The reform of medical insurance payment in Ji'nan
source: the Ji'nan daily
this year is the first year after the full coverage of the urban and rural residents' pension insurance in Ji'nan, Shandong. Today, the Bureau of human resources and social security of the city of Ji'nan has learned that the Department of human society will accelerate the steps to solve the difficult problems this year. As soon as possible, it will take out the old-age pension scheme that has not handled the two generation identity card as soon as possible to ensure that the treatment should be taken.
it is reported that this year, the people's agency of the city will focus on two aspects of the reform of medical insurance pay and the management of out-patient regulations, and the limited medical insurance fund will be used in the most needed patients. In the payment mode reform, the compound settlement method under total control will be carried out to further expand the hospital scope of the total amount control and implement the regulation system. On the basis of the original single disease settlement management, the single disease type is gradually expanded in accordance with the principle of disease entry, cost standard negotiation and dynamic evaluation and adjustment. The scope of settlement. To explore the implementation of medical consumables price limits, guide the rational consumption of medical insurance patients, and reduce the unreasonable expenditure of funds. At the same time, a large relief fund will be set up to provide appropriate relief for serious diseases and serious diseases that happen to special groups.
in strengthening the management of the prescribed disease in the outpatient department, the Department of human society will organize medical institutions and experts to conduct a scientific classification and management of the existing 35 types of portal diseases. To establish the system of grading diagnosis and treatment, by adjusting the proportion of fund payment in the designated medical institutions, and using "economic lever" to guide the insured to take reasonable medical treatment, to realize small diseases in the community and to go to the hospital. The
"gate rule" physical examination hospital has been expanded to 3
today from the Ji'nan social insurance bureau. To facilitate the convenient and convenient diagnosis of the medical insurance of the basic medical insurance participants in Ji'nan city and town, since January 2012, the Ji'nan city gate medical inspection body hospital is from the current Shandong medicine. The 1 second affiliated hospitals of the university expanded to 3, namely the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, the 456 Hospital of the air force and Shandong Armed Police Hospital. The physical examination hospital is determined according to the location of the declaration unit. The site is the Tianqiao area and the Huaiyin District. The 456 hospital is the air force hospital. The site is the Middle District of the city and the Changqing district. The check body hospital is the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine. The site is the calendar, the almanac and the Hi-tech Zone, and the checkup hospital is Shandong Armed Police Hospital. The declaration procedures for door and gauge diseases in each reporting unit are still proceeding according to the original method.