On June 6, the medical website, as long as the condition is met, the hospitalization fee of the people who are in Shanxi Province and outside the city of shaanxi can be settled directly by health insurance card.
The reporter learns from shaanxi province club hall medical haven, from June 1, 13 health care as a whole the area in shaanxi province has been with the national 31 provinces health care network connectivity of system implementation, and 13 provinces, such as the xinjiang uygur autonomous region (area) to become the country's first of all the different ground settlement platform as a whole the area access countries provinces.
According to public information people club department, as of May 5, 2017, in addition to Tibet, the national 31 provinces are part or the whole access other country long-distance medical billing system of insurance of primary medical treatment, opened in 160 and 1008 across the province long-distance medical hospitalization medical expenses directly settle the medical establishment that decide a dot.
People swim club vice minister jun ask people club department showdown on June 2, 6, 7, 8, three months to ensure that the online registration personnel long-distance medical hospitalization medical expenses all across the province to achieve direct settlement.
It is important to note that even though urban health care and new farming close "two unity" are accelerating across the country, but specific to report on the connectivity of long distance, the new farmers and urban residents health care still belong to the two systems.
In addition to different ground settlement progress, urban and rural residents with different junction directly to the coverage of more and more big, how to impact in the context of hierarchical diagnosis and reconstruction, rather than medical order, and still is for solution of the problem.
There are preconditions for the long distance statement
According to the ministry of human resources and social security in shaanxi province, there are preconditions for the use of medi-cal. Ginseng protect personnel to be unified by the unit or individual for the record to live as a whole the area ahead of time, the social security card in the corresponding medical establishment that decide a dot can be achieved in the hospital medical treatment cost settlement directly.
21st century economic report that shaanxi province has opened 184 across the province the medical establishment that decide a dot for ginseng protect personnel to choose, the quantity and the medical establishment that decide a dot is changing, ginseng protect personnel can query the medical establishment that decide a dot online updates.
Health care, farmers in shaanxi province new long-distance knot propulsion situation remains to be seen, to be sure, in different junction on the advance of shaanxi's health and new farming still belong to the two systems.
In November last year, eight provinces, including shaanxi, gansu and hainan, signed the agreement on the Internet connection service of new agricultural and trans-provincial hospitals. That is to say, although shaanxi health insurance has been connected to the 31 provinces, the new farmers' exchanges will not be the same.
In addition to the inconsistencies in the treatment of the insured, the two long-distance reporting systems also bring new burdens to the hospital. Risk management and insurance department of nankai university professor ju Ming to tell a reporter, finished in name in some places, "the unity of" the second confirmed hospital still operating at the same time a number of different settlement system, submitted to the system of on-line with long distance, the hospital has added a system on the tip of the settlement.
"There is actually no organic integration between medicare and the new agribusiness." Under the state council development research center, deputy researcher Jiang Yu told 21st century economic report, although the "two unity", but as a result of the combined departments is not yet clear, thus "protect" both work system, such as data still divided.
"The direction of policy is clear." Zhu said that the construction of the database and the management of the administrative system need a period of improvement, which is still in transition.
How to prevent patients from flooding into large hospitals
According to the people club department, the ministry of finance issued in December last year regarding the basic medical insurance settlement is directly across the province long-distance medical hospitalization medical expenses work notice, in 2017 began to gradually solve the inter-provincial relocated retiree hospitalization medical expenses directly settlement, expanded to conform to the stipulations of the referral staff by the end of long distance medical hospitalization medical expenses directly and settlement.
From eligible for relocated to meet the requirements for the referral, and different coverage widening of the settlement, the difficulty is also gradually rise, because compared to relocated, eligible referral more difficult.
Hospital management research institute, tsinghua university, a professor at once to the 21st century economic report, said the long distance and increased the difficulty of the health control cost, and hierarchical diagnosis and treatment of medical order.
Mr Zhu argues that the need for better health care, and a long distance report, will undoubtedly boost demand for health care. Jiangyu believes that if the classification system is not formed, the long-distance report will exacerbate the patient's flood to the big hospital.
How to be able to seek medical treatment conveniently in the other place, the rational allocation of the medical resources, prevent the classification and diagnosis to go backward?
Around the generally used the strict referral program and use appropriate ways of reducing the proportion of reimbursement limit reimbursement leverage patients directly poured on to the big hospital, but how is the effect remains to be seen.
Beyond the knot to look just settlement site and process changes, behind also relate to the local government financial input to the public medical institutions and high quality medical resources administrative configuration.
Ju Ming to tell in the 21st century economic report, unlike relate only to pension funds, long distance and submitted to the reimbursement ratio not only needs to raise standards and negotiation and coordination among different regions, involving the use of high quality medical resources, it is also a new farming and overall level is still in the county, the health insurance plan as a whole level is still in the city, both are hard to ascend to the cause of the provincial and even national directly.
"Local governments in different parts of the country have a very different level of input in public hospitals." Jiang believes that the level of input and development of public hospitals is a deeper problem in the settlement of long-distance settlement.
From the international point of view, public hospitals accounted for over 90% of the UK can do "chess" nationwide coverage, this is because the British public hospitals by the central government, both in the fields and in patients with city, fees shall be borne by the central government.
The consensus among experts is that it is difficult for health care providers to regulate medical institutions across the region.
Ju Ming to think, beyond the knot under the background of rapid advance, because it is difficult to regulation of medical institutions across the province, the economic development is relatively backward area medical insurance fund risk is bigger. Jiangyu said that because health care funds in different areas are not in the same basket, the difficulty of cross-regional regulation has made it easier to cheat and overcare.
Experts believe that the need to standardize and unify the treatment path at the national level as soon as possible will prevent the rapid rise of medical costs from overhealth care. In addition, still have to return to the path of the reform of public hospitals, improving the capacity of grassroots medical services and treatment, through the classification and treatment to avoid the abuse of medical resources and waste.
For backward area of medical insurance fund deficit risk, ju Ming to suggest that these regions may establish risk exploration at the provincial level funded by financial funds, to prevent the medical insurance fund for long-distance knot to wear. |