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艾社康知识中心双周报 – 8月下篇 |ACCESS Health August Research Newsletter,August

本期主题:

 政策聚焦

 新闻速递:保险创新和医疗融资

 科研与社论:由病人设计的医疗健康体系

Policy Highlights 政策聚焦
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Picture Credit:Sohu
【8.16】广州计划明年建成养老综合服务平台

8月16日,广州市发展改革委发布《广州市促进健康及养老产业发展行动计划(2017-2020年)(送审稿)》(下称“计划”),公开征求意见。计划显示,2020年将基本形成“一核引领、五基驱动、三带联动、多点支撑”的健康及养老产业空间总体格局,到2020年建成提升广州健康医疗中心、广州国际健康产业城,每年滚动实施100项健康及养老产业重大项目。

在与国际接轨方面,未来将在南沙、中新广州知识城等区域建成一批高水平国际高端医疗服务机构并形成产业集聚态势,在南沙建成国际医药保税港和具有世界先进水平的国际医疗综合服务枢纽。粤港澳医疗养老合作体制机制取得重大突破,建成一批粤港澳医疗养老全面合作示范区。在造血干细胞移植、基因芯片诊断、免疫细胞治疗等生物技术产业形成一批国际领先的产业集群。

在信息化平台建设方面,力争在2020年前,建设医养护一体化运营平台。依托市政府信息化云平台、政府信息共享平台等基础性公共信息平台,到2018年前建成广州市养老综合服务信息平台(一期),到2020年前建成二期,推进医养护一体化智慧健康服务数据库建设,完善社区居家养老服务信息数据库,实现社区居家养老服务接入受理、服务对象和服务机构评估等功能。

【Aug 16】Guangzhou to Establish a Comprehensive Senior Care Ecosystem

On August 16th, the Development and Reform Commission of Guangzhou Municipality issued a document entitled “Plan to Push the Development of Health and Nursing Care  Industries”. According to the Plan, by 2020, the Guangzhou government will finish the construction of the Guangzhou Health and Medical Center and Guangzhou International Healthcare Industry Park. With the completion of these two major healthcare landmarks, Guangzhou will be one step closer towards establishing a comprehensive healthcare ecosystem.

Moreover, a series of international medical and healthcare facilities will be constructed in such areas as Nansha and Guangzhou Zhongxin Technology Park. These areas are to become the clusters of international healthcare resources according to the Plan. In particular, an international port for pharmaceutical imports and exports will be constructed in Nansha, making it a hub for international medicare services. The plan also stipulates the establishment of a pilot zone containing medical resources from Guangdong Province, Hong Kong, and Macao. This zone is expected to encourage collaboration among medicare providers at these three locations. Cutting edge technologies such as hematopoietic stem cell transplantation, gene chip diagnosis, and immune cell therapy would be introduced.

As for the construction of an information platform, a comprehensive operational platform containing medicare, healthcare, and senior care services would be established by the end of 2020. This program will include two phases. The first phase is to complete the construction of the Guangzhou senior care service information platform by the end of 2018. The second phase is to construct a smart health service database, to improve the community care service database, and to instill such functions as evaluation of service providers and recipients by the end of 2020.

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Picture Credit:Xinhua NewsCreated by Qu Jiaxi
【8.21】民政部:将建立养老院黑名单制度和市场退出机制

在民政部、公安部等七部门今日联合召开的全国养老院服务质量推进视频会议上,民政部副部长高晓兵指出,我国养老院服务质量仍然存在安全隐患突出、服务管理制度不健全、养老服务队伍建设亟待加强、农村敬老院服务质量基础相对薄弱等问题。将抓紧研究制定相关标准规范,建立信用体系、黑名单制度和市场退出机制。对此,民政部副部长高晓兵强调,要深入分析,明确整治着力点,注重精准施策,着力抓好五个方面:一是要聚焦安全隐患,筑牢安全防线,对养老院的消防、食品、医疗、特种设备等方面的安全隐患进行集中整治。二是要聚焦深化放管服改革,要贯彻落实近期出台的放管服改革措施,降低准入门槛,加强事中事后监管。三是要聚焦制度缺失,抓紧研究制定相关标准规范,建立信用体系、黑名单制度和市场退出机制。四是要聚焦队伍建设,加大养老院管理服务人员的专业培训力度,不断提升服务能力、管理水平和职业素养。五是要聚焦农村敬老院建设,补齐农村养老服务质量短板,要继续开展农村特困人员供养服务机构等级评定工作,以标准化建设促进农村敬老院服务质量提升。

