Strengthen the service management of designated medical institutions, and promote centralized procurement to benefit more patients… Recently, Luoyang Medical Security Bureau announced the main points of medical security work in 2022. These upcoming new changes are closely related to you.
●Expanding the scope of direct settlement of hospital outpatient expenses for off-site medical treatment
This year, Luoyang will realize the direct settlement of off-site medical treatment for general outpatient expenses and 5 kinds of pilot outpatient chronic diseases in all counties and districts of Luoyang Full coverage, promote more designated medical institutions to realize the direct settlement of outpatient expenses for medical treatment in different places, and improve the settlement efficiency and direct settlement rate of settlement funds for medical treatment in different places.
●Make good use of the dynamic adjustment mechanism of medical service prices
Relying on the national information platform, Luoyang will create a “Luoyang Medical Service” through big data, cloud computing, blockchain and other information technologies. “Intelligent Price Supervision System”, establish and improve the monitoring mechanism for medical service prices and drug prices, strengthen monitoring and early warning for abnormal fluctuations in drug prices and abnormal growth in the consumption of medical service items, and initiate inquiries and interviews in a timely manner for violations of regulations, and include credit Evaluation to create a good medical environment for patients.
●Continue to innovate and promote centralized procurement with volume
This year, Luoyang Medical Security Bureau will innovatively organize the procurement of medical consumables with volume of Henan Southwest Alliance and inter-provincial and municipal alliances. Promote the direct settlement of medical insurance funds for centralized procurement of drugs and medical consumables and pharmaceutical companies, and promote more high-priced drugs and consumables to enter the “parity era”.
Incorporate the implementation of the centralized procurement policy into the management scope of the medical insurance agreement, strengthen the supervision and inspection of the implementation of the centralized procurement policy, focus on the work of the township health centers to purchase the centralized procurement of drugs for the village clinics, and strengthen the medical insurance designated pharmacies. Supervision of the purchase and sale of centrally-purchased drugs. Create a joint meeting system for the centralized procurement of medicines and medical consumables in Luoyang, and open up the “last mile” of centralized procurement, so that more patients can benefit from centralized procurement.
● Vigorously promote the application of electronic vouchers
This year, Luoyang will urge and guide designated medical institutions to strengthen the construction of application scenarios of medical insurance electronic vouchers, and realize the full-process medical service of “scan code” of medical insurance electronic vouchers. Allow patients to enjoy more convenient medical services.
●Improving and perfecting the medical security treatment policy
Completely establish a mutual aid security mechanism for employee medical insurance outpatient clinics. In accordance with the province’s unified deployment to scientifically and reasonably determine the scope and level of security, Luoyang will establish a medical insurance outpatient security mechanism for employees, and simultaneously implement the reform of employees’ personal accounts. In the future, the employee medical insurance personal account can be used to pay the medical expenses borne by the employee himself and his spouse, parents and children in medical institutions designated by medical insurance.
●Strengthen the construction of the grass-roots medical insurance service system
According to the work goals and requirements of the country and the province to gradually establish a five-level medical insurance management system at the provincial, city, county, township and village levels, deepen the medical insurance In the field of “decentralization, regulation and service” reform, we will promote the front-end, front-gate, and service sinking of medical insurance agencies, adopt the method of pilot first, and then comprehensively promote, focus on strengthening the construction of the grass-roots medical security service system, and resolutely open up the agency service” last mile”. In the future, urban and rural residents will also be able to easily apply for medical insurance at the township and village levels.