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电竞竞猜推进紧密型县域医疗卫生共同体医疗保障管理改革的意见政策解读

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为发挥医保在资源配置中的杠杆作用,落实分级诊疗,减轻群众医疗负担,省医疗保障局、财政厅、省卫生健康委、人力资源和社会保障厅联合制定了《四川省医疗保障局等四部门电竞竞猜推进紧密型县域医疗卫生共同体医疗保障管理改革的意见(试行)》(以下简称《意见》),现就《意见》解读如下。

yi、zhengcebeijing

电竞竞猜《guowuyuanshenhuayiyaoweishengtizhigaigelingdaoxiaozudianjingjingcaijinyibutuiguangfujianshenghesanmingshishenhuayiyaoweishengtizhigaigejingyandetongzhi》(guoyigaifa〔2019〕2hao)、《zhonggongzhongyangguowuyuandianjingjingcaishenhuayiliaobaozhangzhidugaigedeyijian》(zhongfa〔2020〕5hao)juntichuchixutuijinyibaozhifufangshigaige,tansuoduijinmixingyiliaolianhetishixingzongefufei。weiguancheluoshishangshulianggewenjianjingshen,zhubujianliguanyonggaoxiaodeyibaozhilixinjizhi,fahuiyibaodegangganzuoyong,tuidongyigongtijiankangliangxingfazhan,shengyibaojuhuitongcaizhengting、shengweijianwei、renshetingdengzhidingle《yijian》。

er、《yijian》zhuyaoneirong

《yijian》gongwugebufen,jutimingquelewoshengtuijinjinmixingxianyuyiliaoweishenggongtongtiyiliaobaozhanggaigedezongtiyaoqiu、gaigerenwu、baozhangcuoshi、zuzhishishihekaohebanfa。zhuyaobaokuoyixianeirong:

(yi)zongtiyaoqiu。

yixijinpingxinshidaizhongguoteseshehuizhuyisixiangweizhidao,shenruxuexiguanchedangdeshijiudahexijinpingzongshujiduisichuangongzuoxiliezhongyaozhishijingshen,luoshishengwei、shengzhengfu“jiankangsichuan”yixiliezhanlvebushu,buduantuijinyigongtiyibaoguanligaige。quedinglebaozhangjiben、jianquanjizhi、yindizhiyi、mingquezerendejibenyuanze,tichuletishengjicengyiliaojigoufuwunengli、kongzhiyiliaofeiyong、tigaoyibaojijinjixiaojiangdigerenfudandezhuyaomubiao。

(er)gaigerenwu。

电竞竞猜《yijian》zhenduiyigongtiyibaoguanlimubiao,tichulewuxianggaigerenwu。yishishishiyibao“yigezonge”guanli,zaijinmixingxianyuyigongtishixingyibaojijin“yigezonge”yusuanguanli,duishixianrenyuanguanli、caiwuguanli、xinxixitong、yibaojiesuan、kaohejianguan“wutongyi”deyigongtikeshixing“yigezongefufei”;ershituijinjiatingyishengqianyuefuwu,yiyigongtiweizaitizuodazuoqiangzuoshijiatingyishengfuwu,jianlijiatingyishengyibaoqianyuefuwubao;sanshizhichigongxiangyiliaofuwu,bayigongtineigongxiangfuwunaruyibaozhifufanwei;sishishixingyaopinhaocaitongyicaigou;wushitansuoshoufufeigaige,jieheanjibingzhenduanxiangguanfenzu(drg)fufei、bingzhongfufei、chuangrifufeideng,lvxianzaiyigongtineikaizhanshoufufeigaige。

(san)baozhangcuoshi

weilequebaogaigerenwuluodaoshichu,《yijian》tichulesixiangbaozhangcuoshi。yishiqiandingyigefuwuxieyi,gaigedingdianfuwuxieyideqiandingfangshi,yigongtiqiantoudanweidaibiaosuoyouyigongtichengyuandanweiyuyibaojingbanjigouqiandingyigeyibaodingdianfuwuxieyi;ershituixingyitaojianguantixi,mingquegejiyibaobumenyuyigongtiqiantouyiliaojigouxietongchengdanyibaojijindejianguanzeren;sanshidajianyitihuaxinxipingtai,tuijinjinmixingxianyuyigongtiyitihuaxinxipingtaijianshe;sishiyangeshishikaohezhidu,duiyigongtiyibaoguanligaigechengxiaoshixingyijieguoweidaoxiangdekaohejizhi。

(si)zuzhishishi

youyugaigeshixiangduo、fanweiguang,shejiduofangliyidediaozheng,《yijian》mingquelezuzhishishideyixieyaoqiu。zaishishiguochengzhonggediyaojiaqiangzuzhilingdao,bumenxietongpeihe、zuohaozhengcexianjie、fahuizhengceheli;yaojieheshijizhidingyigongtiyibaoguanligaigedeshishifangan,gexianggaigeyaoyoushijianbiao、luxiantu,yaowenbuyouxutuijin;yaojishikaizhangaigexiaoguopinggu,jiaqiangduchadiaoyan、gongzuozhidaohejingyantuiguang,zuohaopingguzongjie;yaoqianghuaxuanchuanpeixun,chongfenfahuigonggongmeitidexuanchuanzuoyong,jiaqiangduiyibaoyishihexiangguanrenyuandezhengcepeixun。

(wu)kaohezanxingbanfa

yigaigejieguoweidaoxiang,《yijian》tichuleyigongtiyibaoguanligaigekaohexiangguanyaoqiu。zaikaohefanweifangmian,fenbieyigeyigongtizhengti、jiayituanduizhengtiweidanweidui“yigezongefufei”、jiatingyishengyibaofuwujinxingniandukaohe;zaikaohezhibiaofangmian,fenbiezhidingle“yigezongefufei”dekaohezhibiao(baokuoyiliaofeiyong、yibaozhichu、fenjizhenliao、yiliaozhiliang、gerenfudanhemanyiduzhibiao),yijijiatingyishengqianyuefuwukaohezhibiao(baokuoqianyuexiangguan、jiatingfuwu、jiuzhenhezhuyuan、yiliaofeiyonghejiankangcujin、juminmanyiduzhibiao)。zaikaohefangshishang,quedingleliyong“hulianwang、dashujujinxingkaohefangshi,tigaokaohexiaolv。zaikaohejieguojiqiyingyongshang,mingqueleyouxiu、lianghao、hege、buhegedekaohedengcidefenfanweiyijibutongdengcidejieguoyunyong。

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政策原文: http://hulyameral.com/scsybj/c100061/2020/6/19/5ec15897799d4a08a90d234e0d5c43e0.shtml

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