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宁夏积极推进家庭医生签约服务

2017-08-23 13:11:40   央广网

央广网银川8月23日消息(记者廉军)为更好维护人民群众健康,转变基层医疗卫生服务模式,强化基层医疗卫生服务功能,宁夏积极推进家庭医生签约服务工作,近日宁夏出台政策,从五个方面对家庭医生签约服务医疗保险做出规定。

据介绍,开展家庭医生签约服务是实现基层首诊、分级诊疗,有效缓解“看病难、看病贵”问题重要突破口。出台的政策对家庭医生签约服务的适用范围、服务机构、资金渠道、促签政策、支付办法等五个方面做出了明确规定。

根据政策,凡城镇职工和城乡居民基本医疗参保人员都可参与;服务机构为经卫生行政部门许可、具备全科服务能力、纳入基本医疗保险协议医疗服务管理,并明确签约服务方式的乡镇卫生院、村卫生室和城市社区卫生服务中心、社区卫生服务站等基层医疗卫生机构;家庭医生团队为参保人员提供约定的签约服务,本着自愿签约的原则,根据签约服务人数按年收取签约服务费,由医保基金、基本公共卫生服务经费和签约参保人员等付费分担。个性化服务内容及签约服务费根据各设区的市确定的标准。

为充分发挥医保政策引导参保人员到基层就医的作用,实行差异化医保支付政策,促进家庭医生签约服务。参保人员经家庭医生签约服务后转诊到上级医疗机构就诊的参保人员,执行下级医疗机构的门诊报销比例,未经转诊的执行原报销比例;未经转诊自行前往区内三级协议医疗机构和区外协议医疗机构住院的,按规定报销比例的50%支付。家庭医生签约服务费医保补助资金按照“多劳多得、绩效挂钩、统筹兼顾”的原则,按照参加职工医疗保险、城乡居民医疗保险的实际签约服务人数确定签约服务费医保基金支付总额,经年度绩效考核后根据考核情况拨付实际补助金。

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