According to the news of the National Medical Insurance Bureau on March 25, in February 2022, the coverage of direct settlement of outpatient expenses across provinces was further expanded, and 826 designated medical institutions in 63 coordinated areas across the country launched a pilot pilot of direct settlement of 5 kinds of outpatient chronic disease-related treatment costs such as hypertension, diabetes, malignant tumor outpatient radiotherapy and chemotherapy, uremia dialysis, and organ transplant postoperative anti-rejection therapy.
First, the direct settlement of hospitalization expenses across provinces is stable
As of the end of February 2022, there were 54,200 designated medical institutions in the network for direct settlement of hospitalization expenses across provinces nationwide; the cumulative hospitalization expenses in that year were directly settled across provinces by 749,000 person-times, involving medical expenses of 17.091 billion yuan, and the fund paid 9.793 billion yuan, with the proportion of fund payments of 57.3%. In February, the national hospitalization expenses were directly settled across provinces by 315,200 person-times, involving medical expenses of 6.832 billion yuan, and the fund paid 3.922 billion yuan, a decrease of 27.3%, 33.4% and 33.2% respectively; the proportion of fund payment was 57.4%.
2. The direct settlement of outpatient expenses across provinces has been steadily promoted
As of the end of February 2022, the national direct settlement of outpatient expenses across provinces has reached 49,200 designated medical institutions and 89,800 designated retail pharmacies; the cumulative outpatient expenses in that year were directly settled across provinces by 3,109,700 person-times, involving medical expenses of 777 million yuan, the fund paid 452 million yuan, and the proportion of fund payment was 58.3%; of which 4,842 outpatient chronic disease-related treatment costs were directly settled across provinces. Involving medical expenses of 5.1338 million yuan, the fund paid 3.6527 million yuan, and the proportion of fund payment was 71.2%. In February, the national outpatient expenses were directly settled across provinces for 1,536,100 person-times, involving medical expenses of 386 million yuan, and the fund paid 225 million yuan, a decrease of 2.4%, 1.2% and 0.8% respectively; the proportion of fund payment was 58.4%; of which the outpatient chronic disease-related treatment costs were directly settled across provinces 2670 person-times, involving medical expenses of 2.6467 million yuan, and the fund paid 1.9859 million yuan, and the proportion of fund payment was 75.0%.
3. The national unified online filing service is convenient and efficient
By the end of February 2022, all co-ordinated areas in the country can realize online filing of medical treatment across provinces through the National WeChat Mini Program for Medical Record-filing in different places and the National Medical Insurance Service Platform APP. In that year, 287,200 people were successfully filed through the national unified online filing channel. At the same time, in the app of the national medical insurance service platform, the off-site medical record column can inquire about the direct settlement of inpatient, general outpatient and outpatient chronic disease-related treatment costs of designated medical institutions in various coordinating areas across provinces, the contact information of medical insurance agencies, and the announcement of system downtime in various places.
