职工医保门诊统筹待遇设计现状与启示

The Current Status and Enlightenment of the Outpatient Co-Ordination Benefit Design for Employees’Health Insurance Policies

职工医保门诊改革是医疗保障领域的一项重要改革。文章梳理了2021年国家启动门诊共济保障改革前已开展普通门诊统筹地区的门诊待遇设计情况,总结“两线一比例”的分布情况和主要特点,为各地进一步推动门诊共计保障改革提供决策依据。

The reform on the outpatient coordination of Employee Medical Insurance is very important in the field of medical secu-rity.It sorts out the design of outpatient treatment in areas where general outpatient coordination has been carried out before the na-tional reform of outpatient security launched in 2021,summarizes the institutional design and main characteristics of“two lines and one ratio”,and provides a decision-making basis for further promoting the reform of total outpatient security in various regions.