Medical network - on February 22, the ministry of finance, human resources, social security and the national health and family planning commission jointly issued a notice on 20, strengthen basic medical insurance fund budget management, control the unreasonable growth of medical treatment charge, easing the burden on individuals, ensure the basic medical insurance system and fund sustainable operation.
February 21, according to the economic daily news, since its establishment, the basic medical insurance system in China, expanding coverage, the safeguard level gradually improve, in the protection of basic medical needs, ginseng protect personnel to improve the level of public health and other aspects have played an important role, but also facing unreasonable medical expenses increased pressure, fund operation, the risk of long-term unsustainable. Unreasonable growth of medical expenses partly offset by the effect of government spending, increased social and individual responsibility.
Three department requirements, must strengthen the basic medical insurance fund budget management, including: scientific establishment budget, each as a whole the area to be in strict accordance with the "branch surely with closing, balance of payments, somewhat balance" the principle of compiling budget; Full specified amount collection of insurance premiums in accordance with the law and the region as a whole to further enlarge the coverage of basic medical insurance, should ensure that all insurance; Specification individual account spending, strengthening expenditure management employee basic medical insurance personal accounts, personal accounts, in principle, shall not be used for the medical expenses; Perfect the pay pay policy, standard of treatment of insurance of primary medical treatment to funding level and adapt to the local economic development level, improve the level of basic medical insurance shall not exceed fund of insurance of primary medical treatment to bear ability. In addition, stick to fund an actuarial balance.
In addition, three department is required to implement the basic medical insurance payment reform, as a whole the area to combine local reality, based on the total budget, the full implementation of the outpatient service capitation payment, according to disease, according to hospital diagnosis related group (DRGs), by combination of a variety of ways, such as bed day paid to adapt to different people, different compound of payment of the characteristics of the disease and medical services, gradually reduce the project payment, payment will cover all medical institutions and medical service reform. Establishing and perfecting the "balance retention, reasonable overruns share" incentive constraint mechanism, to stimulate medical institutions to improve service efficiency and quality.
Three departments also demanded that around to strengthen the performance appraisal of orgnaization of agency of insurance of primary medical treatment, such as budgeting, cost control, quality of service into the inspection scope, its focus from audit reimbursement to cost control, strengthen the budget management, improve service quality. As a whole the districts are encouraged to explore the establishment and orgnaization of agency of insurance of primary medical treatment work performance incentive mechanism. |
