Zhejiang uses medical insurance "leverage" to pry the graded diagnosis and treatment

"Further widen the gap in the proportion of medical insurance reimbursement in and outside the county, county and township medical and health institutions, and guide the formation of an effective order of first consultation, two-way referral and graded consultation at the grass-roots level." Reporters recently from Zhejiang Province to comprehensively promote the construction of the county medical union press conference was informed that the Zhejiang medical security system not only to protect the health of the masses, but also to promote the practice of medical norms and orderly medical treatment.
understood that Zhejiang in 2014 to establish a unified insurance system for major diseases. As of the end of October this year, the number of people covered by basic medical insurance in the province was 53.3 million, and the participation rate of the province's household registration population was 98%; The health insurance fund achieves sustainable operation and basically achieves the goal of "medicare for all".
In promoting the construction of the county medical union, Zhejiang medical insurance plays a new leverage role in cost control, cost reduction, quality assurance and efficiency, accelerates the vertical unification of the medical insurance for workers and urban and rural residents, narrows the differences in the treatment of medical insurance policies in the province; Zhejiang Province, in accordance with the principle of "receiving and collecting expenditures", through consultation and negotiation between medical insurance institutions and medical institutions, reasonably determines the total amount of medical insurance funds of the medical institutions in the region, establishes a mechanism of "total budget, balance retention and overspend sharing" to improve the performance of the use of health insurance funds.
Wang Pingyang, deputy inspector of the Zhejiang Provincial Medical Security Bureau, said that packaging the cost of medical insurance to the county medical community would force the medical community to take the initiative to do a good job in rational diagnosis and treatment, preventive health care and health management, strengthen rational examination and rational drug management, and save the direct cost of medical treatment for the masses. To promote inpatient services according to the number of points of the disease group, outpatient services combined with family doctors signed pay-per-person reform, to guide the medical community to achieve the dual objectives of controlling the waste of medical insurance funds and improving the quality of medical services. At the same time, let the masses at home near the medical treatment, saving transportation, accommodation and other indirect costs.
it is learned that Zhejiang Province will improve the management of medical insurance agreements, the medical union as a unified medical insurance fixed-point institutions to sign management agreements, not alone with medical institutions in the medical system signed agreements. Real family doctor contract service, so that family doctors become the public health and health insurance fund "double gatekeeper", encourage the medical community to fully push out the continuous prescription of chronic diseases, a prescription of medical insurance for up to 12 weeks. Actively promote the third-party distribution of medical insurance drugs, the direct distribution of chronically ill drugs to the home. Strive to open health insurance mobile payments in all county-level hospitals and medics' union-led hospitals by the end of December this year. (Health News)