摘要
医疗保险跨省异地就医住院费用直接结算是一项解民忧、惠民生、得民心的重大民生工程,也是提升社会保险经办管理能力的重大系统工程。北京市自2017年6月19日正式接入国家异地就医联网结算系统,实现进出双向跨省异地就医住院就诊181264人次,实际结算162137笔,结算金额269116.49万元,其中,本市参保人员赴外省市就医住院3916人次,外省参保人员赴京就医住院177348人次,每位患者平均少垫付1.66万元。经过一年的运行,已得到了广大参保群众的高度认可。在提供"省心、省时、省力、省事"等方便的同时,也为医保经办管理工作和制度的可持续带来了诸多值得关注的问题和挑战,如何确保基本医保跨省就医直接结算这项便民利民工程的行稳致远,亟待深入研究和高度关注。
The inter-provincial on-line settlement of medical expenses is a major livelihood project,and also a systematic project to enhance the social security management capability.In June 19,2017,Beijing formally connected to the National Inter-provincial On-line Settlement System.After more than one year's operation,it has been highly recognized.At the same time,it brings many problems and challenges for the sustainable development of medical insurance management and system.How to ensure the smooth operation of the inter-provincial on-line settlement is urgently needed to be further studied.
作者
刘云华
贺伟
范样改
Liu Yunhua;He Wei;Fan Yanggai(Beijing Medical Insurance Administration Center,Beijing,100050)
出处
《中国医疗保险》
2018年第7期38-41,共4页
China Health Insurance
关键词
医疗保险
跨省就医
直接结算
问题与挑战
medical insurance
inter-provincial medical treatment
on-line settlement
problems and challenges
