潜江市新型农村合作医疗支付方式改革与探索浅析

随着新型农村合作医疗筹资规模不断扩大和提高医疗保障水平等一系列政策出台,农民就医需求得到了进一步的刺激和释放,使医疗费用上涨速度过快.如何调整医、保、惠三方利益,将医疗费用增长控制在合理范围,是新型农村合作医疗经办机构当前面临的主要问题.对此,潜江市开展了新型农村合作医疗费用支付方式改革,在加强供方医疗机构服务行为监管的同时,通过实行总额预算、按病种付费等综合改革,促进了定点医疗机构加强自律管理,将住院例均费用增长控制在9％以内,确保了新型农村合作医疗基金的安全运行,提高了基金使用效率.

Analyzing Payment Reform Exploration of New Rural Cooperative Medical System in Qianjiang

As the fund-raising scale continues to expand, a series of policies have been published to improve the level of medical care insurance, the medical needs of rural residents are further released and stimulated, and the medical costs are rising too fast. How to adjust profits of medical care, insurance and the patients and how to control the growth of health care costs within reasonable limits are the main problems of the new rural cooperative agencies. The refore, the government of Qianjiang launched a new payment of medical cost reform, which strengthened the medical service behavior supervision of medical institutions, improve self-management of fixed medical institutions by carrying the comprenensive reform of gross amount budget and payment by disease type, the growth of average hospitalization cost is controled within 9% to ensure the safe operation of new rural cooperative medical fund, and theprofit of the fund expense is improved.