【Aug 21】Black List and Exit Mechanism for Nursing Homes to be Established 

On August 21st, Vice Minister of the Ministry of Civil Affairs, Xiaobing Gao, hosted the Conference on Improving the Service Quality of Nursing Homes, at which he outlined a series of issues underlying the national senior care system. These issues include potential safety hazards of nursing homes, loopholes in the service management system, substandard service providers, poor quality of rural nursing homes, etc. Gao emphasized five key areas in which policy improvement is needed. The first is to improve the safety and security of nursing homes nationwide. Secondly, authorities should further explore the reform on reducing bureaucracy, increasing management capacity, and improving service quality. This can be done by lowering the entrance standard of nursing homes while maintaining strict control and supervision on the operation of these nursing homes. Thirdly, authorities should focus on policy making in areas where no regulations currently exist. A nursing home credit system and an exit mechanism should be established to maintain and improve the service quality of operating nursing homes. Fourthly, nursing homes should focus on establishing a comprehensive training model to enhance the professionalism and service quality of nursing service providers. Lastly, authorities should invest more in the construction of nursing facilities in rural areas. Facilities serving the impoverished population in rural areas should be rated based on their service quality and feedback of service recipients to stimulate better performance.

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Picture Credit:Sohu
【8.22】三部委:PPP模式支持养老服务业发展

近日,财政部、民政部、人力资源社会保障部共同发布了《关于运用政府和社会资本合作模式支持养老服务业发展的实施意见》(以下简称《意见》)。该《意见》的发布旨在鼓励运用政府和社会资本合作(PPP)模式推进养老服务业供给侧结构性改革,加快养老服务业培育与发展,形成多层次、多渠道、多样化的养老服务市场,推动老龄事业发展。

《意见》具体提出如下三点鼓励政策:1. 鼓励政府将现有公办养老机构交由社会资本方运营管理。2. 鼓励政府和社会资本在城乡社区内建设运营居家养老服务网点、社区综合服务设施,兴办或运营老年供餐、社区日间照料、老年精神文化生活等形式多样的养老服务。支持政府将所辖区域内的社区养老服务打包,通过PPP模式交由社会资本方投资、建设或运营,实现区域内的社区养老服务项目统一标准、统一运营。3. 鼓励养老机构与医疗卫生机构、健康服务机构开展合作,支持打造“以健康管理为基础、以养老服务为核心、以医疗服务为支撑”的全生命周期养老服务链,兴建一批养老为主题,附加康养、体育健身、医疗、教育、文化娱乐、互联网等现代服务业的“养老+”综合新业态。

【Aug 22】Public-Private Partnerships Encouraged to Develop Senior Care

Recently, the Ministries of Finance, Civil Affairs and Human Resources and Social Security co-issued the “Instruction to Use the Public-Private Partnerships Model to Support the Development of the Senior Care Industry”. The Instruction is meant to encourage the application of the Public-Private Partnerships model to reform the supply chain of the senior care industry and create a more diverse senior care market.

The Instruction specifically sets forth three policy guidelines to encourage more social capital investment in the senior care industry. Firstly, the Instruction encourages local governments to allow private investors to operate existing public nursing facilities. Secondly, the Instruction encourages the application of the Public-Private Partnerships model to construct, invest in, or operate food and daycare services. Local governments are instructed to bundle all senior care services in the region together and allow private investors to manage these bundled services.  Lastly, the Instruction encourages more collaboration between nursing facilities and medical or healthcare facilities. This is to create a full cycle of senior care services. These services will span across such areas as physical exercise, education, medical services, entertainment, rehabilitation, nursing services, and internet powered services.

