CCB, Beijing, July 30 (Reporter Guo Jun) The State Council’s executive meeting recently reviewed and approved the "Opinions on Optimizing Convenient Services in the Field of Medical Insurance" (hereinafter referred to as the "Opinions"), introduced by Li Tao, Deputy Director of the National Medical Insurance Administration, "Opinions" 》Clarified the overall goal of optimizing medical insurance services for the convenience of the people, focusing on accelerating the standardization, standardization and facilitation of medical insurance services, focusing on optimizing medical insurance government services, and making practical moves in convenient services; focusing on the "three-medical linkage" of medical insurance, medical care and medicine , To deepen information sharing between departments; focus on protecting the "life-saving money" of the people, and severely crack down on fraud and insurance fraud in the medical insurance field.
The medical security system is an important institutional arrangement for reducing the medical burden of the people, improving people's livelihood and welfare, and maintaining social stability.
According to statistics, by the end of 2020, the number of people participating in basic medical insurance in my country has reached 1.36 billion, and the participation rate has stabilized at more than 95%.
In 2020, the national medical insurance fund income will reach 2.48 trillion yuan, and the expenditure will be 2.1 trillion yuan. The proportion of hospitalization expenses within the scope of the employee medical insurance and resident medical insurance policies has stabilized at around 80% and 70%, respectively.
Li Tao introduced that in recent years, the National Medical Insurance Administration has continued to promote the reform of "delegating control, delegating control, and serving the government to services" in accordance with the decisions and deployment of the Party Central Committee and the State Council, and has achieved certain results.
However, there is still a certain gap between the uniformity, standardization and convenience of the management of medical insurance services and the expectations of the masses.
In order to solve the problems of "urgency, difficulty, worry, and hope" among the people in the medical insurance service sector, and to make medical insurance services more convenient, and the people to deal with things less often, the National Medical Insurance Bureau and the State Council Office of the General Office of the State Council have researched and drafted the "Opinions". The second field survey sought the opinions of 31 provinces across the country and the Xinjiang Production and Construction Corps, as well as 17 departments including the Ministry of Public Security, the Ministry of Human Resources and Social Security, and the Health and Health Commission. It was reviewed and approved by the State Council Executive Committee on July 7, and was formally issued recently.
Regarding the promotion of cross-provincial direct settlement of outpatient expenses, Jiang Chengjia, head of the Medical Insurance Management Center of the National Medical Insurance Administration, said that from the current point of view, the progress is basically in line with expectations. 315 coordinating areas have been opened in 29 provinces and the Xinjiang Production and Construction Corps. Ordinary outpatient expenses are directly settled across provinces, covering 70% of the overall planning area of the country. Among them, 18 provinces such as Beijing, Tianjin, Hebei and Xinjiang Production and Construction Corps have achieved full coverage of all coordinated areas in the region. The cost of general outpatient clinics across the country has reached 23,700 inter-provincial networked medical institutions, covering nearly 50% of the country's counties and districts; networked pharmacies have also reached 42,600. From January to June this year, about 3.39 million direct settlements of outpatient expenses across the provinces across the country involved 848 million yuan in medical expenses, and 465 million yuan paid by the fund, which exceeded the settlement scale for the whole year of last year.