Medical insurance nationwide roaming, do not like cross provincial pilot as late-步步高i606

The national health insurance "roaming", don’t be late for the pilot provinces like]11 18, Liaoning, Jilin, Heilongjiang, Hainan, Sichuan, Guizhou, Shaanxi, Gansu 8 provinces signed the new rural cooperative medical care in Beijing (Medicare and rural residents) inter provincial medical reimbursement networking service agreement now, each province according to the status of floating population the active priority to speed up the convergence of close cooperation and contact provinces, thus gradually expand to the national health care network "". November 18th, Liaoning, Jilin, Heilongjiang, Hainan, Sichuan, Guizhou, Shaanxi, Gansu 8 provinces signed the new rural cooperative medical care in Beijing (Medicare and rural residents) inter provincial medical network settlement service agreement, marking China’s inter provincial NCMS medical networking reimbursement pilot officially launched. In future, the patients participating in the agreement provinces will be transferred to the designated provinces and hospitals by referral to the agreement provinces, and the discharged patients can be reported directly to the new rural cooperative medical scheme. The regional division of medical insurance settlement is the most important part of the medical insurance system reform in recent years. At present, the vast majority of provinces have also implemented medical insurance in the province settlement; the new rural cooperative medical information platform has also been interconnected with a number of provinces across the country. The 8 provinces signed the urban and rural residents medical insurance inter provincial medical networking reporting service agreement, which is further. However, the speed of the current inter provincial settlement of medical insurance is still difficult to speak rapidly. In fact, in 2015 the State Planning Commission had announced the reform timetable: "will rely on national NCMS Information Platform this year, some areas and designated medical institutions, to carry out inter provincial medical costs of verification and immediate settlement pilot". But the real substantial progress still occurs after the second half of this year. Along with the floating population scale continues to expand, and the public on the level of protection of health insurance required to enhance the implementation of medical insurance in the country within the scope of the "roaming", has become increasingly urgent. As far as we can see, there is still a gap between the speed of reform and the reality. The main emphasis of the past or technical problems, but now more and more technology (platform) is not a problem, the province health insurance settlement breakthrough, the integration of urban and rural medical insurance, are all evidence. The key is that there are differences in the understanding of the importance of breaking the regional division of health insurance in some places and departments. The 8 provinces signed the inter provincial settlement agreement of health insurance, in fact, not surprising. The population flow between Northeast and Hainan have been frequent, Sichuan, Guizhou and Shaanxi in the region adjacent to large provincial remote medical needs of the people. It can be said that it is based on the visible reality needs, these places are at the forefront. But to promote inter provincial settlement of medical insurance, we should not only look at the present. In the long run, access to the Internet should also include the major population inflows. After all, these places are the most foreign population areas, followed by the path of easy and difficult, the pilot will be extended to the surface of these places, and then extended to the country, is to represent the general trend. See now, the scale of floating population Chinese has reached 240 million, while the distribution of the floating population and uneven flow, but there is no pure inflow and outflow points. Then promote the health care national network, to ensure that public services need to keep up with the development of social mobility, to improve the status of human resource area, has the noticeable external gain. On the whole, each)

医保全国“漫游”,别像跨省试点般迟到 [摘要]11月18日,辽宁、吉林、黑龙江、海南、四川、贵州、陕西、甘肃8省份在北京签署新型农村合作医疗(城乡居民医保)跨省就医联网结报服务协议 眼下,各省份可根据自身的人口流动现状,主动优先加快与联系紧密省份的衔接合作,由此逐步扩大到医保全国“联网”。11月18日,辽宁、吉林、黑龙江、海南、四川、贵州、陕西、甘肃8省份在北京签署新型农村合作医疗(城乡居民医保)跨省就医联网结报服务协议,这标志着我国新农合跨省就医联网结报工作试点正式启动。今后,协议省份内参合患者经转诊至协议省份的定点联网机构就医,患者出院可直接“新农合”结报。终结医保结算的地域分割状态,是近年来医保制度改革的重中之重。目前绝大多数省份也都实现了医保省内异地结算;国家新农合信息平台也与全国多个省份进行了互联互通。此次8省份签订城乡居民医保跨省就医联网结报服务协议,算是更进一步。但当前医保跨省结算的推进速度仍难言迅速。事实上,2015年国家卫计委就曾对外公布该项改革的时间表:“今年将依托国家新农合信息平台,选择部分统筹地区和定点医疗机构,开展跨省就医费用核查和即时结报试点”。但真正的实质性进展,还是在今年下半年以后才出现。随着人口流动规模的继续扩大,及民众对医保保障水平要求的提升,实现医保在全国范围内的“漫游”,已越来越急迫。就现在看,改革推进的速度与现实需要之间仍有落差。过去主要强调的或是技术难题,但现在技术(平台建设)越来越不成问题,医保省内结算的突破、城乡医疗保险的统筹等,都是明证。关键还是某些地方与部门对打破医保地域分割状态重要性的认识存在差异。这次8省份签订医保跨省结算协议,其实并不让人意外。东三省与海南之间的人口流动一直频密,四川、贵州、陕西等在地域上相邻,民众省际异地就医的需求较大。可以说,正是基于看得见的现实需要,这些地方走在了前列。但推进医保跨省结算,不能仅看眼前。长期看,加入联网的,还应有那些主要的人口流入地。毕竟,这些地方是外来人口最多的地区,遵循由易及难的路径,将试点面扩大至这些地方,进而扩及全国,是大势所趋。得看到,如今中国流动人口规模已达到2.4亿,尽管流动人口的分布与流向不均,但已不存在纯粹的流入地和流出地之分。那么推进医保全国联网,确保公共服务跟上流动社会的发展需要,对于改善地区的人力资源状况,具有不可忽视的外部性增益。整体上看,每个地区都应是医保跨省漫游的受益者。当然,那些人口流入地在改革中需承受相对更高的成本,这需要这些地方别光看到“负担”,更要看到人口流入对地方经济社会的综合促进作用;各省(区、市)之间也要在统筹结算上做好利益协调,如在报销比例、支付标准等方面予以适当平衡。因此,当前推进医保结算,不妨从两个方面共同发力。一是,国家层面,相关部门继续加强统筹合作,并通过适当的激励机制,缓解地方上动力不足的问题;二是,各省份可以根据自身的人口流动现状,主动优先加快与联系紧密省份的衔接合作,由此逐步扩大到医保全国“联网”。医保实现全国漫游,既关系到整个国民医保福利的获得感,也关系到一个全国统一市场经济环境的构建。此前人社部曾透露,到2017年基本实现符合转诊条件的参保人员异地就医住院费用的直接结算。这被解读成为全国医保“漫游”列了时间表。如今时间紧迫,也望涉事各方为改革按下加速键。(社论)相关的主题文章: