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wta总决赛|打造无瑕美肌的秘诀!
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wta总决赛|打造无瑕美肌的秘诀!

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  北京4月18日电(记者李纯)2025年医保支付方式改革蓝皮书发布会暨趋势交流会4月18日在北京举行。国家医疗保障局医药管理司副司长徐娜在致辞中表示,支付方式改革目前已取得积极成效。按病种付费基本实现全覆盖,形成全国“一盘棋”。

  徐娜介绍说,截至目前,全国393个统筹地区中实施按病组(DRG)付费191个、按病种分值(DIP)付费200个,天津与上海兼具两种付费模式,实现了统筹地区全覆盖、符合条件的医疗机构全覆盖,病种覆盖率达到95%,医保基金覆盖率达到80%。

  她还介绍说,支付机制不断完善,政策工具更加丰富,其中特例单议、预付金、意见收集、谈判协商和数据工作组五大机制不断完善。支付方式改革成效初显,医、保、患三方初步共赢。例如,基金运行平衡,使用效率提升;医疗机构获得更多医保结余,内部收入结构改善;患者就医经济负担减轻,住院自负费用稳中有降。

  徐娜也指出,支付方式改革目前还存在医疗费用增长与支付方式管理之间存在矛盾、整体改革质量仍有较大提升空间、改革多方协同合力发挥不充分三大挑战。未来将采取统筹推进多元化支付体系建设、加快完善配套管理机制、加强支付改革工作协同、着力提升数智化管理水平等举措,紧盯三年行动计划收官重点任务,稳妥推进2.0版分组落地实施,聚焦提质增效,持续推进医保支付改革走深走实。

  国家医保局医保中心副主任隆学文在致辞中表示,作为改革执行者,医保经办系统始终秉持“服务民生、保障公平、提升效率”,取得积极成效。

  隆学文介绍说,支付方式经办规范化、标准化水平不断提升。今年1月,国家医保局印发《按病种付费医疗保障经办管理规程(2025版)》。新版规程是对2021试行版规程的继承和发展,并结合近三年支付方式改革实践进行了优化完善,以适应按病组和病种分值付费2.0版分组方案和工作机制的要求。

  隆学文表示,异地就医住院费用纳入按病种付费管理稳步推进。截至一季度末,除了6个省级统筹省份和11个不作为就医地的统筹地区以外,23个省份的235个统筹区开展了省内异地就医住院费用纳入按病种付费管理,177个统筹区已实际付费。

  他还提到,医保结算改革蹄疾步稳、纵深突破。2024年在国家层面统一和完善医保基金预付制度,支持基金运行安全的地区,在年初向信用良好的定点医疗机构预付资金。2025年一季度预付总规模为723亿元,有效破解医院垫资难题,助力公立医院轻装上阵,将更多资源投入到学科建设和服务优化中。截至3月底,全国24个省份实施医保基金即时结算,覆盖定点医药机构24.67万家,拨付金额1657亿元,有效缓解了医院运营压力,为医疗服务质量提升注入“源头活水”。

  在18日的活动中,由《中国医疗保险》杂志社研创、社会科学文献出版社出版的首部医保支付方式改革蓝皮书——《中国医疗保障支付方式改革发展报告(2023-2024)》正式发布。蓝皮书就当前的医改重点,以政策为导向,民生关怀、社会效益为出发点,全方位回顾我国医保支付方式改革进展成效,精选部分国家和地区医保支付方式的先进改革经验,并对下一阶段医保支付方式改革形势和重点进行展望,提出相关对策建议。该书集理论与实践于一体,为医保部门、医疗机构、高等院校、科研部门的理论研究和实践工作提供有效参考,具有较强的权威性和指导性。

  来自国家医保局、中国医疗保险研究会、首都医科大学国家医疗保障研究院,以及高校院所、医疗机构、地方医保部门的上百名代表出席了当天的活动,共同分析研判当前医保支付方式改革工作的形势及发展趋势,研讨医保支付方式改革提质增效的对策建议。(完)新闻结尾 wta总决赛|打造无瑕美肌的秘诀!的相关文章
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