of grass-roots services. As of October 2022, more than 2700 Internet hospitals have been set up nationwide, and municipal and county-level tel

Next, the National Health Commission, together with relevant departments, will continue to promote the construction of a hierarchical diagnosis and treatment system, establish new mechanisms for the operation of national medical centers and regional medical centers, improve the operation mechanism of medical consortia, deepen the reform of medical service prices, and promote the reform of diversified and composite medical insurance payment methods. At the same time, we will strengthen the construction of grassroots medical and health teams with a focus on general practitioners, give full play to the role of family doctor teams as "health gatekeepers", and consolidate the foundation of urban and rural grassroots medical and health services.

6. the "Task" mentions "promoting the establishment of a management system and operating mechanism compatible with national regional medical centers", what are the next considerations?

In October 2019, the National Development and Reform Commission, the National Health Commission and other four departments jointly issued the ''Regional Medical Center Construction Pilot Work Program'', launched the national regional medical center construction pilot, and proposed to increase policy support, in terms of price, medication, More flexible policies are given in terms of talents, etc., in order to establish a modern hospital management system that mobilizes enthusiasm and guarantees sustainability