The burden of 274,000 households was 2.13 billion yuan!Qingdao showed new progress in practical work in the "Medical Insurance" city office

To reduce the burden of 274,000 households by 2.13 billion yuan, the medical insurance fund of maternity and medical expenses increased by 42.1%year -on -year, and the reimbursement standard for increasing some high -value consumables was to reduce the burden of 376 million yuan in the insurance participation patients-

New progress in the city's "medical insurance" cities in our city

Qingdao Daily/Guanhai News, September 21st. Today, the Municipal Medical Insurance Bureau organized a 2022 "Entering the Municipal Handling Performance Project" and the "Open Day of the Medical Insurance Organ". In the medical insurance bureau agency and service hall, listen to the report on the handling of 3 medical insurance cities. The reporter was informed that in terms of continuous reduction of employee medical insurance payment rates, this year has reduced the burden of 2.13 billion yuan for 274,000 households; The expenditure was 270 million yuan, an increase of 42.1%year -on -year. In addition, the city has increased more than 5 categories of more than 60 clinical commonly used high -value medical consumables medical insurance payment standards this year, and has reduced personal burdens of about 376 million yuan for patients participating patients.

The expenditure of the medical insurance fund of maternity and medical expenses was 270 million yuan, an increase of 42.1% year -on -year

As of the end of August, the number of participants in the city's social medical insurance reached 90.601 million, and a total of 16.908 billion yuan in medical insurance funds were expended. Among them, 601,100 hospitalized patients were reimbursed 7.799 billion yuan; 641,700 patients were reimbursed 3.235 billion yuan; 2.296 million general outpatient patients reimburseed 569 million yuan; 616,000 yuan. The city's medical insurance fund settled 63,600 and 68 million yuan per day, steadily holding the bottom line of the general citizens.

The Municipal Medical Insurance Bureau introduced the handling of three medical insurance cities this year. This year, the Municipal Medical Insurance Bureau continued to reduce the employee's medical insurance payment rate and reduced the burden on the market subject. Since the epidemic, the fifth implementation of fee reduction policies has been reduced by 0.5 percentage points of the payment rate of employee medical insurance units from January 1 this year. As of the end of August, this year has reduced the burden of 2.13 billion yuan for 274,000 households. Since July, the implementation of the three -month -old phase -delayed payment policy for the implementation of small and medium -sized enterprises that meet the conditions will be exempted from hid fees during the slow payment period. "Out of mode.

Since the implementation of the national new fertility policy, in order to give full play to the guarantee function of maternity insurance and reduce the cost of fertility of women's fertility, the Municipal Medical Insurance Bureau considers and take the initiative to further improve the standards for maternity and medical expenses for employees. Since January 2022, the settlement standards of related diseases including prenatal examinations, childbirth costs, and fertility complications have been adjusted and improved. Improving the reimbursement standard for fertility complications involves more than 30 diseases, and the settlement standards for most diseases have doubled. Expansion related diseases, incorporate tire reduction treatment commonly used in IVF technologies into the scope of fertility diseases. At the same time, the reducing and reimbursement process is reduced, and the prenatal examination costs are directly paid by the medical insurance fund when the maternal insurance fund is discharged. As of the end of August, the city's maternity and medical expenses medical insurance fund expenditure was 270 million yuan, an increase of 42.1%year -on -year, and the policy effect was obvious.

Considering the actual situation of the city's supplementary medical insurance system, in order to effectively reduce the burden on the insured person, the Municipal Medical Insurance Bureau will be involved in vascular intervention, non -vascular intervention, orthopedic, cardiac surgery, and ophthalmology from January 1 this year. More than 60 clinical high -value medical consumables have improved medical insurance payment standards. For example, the cardiac block used by patients with congenital heart disease, the payment standard is increased from 10,000 yuan to 50,000 yuan; the pacemaker used to treat severe arrhythmia increases from 30,000 yuan to 50,000 yuan; tumor intervention intervention; tumor intervention The radio frequency electrode used in surgery was increased from 1,000 yuan to 6,000 yuan. As of the end of August, the proportion of medical insurance sharing of medical consumables in our city has increased by 19.61%compared with the same period last year, and a total of about 376 million yuan in personal burdens for participating patients.

The average personal burden of 18 DRG pilot hospitals decreased by 8.59% year -on -year

This year, the Municipal Medical Insurance Bureau launched a solid activity of "improvement of style", and vigorously cultivated the work style of "strictness, real, fast and fast". In addition to the municipal practical project, the Municipal Medical Insurance Bureau strives to handle other people to benefit the people and the people, and work hard to solve the people after seeing a doctor.

The Municipal Medical Insurance Bureau upgraded and implemented a long -term rural nursing insurance promotion plan to increase the life care service guarantee of up to 1050 yuan per person for insured residents, which improved the level of nursing insurance treatment in rural residents. As of the end of August, the city was enjoying the number of long -term care benefits of 50,000, including 24,100 residents; the expenditure of nursing insurance funds was 616 million yuan; the total number of designated nursing institutions in the city reached 1066 The on -site care service is 14.86 million hours.

Faced with the dual pressure of reduction of fees and income and reminding increases, the Municipal Medical Insurance Bureau used reforms to solve problems and implemented more efficient medical insurance payment policies. Comprehensive promotion of inpatient medical expenses to pay the country's pilot on the reform of the diseased group (DRG). The average number of hospitalization days, sub -hospitalization costs, and sub -average personal burden of 18 pilot hospitals decreased by 8.83%, 2.41%, and 8.59%year -on -year. Implement the paid and paid reform in the West Coast New Area, allowing the medical community to prevent, treated, and healthy the disease prevention of the people participating in the region; improve the medical insurance payment method that meets the characteristics of Chinese medicine. The home expands to the city's second -level B and above or above. The pilot disease has expanded from 13 to 19, and 87.5%of TCM medical service projects are included in the scope of medical insurance reimbursement, which has strongly supported the development of traditional Chinese medicine. In addition, in response to the problems of medical treatment in different places, the Municipal Medical Insurance Bureau simplified the medical records of different places, and changed the approval filing system as a promised filing system. Long -term residence in different places in the province and self -assistance of medical treatment in the province, and temporarily medical treatment in the province. At present, there are 379 medical institutions in the cities in a different place in the city, and there are 818 in the provincial and foreign networking settlement institutions in the province and the province. The province was the first to achieve full coverage of 4,520 fixed -point institutions across the provincial medical insurance card. (Qingdao Daily/Guanhai Journalist Guo Jingli)

(Author: Guo Jingli)

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