Health and Family Planning Commission: report on the real-time medical treatment of the pilot new rural cooperative medical system in different places this year

Source: People's daily May 5, 2014 The state health and Family Planning Commission today (4) reported the progress of the new rural cooperative medical system in 2013 and the focus of its work in 2014 In 2013, more than 88% of the regions in the country realized the instant medical settlement report of the participating farmers in different places in the province; the national new rural cooperative medical information platform was further improved, and it has been interconnected with 9 provincial platforms and some large medical institutions, and the verification function of cross provincial medical expenses has been preliminarily realized in some regions In 2014, the number of provinces connected with the national platform will be expanded to 15 On this basis, cross provincial medical cost verification and settlement pilot will be carried out According to the report of the national health and Family Planning Commission, in 2013, the national new rural cooperative system operated smoothly, its coverage remained at a high level, the benefit level of participating farmers, especially the level of serious disease security continued to improve, the level of management and operation continued to improve, the system construction gradually improved, showing a good development trend It is mainly reflected in the following aspects: (1) the level of financing and security continues to improve, and farmers benefit further In 2013, the number of people participating in the new rural cooperative medical system (NRCMS) nationwide was 802 million, with the participation rate reaching 99% The actual per capita financing reached 370 yuan, an increase of 62 yuan compared with 308 yuan in 2012 The proportion of reimbursement for hospitalization expenses within the scope of participating farmers' policy has reached more than 75%, and the actual compensation ratio has continued to increase, among which, nearly 80% at the township level and more than 60% at the county level The actual outpatient compensation ratio is more than 50% China has benefited 1.94 billion people in total, up 11.3% year on year （2） A multi-level and multi-form guarantee mechanism for serious diseases has been initially established First, we will continue to consolidate and improve the work of safeguarding major diseases with diseases as the starting point In 2013, on the basis of the comprehensive promotion of the new rural cooperative medical insurance of 20 diseases, including childhood leukemia and congenital heart disease, two diseases, phenylketonuria and hypospadias, were also included in the scope of major disease insurance A total of 1.99 million patients in the whole country have been compensated for major diseases in NCMS, and the actual compensation ratio of 22 diseases has reached 69%, greatly reducing the economic burden of patients in NCMS Second, we should actively promote the work of serious illness insurance for urban and rural residents with large expenses as the starting point According to the requirements of medical reform, our committee actively promotes the use of the new rural cooperative fund to purchase serious illness insurance In 2013, 28 provinces across the country introduced the implementation plan of serious illness insurance, which compensated 1.23 million people and further reduced the economic burden of patients （3） The management capacity and service level were further improved First, further promote the socialization of handling services, transform government functions and improve the quality of handling At present, the proportion of counties (cities, districts) that entrust commercial insurance institutions to handle the new rural cooperative medical insurance business has reached 24%, realizing the separation of management and management, and the separation of government and society Second, we will continue to facilitate reimbursement of medical expenses More than 88% of the regions in the country have realized the instant settlement of medical treatment in different places within the province of participating farmers; the national new rural cooperative medical information platform has been further improved, and it has been interconnected with 9 provincial platforms and some large medical institutions, which has built a basic environment for the pilot work of cross provincial medical reimbursement, and the verification function of cross provincial medical expenses has been preliminarily realized in some regions Third, the reform of the mode of payment continued to advance in depth All localities have actively promoted the reform of payment methods, covering more than 80% of the areas, which has reasonably guided the flow of medical treatment for farmers and, to a certain extent, controlled the unreasonable growth of medical expenses The national health and Family Planning Commission said that in 2014, it will continue to do a good job in the key areas and key links of the new rural cooperative medical system on the basis of continuing to promote the work of urban and rural overall planning of medical insurance First, we will further improve the financing standards and guarantee level of the new rural cooperative medical system Keep the participation rate above 95% The subsidy standard of all levels of Finance for NCMS was further raised to 320 yuan per person per year We will optimize the overall compensation plan, and maintain the proportion of reimbursement for inpatient and outpatient expenses within the policy scope at about 75% and 50% Second, we will improve the medical security mechanism for major diseases in various forms We will continue to support 22 major diseases, including childhood leukemia We will extend the work of serious illness insurance for urban and rural residents to more than 50% of the new rural cooperative areas, give full play to the advantages of the two major illness insurance mechanisms, i.e by disease type and by cost, organically link up, and further reduce the burden of serious illness on the masses We will basically establish a system of emergency medical assistance for diseases, and make a good connection with the basic medical insurance system, the serious illness insurance system for urban and rural residents, and the medical assistance system Third, accelerate the participation of commercial insurance institutions in the new rural cooperative operation service and serious illness insurance We will promote the participation of commercial insurance institutions in the new rural cooperative medical insurance agency service and the serious illness insurance of urban and rural residents in a larger scope and at a higher level of overall planning Adhere to the government's leadership, through the introduction of social forces to participate in the handling and service of basic medical insurance, give play to the advantages of market mechanism, promote the improvement of the quality and level of handling service, provide diversified products and services, and promote the establishment of a multi-level major disease security system Fourth, comprehensively promote the informatization construction of the new rural cooperative medical system Consolidate and improve the province's off-site medical immediate report We will continue to promote the construction of national and provincial new rural cooperative medical information platforms, and expand the number of provinces connected with national platforms to 15 On this basis, we will carry out cross provincial medical cost verification and settlement pilot Fifth, continue to strengthen the fine management of the new rural cooperative medical system We will standardize and promote the reform of a variety of payment methods, expand the coverage of the reform of payment methods to medical institutions and patients, effectively control the unreasonable growth of medical expenses, and raise the benefit level of participating farmers We will guide local governments to further