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The Creation of "Digital Medical Insurance" in Langxi County to Be Quickly in Line with The Integration of Yangtze River Delta 郎溪县打造“数字医保”快速接轨长三角一体化

郎溪县打造“数字医保”快速接轨长三角一体化

发布时间:2020-09-21 11:48 来源:郎溪县人民政府办公室 浏览:
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"Zero Distance" for Settlement.

It has opened the function of direct settlement of outpatient expenses for medical treatment in different places in the Yangtze River Delta, and implemented real-time settlement of medical treatment in different places across provinces. From January to August, the number of trans-provincial direct settlements reached 202, a total of RMB 2.9812 million.

"Zero Burden" for Buying Medicine.

The “national medicines” have been distributed to grass-roots township health centers and village clinics; the average price cuts for two batches of 57 kinds of “national medicines” exceeded 50%, and the highest price reduction was 92%.

"Super Fast" Certificate Handling.

The authority to handle chronic disease medical certificates was opened, and the system of centralized review meeting of chronic disease experts was cancelled, so that the time limit for issuing certificates was shortened to less than one month.

"Zero obstacle" of Reform.

The medical insurance information system was conducted to realize the unification of the medical insurance platforms for urban and rural residents and urban employees. The reform of medical insurance payment method based on Diagnostic Related Groupings (DRGs) was implemented, and 13 dominant TCM diseases were included in the outpatient DRGs management system; the number of existing diseases of GRGs reached 289, and the implementation rate was 60%. A trial was carried out for the management of Per-diem Bed-using Groupings for inpatients with severe mental illness. From January to August, the number of people using Per-diem Bed-using Groups reached 295, totaling RMB 2.2911 million. 


结算“零距离”。开通长三角异地就医门诊费用直接结算功能,推行跨省异地就医即时结报,1-8月,跨省异地直接结算202人次、298.12万元。

买药“零负担”。将“国谈药”下沉到基层乡镇卫生院、村卫生室,两批57种“国谈药”平均降价幅度超50%,最高中选药品降价92%。及时预拨“17+13+X”种抗癌药和“国谈药”采购款393.5万元。

办证“零等候”。下放慢性病就诊证办证权限,取消慢性病专家集中评审会制度,办证时限缩短至1个月内。1-8月,直接鉴定发放参保慢性病患者就诊证30856个、门诊结算103474人次。

改革“零障碍”。完成医保信息系统整合,实现城乡居民医保、城镇职工医保平台统一。推行以按病种付费为主的医保支付方式改革,13个中医优势病种被纳入门诊按病种付费管理;现有按病种付费病种数达289个,执行率60%。试点开展重性精神病住院按床日付费,1-8月按床日付费295人次、229.11万元。





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