Blockbuster! Qingdao medical treatment of the six hospitals fu biao change

by:Celecare     2020-07-01
On October 11, the reporter learns from the municipal medical insurance bureau, a few days ago, the city issued documents to adjust health care payment policy, through appropriate different level hospitals start to pay gap and improve the grass-roots hospitals in the city referral in patients with serious illness insurance reimbursement ratio, optimize two-way referral health support policy and other comprehensive measures, give play to the role of health guidance on the allocation of medical resources, to support the protection of people's health, promote our city to speed up the formation of grassroots first option, two-way referral, slow partition, upper and lower linkage system of hierarchical diagnosis and treatment. Six hospital treatment fu biao increase since January 1, 2020, zhuhai appropriately raise some level of first-class comprehensive hospital fu biao, designated hospitals at all levels health fu biao gap, reference to domestic similar cities in the province, qdu establishing affiliated hospital, city hospital and central hospital, HaiCi hospital, qilu hospital ( Qingdao) And the people's liberation army 971 hospital, six level of first-class comprehensive hospital medical treatment of fu biao from the current 800 yuan to 1000 yuan, this standard in the province and jinan flat, lower than hangzhou, ningbo and other cities outside the province, other tertiary general hospital and specialized subject hospital, to maintain the original 800 yuan fu biao. After adjustment, the city medical institutions at all levels of fu biao to form four levels: six level of first-class hospital for 1000 yuan a year, other tertiary hospital for 800 yuan, the secondary hospital for 500 yuan, grassroots medical institutions for 200 yuan. Secondary hospital and the gap between the gap between six tertiary hospital, to 3 armour hospital centralized medical resources were critically ill patients, in large hospital difficult problem to some extent. Referral a serious illness insurance reimbursement ratio can be improved at the same time, since January 1, 2020, to take the city referral positive incentives, ginseng protect a worker and ginseng protect residents of the city as a whole, by has the qualifications of referral in grassroots hospital referral to a tertiary hospital treatment, serious illness insurance payment ratio increased by 5%, in order to reflect the tilt guarantee a referral in patients with serious illness; Without referral to tertiary hospital treatment, the medical treatment cost reimbursement ratio shall not be increased. According to the calculation, the adjustment is expected to reduce the financial burden on referral of patients in the city of more than 1200 ten thousand yuan. Referral for approval procedures valid for half a year in the city for the first time referral, on the basis of positive incentives, set up a first option at the grassroots level, two-way referral, acute slow partition, the fluctuation of hierarchical diagnosis model. Clear referral validity: in the city once again by the same disease to the referral hospital for treatment or review, its effective referral for approval formalities for the first time and a half years, more than half a year's need to be dealt with again referral. Encourages two-way referral, referral hospital in according to the provisions of the city, referral hospital shall be regarded as a hospital first and the second charge fu biao, including basic turn for the ginseng of the superior hospital patients with senders pay line, the superior hospital patients from starting line. Turned out to a hospital linkage mechanism, turn on the approval of the basic-level hospitals patients to establish a green channel, the superior hospital appropriate reserve priority arrangement in hospital beds. The superior hospitals provide follow-up treatment in patients with next turn, basic-level hospitals priority to arrange the follow-up rehabilitation health care and long-term care services. Encourage regional city medical group ( A total of) Inside the body of establishing and perfecting the basic primary, two-way referral discount security system. We will deepen reform of the medical insurance payment: in the full implementation of medical insurance fund, on the basis of the total budget management, combining with the regional health planning and establishment of medical institutions, medical group ( A total of) Body building, the number of medical service quality factors, such as total amount control indicators to basic medical and health institutions such as appropriate. Solid research according to the disease diagnosis related group ( DRG) Pay pilot work, further clear and a tertiary hospital, secondary hospital service function orientation, gradually realize the city, with the disease, stagnation, homogeneity, same price payment management, promote the city grading diagnosis system to speed up the formation. Adjust different referral reimbursement regulations considering of long-distance medical demand diversity, the change in the working state, the city on the ginseng protect people outside referral reimbursement regulations have been adjusted. Since January 1, 2020, ginseng protect a man from the city to the long distance, stipulated to the city has the qualifications of a long-distance referral hospital referral formalities, and management according to the following two conditions: 1 a is for the different referral in accordance with the provisions, maintaining the original rules, namely according to the city hospital at the same level it will be reimbursed by 5%; 2, 2 it is to did not deal with referral by itself to the hospital treatment, according to the medical expense reimbursement ratio discretion determine: as a whole range of medical expenses in 40000 yuan or more, it will be reimbursed according to the city hospital was 15% lower at the same level; As a whole range of costs in 40000 yuan the following, it will be reimbursed 25% lower at the hospital in the city. According to the original policy did not deal with different referral of patients with mild, in field medical treatment shall not submit an expense account. Policy adjusted to referral of patients did not deal with other cities in accordance with the cost of high and low for hierarchical classification reimbursement, embodied in patients with severe policy tilt. By the way, all can realize in the settlement procedures directly connected to the Internet and settlement of different ground be in hospital, in order to reduce ginseng protect patients out medical mat endowment pressure. ( Reporter Liang Chao)
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