中新网8月1日电 据国家医保局官方微信消息，今年上半年，全国跨省异地就医直接结算运行基本平稳，惠及参保群众1.08亿人次，减少资金垫付918.53亿元，较2023年同期分别增长了124.69%、32.88%。这一成绩的取得，得益于国家医保局不断推进医保信息化建设，优化异地就医结算流程，以及扩大定点医药机构网络。
截至今年二季度末，全国跨省联网定点医药机构数量达61.34万家，较2023年底增长11.45%。其中，住院定点医疗机构8.06万家，普通门诊定点医疗机构21.40万家，门诊慢特病定点医疗机构6.60万家，定点零售药店39.61万家。这一数字的增加，意味着更多的医疗机构和药店能够为异地就医的参保群众提供直接结算服务，极大地方便了参保人员。
今年上半年，全国跨省异地就医直接结算1.08亿人次，较2023年同期增长124.69%。其中，门诊结算1.01亿人次，住院结算687.24万人次。直接结算的便捷性，减少了参保群众垫付资金的压力，据统计，上半年全国跨省异地就医直接结算为参保群众减少资金垫付918.53亿元，较2023年同期增长32.88%。其中，门诊结算涉及资金162.90亿元，住院结算涉及资金755.63亿元。
国家医保局表示，将继续完善异地就医直接结算政策，提升服务效率，让更多的参保群众享受到更加便捷的医保服务。同时，也将加强监管，确保异地就医直接结算的规范运行，保障参保群众的权益。随着医保信息化建设的不断推进，未来异地就医直接结算的覆盖面和便利性将得到进一步提升，为参保群众提供更加优质的医疗保障服务。
英语如下：
News Title: “Over 100 Million Cross-Province Medical Visits Directly Settled in the First Half of the Year”
Keywords: Cross-Province Settlement, Growth, Medical Insurance Administration
News Content:
BEIJING, Aug. 1 (Xinhua) — According to official WeChat news from the National Medical Insurance Administration, in the first half of this year, the operation of cross-provincial direct medical settlement has been relatively stable, benefiting 108 million participants, reducing the need for upfront payment by 91.853 billion yuan, representing increases of 124.69% and 32.88% compared to the same period last year, respectively. This achievement is attributed to the continuous promotion of medical insurance informatization by the National Medical Insurance Administration, the optimization of cross-provincial medical settlement procedures, and the expansion of the network of designated medical and pharmaceutical institutions.
As of the end of the second quarter of this year, the number of cross-provincial online designated medical and pharmaceutical institutions reached 6.134 million, an increase of 11.45% from the end of 2023. Among them, there are 806,000 designated hospitals for inpatient care, 2.14 million designated medical institutions for general outpatient care, 660,000 designated medical institutions for outpatient care for chronic and special diseases, and 3.961 million designated retail pharmacies. The increase in this number means that more medical institutions and pharmacies can provide direct settlement services to cross-provincial medical participants, greatly facilitating the insured.
In the first half of this year, cross-provincial direct medical settlement reached 108 million visits, an increase of 124.69% compared to the same period last year. Among them, outpatient settlement reached 101 million visits, and inpatient settlement reached 6.8724 million visits. The convenience of direct settlement has reduced the pressure on participants to make upfront payments. According to statistics, cross-provincial direct medical settlement in the first half of this year has reduced the need for upfront payment by 91.853 billion yuan for participants, an increase of 32.88% compared to the same period last year. Among them, outpatient settlement involved 16.29 billion yuan, and inpatient settlement involved 75.563 billion yuan.
The National Medical Insurance Administration stated that it will continue to improve cross-provincial direct medical settlement policies, enhance service efficiency, and enable more participants to enjoy more convenient medical insurance services. At the same time, it will strengthen regulation to ensure the standardized operation of cross-provincial direct medical settlement and safeguard the rights and interests of participants. With the continuous advancement of medical insurance informatization, the coverage and convenience of cross-provincial direct medical settlement will be further improved in the future, providing participants with higher-quality medical security services.
【来源】http://www.chinanews.com/life/2024/08-01/10261533.shtml
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