Hengshui City issued 20 measures to promote high -quality development of medical institutions

In order to thoroughly implement the "ten key tasks" proposed by the Hengshui Municipal Party Committee and the Municipal Government, and the overall requirements of "big learning, big research, big innovation, and big improvement", we will do the "send policy services and protect market entities". The Municipal Medical Security Bureau gives full play to the leveraged role of medical insurance regulation of medical services and guiding the reasonable allocation of medical resources, and has studied and introduced the "Several Measures for the Hengshui Medical Security System to promote high -quality development of medical institutions" (referred to as "Article 20 Measures"), Vigorously promote the supply -side reform of the medical security field, actively support the development of the national real economy, and make the high -quality development of the high -quality development of Hengshui medical institutions.

It is reported that Article 20 measures are based on the five major aspects of medical insurance policy leverage, payment leverage, strategic purchasing leverage, medical insurance and social supervision, and medical security measures during the prevention and control of the epidemic. Innovation measures have promoted the high -quality development of medical institutions.

Establish a multi -level communication and coordination mechanism for medical insurance reform policies. Establish real -time communication coordination mechanisms by the Administrative Division of the Medical Insurance Bureau, the Medical Insurance Office, the Administrative Department of the Medical Institution, and the clinical experts, and fully communicate and demonstrate the decisions of major issues such as major policies and medical insurance reforms, coordinate and solve problems, and ensure that policies and measures are effective.

The expansion of medical insurance insurance is to strive for more fund support for medical institutions. The bureau effectively compacts the responsibility of the county and city, strengthen the awareness of participating in insurance in accordance with the law, further promote the participation plan for the entire people, and strengthen the comparative and dynamic maintenance of the insured database. In response to the special difficulties of the entire people in our city, there are few large enterprises in our city, many students in foreign countries, and more migrant workers, and other people's participation in insurance, the bureau has paid an eye on key groups, strives to prevent leakage and disconnection, steadily expand the coverage of basic medical insurance, and strengthen the payment situation of the payment situation. Inspection and audit, ensure that they should be guaranteed, pay due to their due guarantees, and make large -scale funds, and provide medical insurance fund support for the rapid development of medical institutions.

Implement medical insurance reimbursement policies. The bureau has a step -level hospital and cross -integrated regional hospitals. %And 85%; residents' hospitalization reimbursement ratio is 90%, 80%, and 65%. Reasonably guides insured personnel to seek medical treatment, enhance the ability of county medical services, and promote the development of grass -roots medical institutions.

Through the city -level overall planning of the Medical Insurance Fund, the protection of medical institutions is achieved. The bureau actively strives for national and provincial subsidy funds to ensure that in place in place, and do basic medical insurance city -level overall planning to achieve funding of fund reunification and expenditure; in accordance with the principles of overall management and separate accounting, timely calculation allocated to all counties and cities and cities; Establish a risk -adjusted gold system, and extract a certain amount of adjustment of gold according to proportion to adjust the income and expenditure gaps of funds in each county and cities; Preface development.

Establish and improve the policy of traditional Chinese medicine medical insurance. The bureau reduces the medical insurance reimbursement of traditional Chinese medicine hospitals, and the standards for reimbursement of the medical insurance reimbursement of TCM hospitals with the standards of the first level of the same level of comprehensive hospitals at the same time; increase the proportion of reimbursement of traditional Chinese medicine technology and traditional Chinese medicine tablets in the inpatient patient; For patients with inpatient urban and rural residents, the reimbursement ratio of medical treatment at first -level hospitals has increased by 5%, and the reimbursement ratio of medical treatment for second- and third -level hospitals increases by 10%; the proportion of reimbursement ratios of employees in inpatient urban employees has increased by 2%. Through the establishment of traditional Chinese medicine medical insurance policies, the development of traditional Chinese medicine in our city is promoted.

Fully promote smart medical insurance+smart medical construction. The bureau takes the national medical insurance operation and maintenance system as the core, and the terminal medical institution is used as the terminal to establish the city's smart medical insurance informatization system; open up the obstruction between the medical insurance management system and the information system of the medical institution, realize the real -time connection of information, solve the restriction of medical insurance and medical care The "bottlenecks" and "pain points" of the high -quality development of the institution; vigorously promote the application of medical insurance electronic vouchers to improve the timeliness and accuracy of medical insurance settlement; create medical insurance for direct settlement of medical insurance, direct settlement of chronic diseases in different places, and electronic prescription transfer of employees. Smart medical construction, realize the standardization and unity of medical services, and promote medical institutions to improve informatization and standardization.

Further shorten the dialing cycle of the medical insurance fund. The bureau accelerates the progress of the medical insurance fund allocation, and the allocation cycle of the medical insurance fund of designated medical institutions has been shortened from 30 working days to 20 working days, and the pressure on the capital turnover of fixed -point medical institutions is effectively reduced.

Establish a unified medical insurance prepaid weekly transfer system in the city. In principle, the basic medical insurance prepaid weekly transfer of the basic medical insurance for a month is allocated to the secondary and above medical institutions that are not included in the medical consortium. Conditional counties (cities, districts) can be used to medical consortium with many cities (cities, districts). The hospital's prepaid weekly transfer, maximize the pressure on the capital turnover of designated medical institutions.

