Before the end of the year, all Zhengzhou medical insurance payment will be paid according to the disease score

In order to effectively protect the medical rights and interests of medical insurance participants and improve the efficiency of the use of medical insurance funds, before the end of this year, Zhengzhou's medical insurance payment must be fully paid according to the disease score (DIP). This is the information obtained by the reporter from the Municipal Medical Security Bureau on August 8.

According to reports, medical insurance payment is an important part of basic medical insurance management. It is an important leverage for regulating medical services and guiding the allocation of medical resources. According to the unified deployment of the state and provincial, Zhengzhou determined based on the experience of pilot cities, determining the use of the type of disease score (DIP) payment method, and in accordance with the principles of "provincial and municipal synchronization", to carry out DIP payment with the provincial medical insurance city simultaneously.

The full name of DIP is paid by the diseased score. Under the total budget mechanism, the common characteristics of "disease diagnosis+treatment" are used to objectively analyze the common characteristics of "disease diagnosis+treatment method". The medical insurance department forms a payment standard based on the diseased score and points value, and the standardized payment of each case of the medical institution shall be achieved. The DIP medical insurance payment method has relative to the interests of medical insurance, hospitals, and patients, to achieve the balance between medical quality and cost, effectively reduce excessive medical phenomena such as "big prescriptions" and "big inspection", effectively improve the efficiency of medical insurance funds, effectively maintain insurance participation in insurance Personal rights and interests.

Earlier this year, the first 16 units in Zhengzhou took the lead in launching pilots, and the remaining designated medical institutions subsequently accelerated the pace. Statistics show that since this year, Zhengzhou has continuously improved the payment policy system according to the type of disease (DIP). At present, 11,554 diseases have been initially determined, of which 8,663 core diseases and 2,891 comprehensive diseases, with a total annual total score of 9.7 billion yuan.

According to the plan, all DIP actual payment must be achieved before the end of the year. In the second half of this year, on the basis of the pilot, the municipal medical insurance department will reasonably adjust the weight and scores, refine the grouping of diseases, strengthen the analysis of quality and efficiency, refine measures, and urge the city Paids; Pay in the synchronous type of disease (DIP), pay the paid policy of packaging for the medical community.

Source: Zhengzhou Published

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