Shandong strives to expand the price of disease by the end of the year, striving for the 150 kinds of diseases "package price".
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to promote the reform of basic medical insurance payment in our province. In March 29th, the provincial government website issued the office of the people's Government of Shandong province to carry out the "guidance on further deepening the reform of basic medical insurance payment mode". Knowledge (hereinafter referred to as notifications). According to the notice, by the end of 2018, there will be 150 kinds of disease paid by all kinds of areas in our province.
notice to encourage and support large cities, such as Ji'nan and Qingdao, in accordance with the country's deployment, to actively carry out research and pilot based on disease diagnosis related groups, and gradually expand the practice of paying for diseases in Zibo, Dongying and other cities.
to 2020, the reform of medical insurance payment covers all medical institutions and medical services. In the whole province, the multi compound medical insurance payment method, which is adaptable to different diseases, different service characteristics and incentive and constraint, is generally implemented. The
notice clearly stated that in order to implement the multiple compound medical insurance payment method, every city will start the classification reform of medical insurance payment method as soon as possible. For inpatient medical services, they are mainly paid according to the total amount control and disease categories, according to the relevant groups of disease diagnosis, and paid by the head (or all times). For diseases such as mental illness, hospice care, medical rehabilitation, long-term hospitalization and stable daily expenses, beds can be charged daily.
for hospitalized patients who can not pay according to illness or bed day, they are paid on the basis of total amount control. For the basic medical service and the outpatient service, we can pay the head pay according to the person's head, make clear the scope of the basic medical service package paid by the person, and calculate and determine the standard of the pay quota according to the scope of the basic medical service package. For complex cases and outpatient expenses that are not suitable for package payment, they can be paid according to the project. We should explore ways of payment that meet the characteristics of Chinese medicine service and encourage the provision and use of appropriate Chinese medicine services.
notice also stipulates that the standardized management of medical services should be strengthened, a unified disease classification code, operation and operation coding system are implemented in the whole province, the medical record and the writing standard on the front page of the medical record are clearly defined, and the technical standards and the technical rules of the medical service project, such as the clinical path, which are in line with the basic medical needs, are accelerated. Fan.
at the same time, we should further straighten out the process of medical insurance management, and gradually integrate the system, and integrate the basic medical insurance, major disease insurance and foreign medical network settlement expenses into the integrated settlement and payment system and the medical service supervision system, to ensure the medical insurance fund and the time settlement payment. We should strengthen the assessment of the implementation of medical insurance policies in medical institutions, and link the assessment results with the payment of medical insurance funds.