On September 17, the Office of the People's Government of Sanyuan County, Shaanxi Province, issued a Notice on the Establishment and Improvement of the Network of Primary Health Insurance Services, proposing the establishment of health insurance service stations in towns (offices and centers) and medical insurance service rooms in villages (communities).
Health Insurance Service Office is mainly responsible for the publicity of medical insurance policies in the bailiwicks, mobilization of urban and rural residents to participate in insurance coverage, data collection of applications for chronic diseases by insured persons, collection and file management of relevant information on the poor, monitoring of persons returning to poverty due to illness and feedback on problems in medical insurance services, etc.
same day, the People's Government of Lucheng City, Anhui Province, opened the Implementation Opinions of Liu Market Town Government of Guzhen County on Strengthening the Construction of primary health care security teams.
, the townships should set up a special body responsible for health care functions, the transfer of personnel to form a team of health insurance administrators.
township level is responsible for: health insurance policy publicity at all levels, medical insurance poverty alleviation, insurance collection supervision, information changes, medical insurance refund, medical assistance, fraud insurance report acceptance and assistance investigation, daily information reporting and other work.
village (community) level is responsible for: participation in insurance collection, information entry, policy publicity, assistance in fraud investigation and prosecution and other basic services arranged by counties and townships, etc.
The establishment of township-level medical insurance service station to solve at least three practical problems of the grass-roots physician commune writer Code Wanxuan for this phenomenon, put forward his own point of view, he pointed out that the establishment of town-village-level medical insurance service station as a local innovative reform measures, has a strong representative significance, at least to solve the current three practical problems: First, for the grass-roots doctors to reduce the burden of well-known, grass-roots medical personnel in addition to providing basic medical services for patients, but also assume the task of health insurance policy education.
Village-level medical insurance service stations and staffing, can increase the work fulcity for insured persons, fixed-point institutions, in the insurance data comparison, health insurance treatment policy advocacy, health insurance poverty alleviation mapping and other work to find a catcher, and effectively share part of the workload of policy education for grass-roots doctors; In terms of insurance behavior, through the education of insured persons, the normal supervision of fixed-point institutions, so that high-risk subjects involved in the case, individuals dare not cheat, can not cheat, do not want to cheat;
Rural medical insurance management network to build momentum of the grass-roots medical institutions face more stringent supervision of the author to consult the data in recent years found that the local establishment of medical insurance service stations, the formation of medical insurance administrators, although the measures have a long history, some functional departments will be decentralized, requiring secondary medical institutions must set up independent medical insurance service stations to facilitate the provision of medical insurance services for patients, but the real sinking to the grass-roots initiatives are not many.
In February this year, the State Council issued the Opinions on Deepening the Reform of the Medical Security System, which clearly states: Build a unified national management system for the operation and management of medical security, vigorously promote the sinking of services, and achieve full coverage of provinces, cities, counties, townships (streets) and villages (communities).
strengthen the construction of the service team, to build a new era of medical security public service requirements in line with the professional team.
from the current implementation of the situation in various places, rural primary health care management network construction work has been in full swing.
for patients, the establishment of the platform to promote health care procedures more convenient and faster, in medical institutions, medical personnel, the broad spread of this reform, meaning that the supervision of health insurance funds more stringent, cheating behavior hit more.
The decentralization of the power of medical insurance supervision to primary medical institutions to avoid the impact of the construction of rural medical insurance management network on the primary health care field, an unnamed expert in the field of medical insurance told the primary physician commune: the main impact and practical significance includes but is not limited to three aspects.
First, the comprehensive policy and practical impact of health care reform has been avoided, should be actively faced with, timely use, in chronic disease management, rehabilitation treatment, basic drugs and the use of the procurement of drugs with volume, looking for opportunities for cooperation; Advice should be made in due course.
health care reform is a powerful lever to pry the development of medical institutions, especially for the primary health care sector is more historic.
the construction of rural medical insurance management network gradually pushed away, prompting more and more medical insurance service stations, health insurance attendants to directly serve the rural groups, to facilitate residents.
more importantly, these institutions and individuals will assume the regulatory functions of the health care sector, more directly monitoring and tracking every health care expense, so that fraud is nowhere to be seen.