standardize the use and management of the new rural cooperative fund and ensure its safety Source: People's daily May 5, 2014 The state health and Family Planning Commission today (4) reported the progress of the new rural cooperative medical system in 2013 and the focus of its work in 2014 In 2013, more than 88% of the regions in the country realized the instant medical settlement report of the participating farmers in different places in the province; the national new rural cooperative medical information platform was further improved, and it has been interconnected with 9 provincial platforms and some large medical institutions, and the verification function of cross provincial medical expenses has been preliminarily realized in some regions In 2014, the number of provinces connected with the national platform will be expanded to 15 On this basis, cross provincial medical cost verification and settlement pilot will be carried out According to the report of the national health and Family Planning Commission, in 2013, the national new rural cooperative system operated smoothly, its coverage remained at a high level, the benefit level of participating farmers, especially the level of serious disease security continued to improve, the level of management and operation continued to improve, the system construction gradually improved, showing a good development trend It is mainly reflected in the following aspects: (1) the level of financing and security continues to improve, and farmers benefit further In 2013, the number of people participating in the new rural cooperative medical system (NRCMS) nationwide was 802 million, with the participation rate reaching 99% The actual per capita financing reached 370 yuan, an increase of 62 yuan compared with 308 yuan in 2012 The proportion of reimbursement for hospitalization expenses within the scope of participating farmers' policy has reached more than 75%, and the actual compensation ratio has continued to increase, among which, nearly 80% at the township level and more than 60% at the county level The actual outpatient compensation ratio is more than 50% China has benefited 1.94 billion people in total, up 11.3% year on year （2） A multi-level and multi-form guarantee mechanism for serious diseases has been initially established First, we will continue to consolidate and improve the work of safeguarding major diseases with diseases as the starting point In 2013, on the basis of the comprehensive promotion of the new rural cooperative medical insurance of 20 diseases, including childhood leukemia and congenital heart disease, two diseases, phenylketonuria and hypospadias, were also included in the scope of major disease insurance A total of 1.99 million patients in the whole country have been compensated for major diseases in NCMS, and the actual compensation ratio of 22 diseases has reached 69%, greatly reducing the economic burden of patients in NCMS Second, we should actively promote the work of serious illness insurance for urban and rural residents with large expenses as the starting point According to the requirements of medical reform, our committee actively promotes the use of the new rural cooperative fund to purchase serious illness insurance In 2013, 28 provinces across the country introduced the implementation plan of serious illness insurance, which compensated 1.23 million people and further reduced the economic burden of patients （3） The management capacity and service level were further improved First, further promote the socialization of handling services, transform government functions and improve the quality of handling At present, the proportion of counties (cities, districts) that entrust commercial insurance institutions to handle the new rural cooperative medical insurance business has reached 24%, realizing the separation of management and management, and the separation of government and society Second, we will continue to facilitate reimbursement of medical expenses More than 88% of the regions in the country have realized the instant settlement of medical treatment in different places within the province of participating farmers; the national new rural cooperative medical information platform has been further improved, and it has been interconnected with 9 provincial platforms and some large medical institutions, which has built a basic environment for the pilot work of cross provincial medical reimbursement, and the verification function of cross provincial medical expenses has been preliminarily realized in some regions Third, the reform of the mode of payment continued to advance in depth All localities have actively promoted the reform of payment methods, covering more than 80% of the areas, which has reasonably guided the flow of medical treatment for farmers and, to a certain extent, controlled the unreasonable growth of medical expenses The national health and Family Planning Commission said that in 2014, it will continue to do a good job in the key areas and key links of the new rural cooperative medical system on the basis of continuing to promote the work of urban and rural overall planning of medical insurance First, further improve the financing standards and guarantee level of the new rural cooperative medical system Keep the participation rate above 95% The subsidy standard of all levels of Finance for NCMS was further raised to 320 yuan per person per year We will optimize the overall compensation plan, and maintain the proportion of reimbursement for inpatient and outpatient expenses within the policy scope at about 75% and 50% Second, we will improve the medical security mechanism for major diseases in various forms We will continue to support 22 major diseases, including childhood leukemia We will extend the work of serious illness insurance for urban and rural residents to more than 50% of the new rural cooperative areas, give full play to the advantages of the two major illness insurance mechanisms, i.e by disease type and by cost, organically link up, and further reduce the burden of serious illness on the masses We will basically establish a system of emergency medical assistance for diseases, and make a good connection with the basic medical insurance system, the serious illness insurance system for urban and rural residents, and the medical assistance system Third, accelerate the participation of commercial insurance institutions in the new rural cooperative operation service and serious illness insurance We will promote the participation of commercial insurance institutions in the new rural cooperative medical insurance agency service and the serious illness insurance of urban and rural residents in a larger scope and at a higher level of overall planning Adhere to the government's leadership, through the introduction of social forces to participate in the handling and service of basic medical insurance, give play to the advantages of market mechanism, promote the improvement of the quality and level of handling service, provide diversified products and services, and promote the establishment of a multi-level major disease security system Fourth, comprehensively promote the informatization construction of the new rural cooperative medical system Consolidate and improve the province's off-site medical immediate report We will continue to promote the construction of national and provincial new rural cooperative medical information platforms, and expand the number of provinces connected with national platforms to 15 On this basis, we will carry out cross provincial medical cost verification and settlement pilot Fifth, continue to strengthen the fine management of the new rural cooperative medical system We will standardize and promote the reform of a variety of payment methods, expand the coverage of the reform of payment methods to medical institutions and patients, effectively control the unreasonable growth of medical expenses, and raise the benefit level of participating farmers We will guide local governments to further standardize the use and management of the new rural cooperative fund and ensure its safety