全国仅剩6省未执行两票制！

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                    <section data-role="paragraph" data-color="rgb(182, 228, 253)" data-custom="rgb(182, 228, 253)"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section><p><p><img src="image/20201014/86b79d371e9862b01189f0252a03b2cd_1.png" /></p></p></section><section><section><span><strong></strong></span></section><p><span>医疗器械媒体报道先锋</span></p><p><span>分享专业医疗器械知识</span></p></section><section><section><section><span>关注</span></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section><p><br  /></p><section data-role="outer" label="Powered by gulangu"><section data-tools="gulangu" data-id="92737"><section data-width="100%"><section data-width="100%"><section>&nbsp;耗材两票制、耗材零加成，已全国铺开。</section></section><section><section><br  /></section></section></section></section></section><p><br  /></p><section data-role="outer" label="Powered by gulangu"><section data-tools="gulangu" data-id="87844" data-color="#27939d"><section data-width="20em"><section><section><p data-brushtype="text"><strong><span>仅剩6省未执行两票制</span></strong></p></section></section><section></section></section></section><section data-role="paragraph" data-color="#27939d"><p><br  /></p></section></section><p><span>近日，光大证券梳理了全国耗材两票制和耗材零加成的进展情况，根据光大证券信息，截至2019年9月6日，全国有25省已开始或全面实施耗材两票制，仅剩 6 省市未发布相关政策。</span><strong><span></span></strong><span></span></p><p>&nbsp;</p><p><p><img src="image/20201014/222bc1bafc19491f05ecd17faf4beb8b_2.jpg" /></p></p><p><span>来源：光大证券研究所</span></p><p><br  /></p><p><span>目前内蒙古、辽宁、陕西、安徽、湖北、江西、贵州、广东、福建、海南、青海、西藏12 个省份已全面执行耗材两票制；</span><br  /></p><p><span>&nbsp;</span></p><p><span>黑龙江、河北、山西、河南、江苏等 6 个省份在部分试点城市执行耗材两票制；</span></p><p><span>&nbsp;</span></p><p><span>湖南、广西、浙江、四川、甘肃、宁夏、山东等 7 个省份已发布相关文件。</span></p><p><span>&nbsp;</span></p><p><span>全国目前仅剩北京、上海等 6 个省市未执行耗材两票制，但根据此前相关规定，北京、上海等 15 个医改国家级示范城市必须在2018 年推行高值耗材两票制，因此预计到今年底仍有较多省市进入耗材两票制执行阶段。</span><span></span></p><p><br  /></p><section data-role="outer" label="Powered by gulangu"><section data-tools="gulangu" data-id="87844" data-color="#27939d"><section data-width="20em"><section><section><p data-brushtype="text"><strong>11省市实施零加成</strong></p></section></section><section></section></section></section><section data-role="paragraph" data-color="#27939d"><p><br  /></p></section></section><p><span>7月 31 日，国务院印发《治理高值医用耗材改革方案》，明确提出将在 2019 年底前取消医用耗材加成。</span></p><p><span>&nbsp;</span></p><p><span>根据光大证券信息，截至2019年9月6日，目前国内共有北京、天津、辽宁、安徽、福建、广东、湖北、贵州、四川、宁夏、新疆等 11 个省市开始或计划实施医用耗材零加成。</span></p><p><span>&nbsp;</span></p><p><span>山东和浙江部分试点城市实施医用耗材零加成，湖南省则推行降低医用耗材加成政策，另有江苏新沂市、扬州市研究取消医用耗材加成的政策措施。</span><span></span><span></span></p><p>&nbsp;</p><p><p><img src="image/20201014/222bc1bafc19491f05ecd17faf4beb8b_2.jpg" /></p></p><p><span>来源：光大证券研究所</span><br  /></p><p><br  /></p><section data-role="outer" label="Powered by gulangu"><section data-tools="gulangu" data-id="87844" data-color="#27939d"><section data-width="20em"><section><section><p data-brushtype="text"><strong><span>斩断耗材利益链</span></strong></p></section></section><section></section></section></section><section data-role="paragraph" data-color="#27939d"><p><br  /></p></section></section><p><span>不论是耗材两票制还是耗材零加成，其思路都是要斩断不合理的利益链，挤压耗材价格水分，促进价格回归市场。</span></p><p><span>&nbsp;</span></p><p><span>7月30日，国家税务总局武汉市税务局连发28份税务处理决定书，显示有5家广告、管理或咨询公司存在大量虚开增值税发票现象，涉及虚开发票的多为药械企业。</span></p><p><span>&nbsp;</span></p><p><span>这5家公司共虚开发票410份，价税合计约3416万，已查实的3家公司共有122例对下游企业虚开发票的情况，其中74例的下游企业均是药械企业。</span></p><p><span>&nbsp;</span></p><p><span>有业内人士分析称，耗材两票制并没有彻底斩断利益链，之前“票走货不走”的方法行不通后，械企就通过高开的方式进行利益分配，同时通过虚开增值税发票让其中的不合理费用合法化，相关部门正是在两票制后抓住虚开发票的这一点，集中发力，治理耗材。</span></p><p><span>&nbsp;</span></p><p><span>对于耗材零加成，从今年6月起，北京取消3700家医疗机构的耗材加成，再到7月31日国务院明确年底取消全国耗材加成，医院方的耗材治理也已迎来风暴。</span></p><p><span>&nbsp;</span></p><p><span>相比于两票制，取消耗材加成聚焦点不只在耗材，同时也会提升部分医疗服务的价格，着手解决医生价值与收入问题。</span></p><p><span>&nbsp;</span></p><p><span>同时值得注意的是，除了两票制和取消加成，带量采购也已落地。</span><span>今年8月安徽和江苏医保局相继完成带量采购谈判，之后陕西医保局又发文表示，要推动跨区域联合带量采购。</span></p><p><span>&nbsp;</span></p><p><span>其实耗材两票制、取消耗材加成和带量采购三种方法，单独任意一种都难以做到斩断不合理的利益链。</span></p><p><span>&nbsp;</span></p><p><span>但是耗材两票制属于“医药”，取消耗材加成属于“医疗”，带量采购属于“医保”，这三者结合在一起正是三医联动的思路，而三医联动是医改走向成功的关键所在，上述三个政策结合到一起，或许就会产生互相促进和补充的治理效果。</span><strong><span></span><span></span></strong></p><p><span><br  /></span></p><section 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