In the News新闻速递
Picture Credit:HealthPoint
【8.15】上药云健康联合华泰推出全国第一张疗效保单

8月15日,华泰财险在上海针对百时美施贵宝推出的抗丙肝病毒治疗物(百立泽+速维普)的治疗效果出具了保单进行承保,这也是中国第一张“按疗效付费”保单。具体来说,患者在进行投保后将会接受一个24周的疗程,通过后续12周的随访,若是没能达到预定的治疗效果,保险公司将会补偿被保险人部分购药费用,这张保单的补偿金额为30,000元。作为首张“按疗效付费”的保单,实际的投保人是上药云健康,保费800元亦由上药云健康方面支付。此举目的不仅是为了增强保险公司推出这类保单的信心,更重要的是可以增强患者,特别是自费患者的用药信心,促进药品的销量。例如在这则案例中的抗丙肝病毒的联合治疗方案,虽然经过了CFDA的批准,但没有进入社保,病人完成一个疗程大约的费用在5.5-6万人民币之间。

上药云健康的首席运营官张小栋表示,自费患者会对此类高价创新药物疗效产生疑惑是很容易理解的,因此“按疗效付费”的保单的推出可以帮他们消除对未来不确定性的顾虑。事实上,国际上早已推出类似的“按疗效付费”的保单:英国国民医疗健康系统(NHS)和强生公司谈判决定,针对其药物万珂采用按照疗效付费的条件。NHS会购买并使用万珂,但若是在3个月的疗效评估中没达到预期的治疗效果,NHS将会停止万珂的使用,强生也需要退款给NHS。中国的医疗企业和保险机构通过大数据和相应的分析工具对临床试验效果进行研究,对于疗效有保障的药物可以推出更多此类保险,让自费患者多一种选择,多一份保障。 原文来自健康点微信公众号,本文由ACCESS Health研究部整理编辑而成

【Aug 15】Shanghai Pharma Health Commerce and Huatai Introduced Effect-based Insurance Product

On August 15th, Huatai Insurance Group introduced the first insurance product in China that settles claims on the basis of the actual therapeutic effect of treatments. Patients prescribed with anti-hepatitis C drugs Daclatasvir and Asunaprevir will be the first group entitled to these settlements. Specifically, after purchase the insurance, patients will undergo a 24 week therapy, followed by a 12 week observation period. If the effect of these drugs is less than satisfactory, the insurance company will cover part of the drug purchasing expense – 30,000RMB in this case. The insurance premium was paid by Shanghai Pharma Health Commerce Co., Ltd, the insured party in this case. That Shanghai Pharma Health Commerce decided to apply for this insurance is to encourage more insurance companies to roll out similar products as well as to boost the confidence of consumers to purchase such products.

According to Xiaodong Zhang, COO of Shanghai Pharma Health Commerce, new CFDA approved drugs such as the anti-hepatitis C drugs in this case are not covered by social security, and therefore consumers tend to become more reluctant to purchase these drugs that are highly expensive and whose therapeutic effect is uncertain. Insurance products that determine the settlement of claims based on the actual therapeutic effect help clear the doubt. In fact, other countries had developed similar insurance products long before China. For example, Johnson & Johnson and the UK National Health Service had formulated an agreement in which the National Health Service would continue purchasing the Johnson & Johnson produced Velcade on the condition that Velcade reaches the expected therapeutic effect.

The original article appeared on the WeChat subscription account of HealthPoint. This is a transcribed version produced by ACCESS Health Research Unit.

