新型农村合作医疗城市定点医疗机构即时结报研究

新农合城市定点医疗机构即时结报可方便参合农民报账，可提高参合农民受益水平，有利于城市定点医疗机构建立自我约束机制，有利于防范不法分子骗保行为。建议国家出台政策，从2009年起，各省开展试点，3年内以省为单位全面推开。各省建立相对统一的补偿模式。规范的回款机制和转诊制度，改革和完善与即时结报不相适应的管理体制和运行机制。

Study on the real - time reimbursement system of fixed - point medical institutions in urban for new rural cooperative medical system

The real- time reimbursement system of fixedpoint medical institutions in urban, which is for new rural cooperative medical system, can make convenience for farmers to render an account, and enhance the benefit level of residents who take part in the new rural cooperative system. Plus, it is conductive to the establishment of self-restricting mechanism for fixedpoint medical institutions of urban, and also to help prevent illegal acts of insurance fraud. Suggest that the state release the policy, each provinces carry out the pilot project from 2009, and then fully open in the province as a unit in three years. Provinces to establish a relatively uniform compensation model, a standardized mechanism to return money and referral system, reform and improve the management system and operational mechanism which are not fit for the realtime settlement and reimbursement system.