Musi waGunyana 5, State Medical Security Bureau yakapa Chiziviso cheState Medical Security Bureau pamusoro peKuita Basa Rakanaka muManagement of Medical Consumables Payment for Basic Medical Insurance (inozonzi "Chiziviso"), iyo ine 4 mikuru. zvikamu uye 15 zvinyorwa.Zvinhu zvinoshandiswa pakurapa zvinorehwa muChiziviso ndezviya zvakanyoreswa kana kufayerwa nevakuru vemidziyo yekurapa, zvakapihwa chimiro uye zvinogona kubhadhariswa zvakasiyana.
Sekureva kweChiziviso, kubva pazuva rekuburitswa kweChiziviso ichi, mapurovhinzi anofanirwa kuzivisa kuHurumende yeInishuwarenzi yeHurumende Bureau yerekodhi isati yaunza kabhuku kekushandisa pakurapa.Madhipatimendi einishuwarenzi yezvehutano yeProvince anokurudzirwa kutora chimiro chemubatanidzwa wedunhu kana kushandirapamwe kuti aongorore kugadzwa kwekabhuraki inodyiwa yakabatana uye zviyero zvekubhadhara mukati memubatanidzwa kana dunhu.Iyo NHPA ichatanga kuvandudzwa kwebhuku renyika rekushandisa zvekurapa kune inishuwarenzi yekurapa nekufamba kwenguva.
Pfungwa huru dzakapfupikiswa pazasi:
Pfungwa 1: Kurudzira kubatana kwenyika kwechikamu uye kodhi yezvinhu zvinodyiwa
Chiziviso chinotaura kuti kupatsanurwa uye kodhi yezvinhu zvinodyiwa zvekurapa zvinofanirwa kubatanidzwa.Kukurudzira zvakasimba kushandiswa kwekodhi yenyika yeinishuwarenzi yekurapa yekurapa, panguva yakakodzera zvinoenderana neNational Health Insurance Bureau kusimudzira kupatsanurwa kwezvinhu zvinoshandiswa pakurapa uye dhatabhesi rekodhi kuita basa rakanaka rekuvandudza kodhi yezvekurapa inodiwa kuti ivandudze. mashandisirwo echokwadi uye kumiswa kwekodhi yezvekushandisa mukurapa kuti uwane zvinoshandiswa pakurapa nekutenga kodhi, nekodhi yekushandisa, nekodhi yekubhadhara, nekutarisa kodhi, uye kuve nechokwadi chekuti kupatsanurwa kwezvinhu zvinoshandiswa pakurapa uye kodhi yekodhi. kubatana kwenyika.
Pfungwa yechipiri: tekinoroji yekushandisa kupatsanurwa, rudzi urwu rwezvekushandisa mukubhadhara inishuwarenzi yekurapa
Chiziviso chinonongedza kuti chiyero chezvinodyiwa zvinosanganisirwa mukubhadharwa kweinishuwarenzi yekurapa.Kuti uenderane neyakagadziriswa mutengo webasa rekurapa "technical services uye kushandiswa kwezvinhu zvakaparadzana" musimboti, simbisa chirongwa chemutengo webasa rekurapa uye zvekurapa zvinodyiwa zvekubhadhara manejimendi, uye zvishoma nezvishoma hazvizosanganisirwe mumutengo webasa rekurapa kuumbwa kwezvinhu zvinoraswa zvekurapa zvinoenderana ne zvipimo zveinishuwarenzi yekubhadhara manejimendi yekutarisa.
Pfungwa yechitatu: izvi zvinoshandiswa hazvizoverengerwa musimboti mukubhadhara inishuwarenzi yekurapa
Panyaya yekuwana inishuwarenzi yekurapa, iyo "Chiziviso" inopa iyo inonamatira kune "basic" inoshanda chinzvimbo.Kuwana uye manejimendi ezvakakosha zveinishuwarenzi zvekurapa zvekushandisa zvinofanirwa kugara zvakanamatira kune "basic" chinzvimbo chekushanda, kuita zvavanogona, mukati mezvavanogona, uye nekuona zvine musoro kuwanda kwekubhadhara uye kubhadharisa zviyero, vachitarisa pakutenga kwehunyanzvi basa rekurapa. homwe yeinishuwarenzi, ichave yakakosha pakiriniki, yakachengeteka uye inoshanda, ine mutengo wakafanira zvekushandisa zvekurapa muchikamu chekubhadhara inishuwarenzi yekurapa zvinoenderana nematanho.Izvo zvinoshandiswa pakurapa zvichabatanidzwa muchikamu chekubhadhara inishuwarenzi yekurapa maererano nechirongwa.
Muchidimbu, zvekushandisa pakurapa zvine mutengo wakaderera wekiriniki, mitengo kana mitengo inodarika kugona kwehomwe nevarwere, pamwe chete nemidziyo yekudzoreredza isiri-yekurapa haizoverengerwe muchikamu chekubhadhara inishuwarenzi yekurapa.Nokuti nyika yakanyatso kudiwa kuti isabatanidzwe muchikamu chekubhadhara inishuwarenzi yezvokurapa yezvinhu zvinodyiwa, kuomerera kune zvigadziro zvepakutanga.