Picture Credit:NetEase News
【8.28】卓正医疗完成4000万美元融资,蓄力医疗质量管理建设,加大新进市场投入

卓正医疗是一家多学科专科医疗服务提供商,2012年于深圳创立。日前,卓正医疗完成4000万美元C轮融资,吸引了天图资本、中金公司和前海母基金三家知名投资机构。此前,卓正医疗已分别于2014及2015年获得350万美元的A轮融资和1750万美元的B轮融资。

自2012年创立以来,卓正医疗已于国内6座城市运营18家医疗中心,服务覆盖内科、儿科、妇产科、皮肤科、眼耳鼻喉科等科室。这18家连锁医疗中心目前合计达到每月15000人,其中北京望京与CBD医疗中心的门诊量达到每月千人。据健康点消息,卓正医疗目前还在考虑拓展特色科室,今后服务将涉及儿童保健、儿童齿科等。

卓正医疗创立之初本定位社区医疗,然而由于社区医疗较为仰赖医保支付,后渐渐转向多学科专科医疗。据健康点消息,卓正医疗将会利用C轮融资加强医疗质量管理,建设医生继续教育平台与IT信息化平台,部分资金将会投向北京、上海等新进市场。在医疗质量管理方面,卓正医疗将会更加致力于医疗服务规范化,加强专科医师的全科思维及建设亚专科细化专科服务。

【Aug 28】Distinct Healthcare Received a Series C Funding of Forty Million USD

Distinct Healthcare is a multidisciplinary healthcare provider founded in Shenzhen in 2012. Just a few days ago, Distinct Healthcare was reported to have received a series C funding of 40 million USD from three leading investment companies in China, namely Capital, China International Capital Corporation Limited, and Qianhai Parent Fund. Distinct Healthcare had received a series A funding of 3.5 million USD and a series B funding of 17.5 million USD in 2014 and 2015 respectively.

Since its founding in 2012, Distinct Healthcare has established 18 healthcare centers in six cities across the country, providing services in paediatrics, obstetrics and gynecology, dermatology, and Otorhinolaryngology, Head and Neck Surgery (ENT). These eighteen medical centers altogether receive fifteen thousand patients per month, with the two centers in Beijing receiving thousands of outpatients per month. According to Caixin Healthpoint, Distinct Healthcare is now expanding its service offerings to include child care and pediatric dentistry.

A community healthcare provider at the beginning, Distinct Healthcare plans to use its series C funding to improve quality control of its workforce, establish a continuing education platform for medical professionals and an IT information platform. Specifically, Distinct Healthcare will dedicate some of the funding to improving the standardization of services, establishing sub-categories under existing departments, and expanding the expertise of all of its staff. Part of the funding will also be dedicated to Distinct Healthcare’s expansion in new markets such as Shanghai and Beijing.

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Picture Credit: PE Daily
【8.30】互联网医疗互助与保险公司水滴获1.6亿A轮融资

8月30日,水滴公司宣布完成人民币1.6亿元A轮融资,本轮融资由腾讯、蓝驰投创联合领投,创新工场、高榕资本、美团点评等机构跟投。

水滴公司由美团第10号员工沈鹏于2016年创立,目前旗下有水滴互助、水滴筹以及水滴保三项核心业务。公司致力于为中国老百姓提供医疗资金解决方案及一站式移动医疗服务,目前通过微信平台运营三款产品,服务范围涵盖健康险销售与服务、大病医疗互助与医疗服务等业务。

据悉,水滴公司的本轮融资将主要用于新科技+健康险的探索。目前,水滴保已与包括中国平安、泰康在线、众安保险等大型保险公司建立合作关系,推出了众多创新保险产品。资料显示,截至今年8月,水滴互助已为6万多名大病患者提供免费筹款服务,累计筹款金额达到10亿多元。

【Aug 30】Internet Insurance Company Shuidi Received 160 Million RMB Series A Funding

On August 30th, Shuidi announced that it had received a series A funding of 160 million RMB from leading companies in China such as Tencent, BlueRun Ventures, Sinovation Ventures, Banyan Capital, and Meituan.