Promote the reform of DIP payment methods. The bureau establishes the payment method based on the total budget (DIP), stimulates that medical institutions will accelerate the reform of the hospital's internal performance distribution system, strengthen internal refinement management, promote medical service behavior of medical institutions, reduce unreasonable costs, autonomous autonomy Containment over medical care, increase the disposable income of hospitals, and improve the operational efficiency of medical institutions.

Actively promote the "dual -channel" prescription of the country's negotiation drugs to reduce the proportion of drugs. The bureau actively promotes the "dual channel" management policy of national negotiation drugs, improves the prescription circulation system of medical institutions and eligible pharmacies, and explores at the designated medical institution to open a "national talk" card to swipe. Convenience, effectively reduce the burden on medical institutions, reduce the proportion of medical institutions, and promote the balanced development of medical institutions. Continue to carry out concentrated procurement of drug consumables to reduce the cost of medical institutions. The bureau has greatly reduced the virtual high prices of drug consumables, reducing the cost of medical services, the environment of purification of drug consumables, compressed drug consumables in the income of medical institutions, and reducing medical institution funds to occupy the funds of medical institutions through medical insurance funds. On the basis of the current 10 batches of 271 types of drugs (average price reduction of 62%) and 9 batches of 9 batches (average price reduction), about 470 million yuan of annual procurement funds, actively promote the acceleration and expansion of collecting and mining work, and strive to achieve achievement. 350 categories and 20 years of annual targets.

Implement medical institutions for medical institutions for medical insurance for medical insurance for medical insurance. The bureau implements a medical insurance fund balance policy for the designated medical institutions involved in the purchase of centralized band purchases of drugs and medical consumables. The designated medical institutions use the selected drugs and medical consumables. The maximum medical insurance funds for the balance can be allocated to the medical institution at 50%, of which 60%to 70%are used for the salary distribution of medical staff, 30%to 40%are used for the development of medical institutions. Stimulate the work enthusiasm of medical staff. Guide the reasonable reporting of medical institutions, reduce the use of unscaptant products, and maximize the reserved funds for balance.

Establish a dynamic adjustment mechanism for medical services for medical institutions. The bureau is based on the per capita outpatient cost of the hospital, the per capita hospitalization expenses, the growth of medical revenue, the growth of employee's salary and the cost of medical service project pricing. The price of medical services has promoted the establishment of a new mechanism of compensation -oriented with public welfare, and gradually rationalized the price comparison relationship between the price of medical services. At the same time, they have opened new project acceptance green channels for medical service projects that are conducive to reducing costs and obvious diagnosis and treatment effects to accept the development and clinical application of medical technology in medical institutions at any time.

Establish a more actual agreement management mechanism. The bureau further improves the negotiation mechanism of the agreement management and negotiation, and incorporates more quality, appropriate, and reasonable medical institutions in time into the scope of fixed -point management; rationalize the management relationship between the agreement, clarify the management authority of the city and the county level of medical institutions, and unified Agreement management standards, clarify management responsibilities, and prevent multi -management; improve the fixed -point assessment mechanism, and link the results of medical service efficiency evaluation, medical quality assessment and medical service satisfaction. Medical personnel with outstanding performance are tilted, improve the treatment of medical staff, stabilize the medical talent team, and fully mobilize the enthusiasm of medical staff.

Establish a medical insurance fund to monitor the fault tolerance mechanism. The bureau aims to combat fraudulent insurance as a means and standardize medical service behavior, strengthen the two -way communication between the medical insurance department and the medical institution, establish a fund supervision fault tolerance mechanism, open the channels for feedback, widely listen to the demands of medical institutions, and implement the first violation of slight violations. Free penalty.

Strengthen the construction of the medical insurance fund supervision system. They accurately allocate intelligent monitoring rules, give full play to the role of social supervision, promote the openness, fairness, and fairness of fund supervision, guide medical institutions for spontaneous standardized diagnosis and treatment, and improve the level of medical insurance services.

Promote the development of electronic cases. The bureau builds an electronic case audit center, improves software and hardware facilities, and conducts electronic case review for eligible designated medical institutions, improves the timeliness and accuracy of case review work, reduces intermediate links, and reduces the burden on fixed -point medical institutions.

Pay the prepaid money for new crown pneumonia cure medical institutions. The bureau pays two months of medical insurance funds for a two -month medical insurance fund for new crown pneumonia.

Dynamically add and adjust the medical insurance directory during the prevention and control of the epidemic. According to the needs of the epidemic, the bureau temporarily incorporates the drugs and projects covered by the diagnosis and treatment plan in the scope of medical insurance payment, make dynamic adjustment of the catalog, strengthen drug monitoring during the prevention and control of the epidemic, strengthen shortage of drugs, and ensure the normal operation of medical institutions during the prevention and control of the epidemic.

During the establishment of the epidemic prevention and control, the treatment of fixed -point patients transferred to the hospital for green channels. Due to the impact of the epidemic, the bureau opened a green channel from a fixed -point treatment medical institution to other hospitals. Special Affairs Special Affairs Office to ensure the normal and orderly operation of fixed -point medical institutions.

- END -