Pfungwa yechina: kuitwa zvishoma nezvishoma kweinishuwarenzi yekurapa common name management
Chiziviso chinonongedza kuti State Medical Insurance Bureau ichaongorora kugadzwa kwemazita akajairika manejimendi system yezvekushandisa pakurapa pasi peinishuwarenzi yekurapa, zvichibva pakurongeka uye kodhi dhatabhesi rezvekushandisa zvekurapa pasi peinishuwarenzi yekurapa, itarise mazita anoenderana nemabatiro. kubhadharwa kweinishuwarenzi yezvokurapa, zvishoma nezvishoma vanogadzira mitemo yekupa mazita emazita akajairika emhando dzakasiyana dzemishonga inodyiwa, uye gadzira zita rinowanzozivikanwa reinishuwarenzi yekurapa sehwaro hwedanho rinotevera mukutarisira kubhadhara inishuwarenzi yekurapa.
Kune zvigadzirwa zvekurapa zvine mazita akajairika akatogadzirwa, isu tinofanira kushingaira kusimudzira manejimendi ekubhadhara inishuwarenzi yekurapa kune zvekurapa zvinodyiwa zvinoenderana nemazita akajairika.Kune zvigadzirwa zvekurapa izvo zvisati zvagadzira zita rinowanzozivikanwa, iyo yazvino kupatsanurwa uye kodhi ichashandiswa panguva ino yekurapa inishuwarenzi yekubhadhara manejimendi.
Pfungwa yechishanu: "14th-Makore mashanu" nguva, kugadzwa kweiyo purovhinzi yakabatana yeinishuwarenzi yezvehutano consumables catalog.
Chiziviso chinoburitsa pachena kuti iyo yekuwana manejimendi yezvekurapa consumables catalog iri kufambira mberi zvishoma nezvishoma.Kurudzirai kugadzwa kwehurongwa hwekushandisa mune zvekurapa, "14th-Makore mashanu" nguva, inofanirwa kupedzwa zvinoenderana nemutemo wekuwana kusimudzira dunhu (matunhu anozvitonga, makanzuru ari pasi peHurumende yeCentral) akabatana ekutanga inishuwarenzi yekurapa yekurapa.
Panguva ino yakagadzira dhairekitori repurovhinzi yeinishuwarenzi yezvokurapa yakabatana yezvekurapa yedunhu, yakavakirwa kwenguva pfupi parudzi rweinishuwarenzi yezvokurapa yezvokurapa zvemhando uye kodhi, uye zvishoma nezvishoma kune inishuwarenzi yekurapa common name management shanduko.Parizvino haisati yagadzira dhairekitori rakabatana rezvokurapa redunhu kuti riwedzere kuedza kusvika ku "14th Five-Year Plan" nguva yekumisikidza dhairekitori rakabatana remishonga yekurapa.
Kuti utore generic manejimendi yezvinhu zvinodyiwa, nyika zvishoma nezvishoma ichagadzira yakabatana yenyika yeinishuwarenzi katalog, uye zvishoma nezvishoma kuwedzera chiyero chekatalogi yenyika inofukidzwa nechikamu chezvinodyiwa.
Pfungwa yechitanhatu: Gadzira shanduko inochinja uye ongorora mukana wekutaurirana wezvinhu zvinongoshandiswa chete.
Sekureva kweChiziviso, purovhinzi yega yega inofanirwa kuronga zvinodyiwa zvekurapa, zvekiriniki, manejimendi einishuwarenzi yehutano, kuongorora tekinoroji uye dzimwe nyanzvi uye masangano ane chekuita neindasitiri, kuburikidza neyakajairwa yekuongorora maitiro, zvinokodzera zvekurapa zvinoshandiswa mudhairekitori zvinoenderana nemaitiro, uye mhedzisiro yeongororo ichaziviswa kune veruzhinji nenguva.Kurudzirai kuiswa kwekutanga mukhathalogi yezvinhu zvakasarudzwa kubva mukutenga pakati pemabhendi anowirirana nemutemo wekubhadhara wazvino.Ongorora kuwanikwa kune zvakasarudzika kana zvemhando yepamusoro zvigadzirwa kuburikidza nekutaurirana uye nedzimwe nzira.
Mukuwedzera, inonzwika ine simba rekugadzirisa nzira inofanira kusimbiswa.Nyatsofunga kufambira mberi kwehunyanzvi hwekushandisa mukurapa, kushandiswa kwekiriniki, mutengo uye mwero wemitengo, uye kugona kwehomwe yeinishuwarenzi yekurapa uye vanhu vane inishuwarenzi, nezvimwewo, kuona shanduko ine simba yekupinda nekubuda.Kuzadzwa nenguva kwezvinodiwa zvigadzirwa zvetekinoroji, kubviswa kwekiriniki kunogona kutsiviwa zvirinani, kuongororwa kwakashata kwehupfumi, nemadhipatimendi akakodzera anosanganisirwa mune yakashata rondedzero uye zvimwe zvigadzirwa hazvienderane nezvinodiwa zveinishuwarenzi yekurapa.