Shuidi was founded in 2016 by Shen Teng, a former executive at Meituan. Shuidi boasts three main businesses, namely Shuidi Huzhu (a charitable community that encourages grassroots donations), Shuidi crowd funding, and Shuidi Insurance. Shuidi’s vision is to provide healthcare financing solutions and mobile healthcare services so that everyone has access to high quality and affordable healthcare.

Shen Teng, founder and CEO of Shuidi, announced that this series of funding will be dedicated to incorporating cutting edge technologies into healthcare insurance products. As of now, Shuidi has established partnerships with some of China’s leading insurance companies such as PingAn Insurance, Taikang Life Insurance, and ZhongAn Insurance. As of August 2017, Shuidi has raised more than one billion RMB for over sixty thousand people.

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Picture Credit:MedGenome Website
【8.30】印度基因组学创企MedGenome获红杉与Sofina千万美元C轮融资

MedGenome是一家来自印度的基因组数据提供商,专注基因组学的研究和诊断。近日MedGenome对外宣布,公司已获得3000万美元的C轮融资。该轮融资由红杉印度与Sofina领投,也吸引到了包括Zodius Capital, Infosys前CEO以及Cognizant前CEO的投资。据悉,MedGenome会将这笔资金投入到生物标记项目与精准医药的研发之中。

MedGenome成立于2013年,目前在印度和美国加州分别设有办公点与研发设施。公司旨在为大众提供低价的基因测试,主要针对包括癌症、眼疾、新陈代谢疾病在内的疑难杂症。MedGenome拥有东南亚最大的下一代基因定序实验室,在加州也拥有当地认证的测序实验设施。

【Aug 30】Genomics Startup Secured Thirty Million USD Series C Funding

MedGenome, a genomics research and diagnostics startup, has secured a series C funding of 30 million USD led by Sequoia India and Sofina. Other participants include Zodius Capital; Kris Gopalakrishnan, co-founder and former CEO of Infosys; and Lakshmi Narayanan, former CEO of Cognizant. Part of the funds will be dedicated to developing MedGenome’s biomarker discovery programs to reach the ultimate stage of precision medicine, according to Sam Santhosh, the company’s founder and chairman.

MedGenome hails from India and is now present in both India and the U.S. The company provides affordable genetics tests of rare ailments such as cancer, eye disorder, metabolic diseases, etc. It operates the largest next-generation sequencing lab in Southeast Asia as well as a certified sequencing lab in California.

Research and Opinion科研与社论8
Picture Credit: Integrative Practitioner
由病人设计的医疗健康体系

Steve Swensen是Intermountain Healthcare的医疗总监,在一场新英格兰医学杂志举办的演讲会上,他问听众,如果我们的医疗健康体制由病人设计,那我们的医疗体系会变成什么样子?

这个想法源自于Steve与朋友之间的一场对话。Steve的朋友是一个飞机维修工程师,他的朋友告诉他,每当他修理完毕一架飞机之后,自己往往是第一个试飞的人。Steve于是生出了在设计医疗体系时加入病人反馈的想法。在接下来的5年,Steve与他的研究团队走遍全国,采访了众多健康医疗企业高管与医院高层。从这些采访中,他们发现患者在接受治疗阶段往往有以下的三个愿望。 愿望一:真诚、善意、关爱

所有患者都希望在接受治疗的过程中感受到关爱与善意,但人们往往觉得我们现有的医疗体系缺乏人情。Steve认为,没有爱的医疗体系是具有高风险的医疗体系,因为在一个没有爱的医疗体系之中,病人的安全风险更高,病患就医体验更差,进而衍生出高代价高成本。更重要的是,这一份善意和关爱是相互的。如果医护人员对患者表示善意,那么病人更有可能对医护人员表达同样的善意与关心。据统计,在北美,三分之一的处方不是由病人自己填写的,原因还是因为患者与医护人员之间缺少一种信任。如果我们能把这份信任建立起来,那么病人更有可能遵循医生的遗嘱,医患之间的关系会变得更加融洽。

