域外定点医疗机构即时结报模式实践与思考

目的：探索和完善域外新农合定点医疗机构即时结算报销模式。方法：通过建立即时结报补偿、运行和管理＂三大机制＂,统一补偿政策,简化补偿程序,规范补偿管理。结果：有效破解了参合农民域外住院经济负担重、补偿程序繁、结报周期长和监督管理难的＂四大＂难题。结论：该模式切实可行,深受农民拥护,但作为一种新的补偿运行模式,尚需不断探索和完善。

Immediate compensation model in extraterritorial new rural CMS institutions

Objective To explore and improve the realtime settlement of fixed reimbursement model in extraterritorial new rural cooperative medical institutions.Methods Immediate compensation,operation and management ＂mechanism＂ was established to unify compensation policy,simplify compensation procedures,and standardize compensation management.Results Such problems as patients＇burden in extraterritorial hospitals,complex compensation procedure,long period of settlement of claims and difficulty in supervision and management were solved.Conclusion The model is practical and popular with farmers,but as a new operation mode of compensation,it still needs to be explored and improved.