Panguva imwecheteyo, kugadzwa kwenzira inonzwika yekudzivirira njodzi yekugadziriswa kwechikamu chekubhadhara kwemishonga yemishonga inishuwarenzi yekurapa, kuchengetedzwa kwehomwe, kurapwa kwevarwere kwenguva yakareba yekuverenga kwakaringana, kune njodzi dzinogona kuitika. kugadzirwa kwechirongwa, kunyanya chinosanganisira kuendeswa kwechikamu chekubhadhara kwemhando dzeimwe nzira kuita basa rakanaka rekuvimbisa kuchengetedzwa kwekodzero nezvido zvevarwere.
Pfungwa yechinomwe: Zvishoma nezvishoma kuenzanisa mutemo wekubhadhara mukati mepurovhinzi
Chiziviso chinonongedza kuti mutemo wekubhadhara unofanirwa kurongeka uye kugadziridzwa.Kurudzira mutemo wekubhadhara kuti uve wesainzi uye wakanatswa, uye zvishoma nezvishoma bvisa mutemo wekubhadhara wakashata unoenderana chete nechikamu chekubhadhara kwechikamu chemutengo, uye saizi imwe-inokodzera-yese quota kana muripo wekubhadhara.
Nzvimbo dzakarongeka dzinogona kufunga nezvezvinhu zvakadai sekukwanisa kwehomwe uye mutoro kune inshuwarisi, uye maererano nemamiriro chaiwo emamwe emutengo wepamusoro kana mutengo wezvigadzirwa zvemishonga kuti ugadzire chikamu chekutanga chekubhadhara kunze kwehomwe.Madhipatimendi einishuwarenzi yehutano emapurovhinzi anofanira kusimbisa kurongeka, zvishoma nezvishoma kudzikamisa mitemo yekubhadhara uye mwero wedziviriro wematunhu akabatana mukati mepurovhinzi, uye kukurudzira matunhu ane zvimiro kuti atange kubatana pamatunhu nekukurumidza.
Pfungwa yechisere: Kugadzwa kweDRG/DIP synergistic promotion mechanism
Kurudzira mitemo yekubhadhara nenzira yakatsiga uye yakarongeka.Kurudzirai mapurovhinzi kuti aongorore kuvandudzwa kwezviyero zvekubhadhara zvinodyiwa zveinishuwarenzi yekurapa uye kugadzirisa zvinochinja.Kuvandudza synergistic nzira pakati pekubhadhara zviyero uye pakati pemitengo yekutenga, uye tarisa zviyero zvekubhadhara zvezvigadzirwa zvakasarudzwa mu centralized band kutenga zvinoenderana nemirairo yakakodzera.Ongorora nhaurirano dzekuwana uye dzimwe nzira dzekuona zvine hungwaru zviyero zvekubhadhara kune zvimwe zvemutengo wepamusoro zvekurapa.Kune zvekushandisa pakurapa zvine basa rimwechete uye kushandiswa, zvinhu zvakafanana uye maitiro, kutsiva kwekiriniki, uye kusangana kwehutungamiriri hweinishuwarenzi yekurapa, zviyero zvekubhadhara zvakabatana zvinogona kuumbwa.
Synergize nzira yekubhadhara nzira.Kugadzira nzira yekusimudzira synergistic neDRG, DIP yekubhadhara nzira yekuvandudza uye mamwe marongero ekugadzira yakanaka stacking maitiro.Funga nezvehuwandu hwekubhadhara, chiyero chekubhadhara uye mutemo wekubhadhara wezvekushandisa mukurapa nenzira yakabatanidzwa, uye gadzirisa bhajeti rose uye mubhadharo wemhando yezvirwere / mapoka nenguva.
Pfungwa yepfumbamwe: izvi zvinoshandiswa zvinotarisa pakutarisa
Zvinoenderana neChiziviso, nzira yekutarisa uye yekuongorora yekubhadhara inishuwarenzi yekurapa inofanirwa kuumbwa.Mapurovhinzi anogara ari pamusoro peprovince yezvekurapa zvinodyiwa inishuwarenzi yehutano kuwana, kubhadhara mari yeinishuwarenzi yehutano, mutoro wevarwere, nezvimwe, pamwe nekutenga online, chiyero chekutenga online, nezvimwewo, kutarisa, nhamba, kuongorora, kutarisa kushandiswa kwekiriniki kweanopfuura mari yekushandisa uye mutoro wevarwere wezvekushandisa pakurapa kutarisa mutoro unorema.
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Nguva yekutumira: Sep-11-2023