愿望二:医护人员之间互相关心

Steve和他的团队还发现,病人希望医护人员之间能够互相关心、互相照料,因为他们明白,如果医护人员之间能够互相关心,那么他们就更有可能将这份关心传递给自己。团队成员互相照料的最典型例子来自于Barry Wehmiller公司。在2008年经济危机期间,当其它所有公司都在大肆解雇员工之际,Barry Wehmiller公司首席执行官Bob Chapman决定不解雇任何一名员工,而是采用临时休假、统一降薪等方式留人。经济危机过后,Barry Wehmiller公司的员工对公司高层表达了至高的敬意。这样互相关心互相照料的团队,是很多医疗集团与医院都缺少的。

愿望三:病人至上

Steve和他的研究团队发现,目前医疗系统的运作会衍生出很多浪费,其中包括过多治疗、医疗服务提供失误及医疗资源统筹失误。这是因为,我们目前的医疗系统并没有要求医护人员做对病人最好的事情。很多情况下,医护人员的决定是快捷方便的,但不一定是对病患最好的。换句话说,目前的医疗系统没有把病患的利益放在首位。Steve认为,对于医护工作者来说,这是一个启示,也是一个改正的机会。他们的研究表明,将病人利益放在首位不仅对病患有益,同时也能有效解决医护人员工作倦怠的问题,因为如果他们能将自己病患的利益放至首位,他们在心理上也会获得极大的满足,进而激发工作积极性。

What if Our Healthcare System Were Designed by the Patients? 

“What if our healthcare system were designed by the patients?”, asked Steve Swensen, the Medical Director for Professionalism and Peer Support at Intermountain Healthcare. The thought struck him when he learned from a friend that the mechanic would always be the first one to fly a plane right after the maintenance is done. Swensen couldn’t help but ask himself, “what if we think about our healthcare system through the eyes of that mechanic who flies the plan s/he had repaired?”

Through interviews with some of the most successful healthcare leaders in the country, Swensen and his team discovered three wishes of a patient who is about to undergo care.

Wish One: Care about Me

Patients long for kindness and empathy, which unfortunately are often the missing pieces in the care system in America. “Care without love is at-risk care when there are higher risks of safety issues, patient experience issues and higher costs”, argued Swensen. Empathy and kindness are also reciprocal, meaning that patients who are treated kindly will return the same kind of empathy to healthcare professionals. It is estimated that one third of prescriptions filled out in the U.S. are not filled by patients, the reason for which being a lack of trust and rapport between patients and healthcare providers. If that trust and empathy exists, patients are more likely to comply with doctors’ notes and do what is in their best interest.

Wish Two: Care for Each Other

Swensen’s research also shows that most patients wish that healthcare professionals care for each other. These patients understand that if healthcare professionals care for each other, they will extend the same kind of care and empathy to their patients. In an interview with Bob Chapman, CEO of Barry Wehmiller Companies, Swensen discovered that Chapman sees his company as a platform to enrich lives. During the 2008 recession, Chapman’s company did not lay anyone off but instead only had furloughs and pay cuts. After the recession, most of the team members expressed content with the way the company management handled the situation, which led to better patient outcomes, better patient safety, at lower costs.

Wish Three: Put My Interests First 

Swensen’s research estimates a 40% waste of the healthcare system, which is comprised of overtreatment, care delivery failures and care coordination failures. Swensen sees it as an opportunity to put patients’ interests first. Addressing these issues is not only good for the patients but also for healthcare providers because it tackles some of the major drivers of the burnout of physicians.

Copyright © *2017* *ACCESS Health International  艾社康(上海)健康咨询有限公司*, All rights reserved. *ACCESS Health Research Unit*All people, no matter where they live, no matter what their age, have a right to access high quality and affordable healthcare. 所有人,不论身处何地,不论年龄几许,都有权利享受到高质量、付得起的医疗服务。
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