按病种分值结算 科学实现医保基金总额控制

Payment by Disease with Score:To Realize Scientific Medical Insurance Fund Total Amount Control

淮安总额控制下的病种分值结算办法较好地体现了"以收定支、收支平衡、略有结余"的基金运作原则,实施8年间次均医疗费用年均增幅仅为2.79%,低于全国和全省同期平均增幅。在住院人次增加、门诊特定项目费用占比及保障标准提升的情况下,统筹基金当期结余率始终维持在2%-3%的合理水平。

Huai＇an adopted global budget and Payment by Disease with score. This method of payment well embodies the fund operation principle, which is ＂ fixed income support, balance of payments, slightly balances ＂. For 8 years it implemented, average annual growth of per medical expenses is only 2.79%, lower than the national and the province average growth over the same period. In the case of inpatient admissions increased, the proportion of outpatient specific project costs and security standards to enhance, co-ordinate fund current balances rate is always maintained at a reasonable level of 2% to 3%.