Reduce the contribution rate of medical insurance units for employees. Nanjing reduced the burden on employers by 2.77 billion yuan this year.

Reduce the contribution rate of employees' medical insurance insured units, promote the reform of DRG (disease diagnosis related grouping) payment methods, and adjust the prices of some medical services ... Since 2022, Nanjing has introduced a series of medical security reform measures, which will bring benefits to enterprises and individuals? On March 3, the Nanjing Municipal Party Committee and Municipal Government held a press conference to inform the relevant situation. Modern Express reporter learned from the press conference that Nanjing will reduce the contribution rate of employees' medical insurance units from 9.8% to 8.8% (including maternity insurance contribution rate of 0.8%), and it is estimated that the burden of employers in the city will be reduced by 2.77 billion yuan in 2022.

△ Meeting site

In order to reduce the burden on enterprises, the contribution rate of employees' medical insurance units decreased from 9.8% to 8.8%.

The construction of business environment should reduce costs for the real economy, increase vitality for market players and accumulate stamina for innovation and development. Diao Renchang, Party Secretary, Director and First Class Inspector of medical insurance bureau, Nanjing, introduced at the meeting that medical insurance bureau, Nanjing, together with the Municipal Finance Bureau and the Municipal Taxation Bureau, issued the Notice on Reducing the Payment Rate of Employees' Basic Medical Insurance Units and Other Related Matters. This has brought many benefits to enterprises and individuals.

Reduce the contribution rate of medical insurance units for employees. From June 5438+ 10, 2022, the unit contribution rate of all employers participating in Nanjing employee medical insurance, including various enterprises, social organizations, private non-enterprises and individual industrial and commercial households, decreased by 1 percentage point, from 9.8% to 8.8% (including maternity insurance contribution rate of 0.8%).

Reduce the contribution rate of flexible employees. From July 2022, the contribution rate of flexible employees to employee medical insurance in Nanjing will be reduced by 1 percentage point on the basis of the sum of the contribution rate of employees' medical insurance units and the contribution rate of individuals, and will be adjusted from 1 1% to 9%. From June to June, 2022, the payment standard for flexible employees to participate in medical insurance is 380 yuan/month (including medical assistance for serious illness 10 yuan/month).

Clarify the upper and lower limits of the salary base for employees' medical insurance contributions. In 2022, the minimum wage base of medical insurance and maternity insurance for employees in Nanjing is 4250 yuan, and the upper limit is 2 182 1 yuan.

Yan Renchang introduced that reducing the contribution rate of employees' medical insurance units has three characteristics. First, the policy is more lasting. Different from the stage of rate adjustment during the epidemic, this adjustment is a long-term and continuous institutional arrangement. Second, more powerful. It is estimated that in 2022, the burden of employers in the city will be reduced by 2.77 billion yuan, accounting for 13% of the annual income of the employee medical insurance pooling fund compared with 202 1. Third, the benefits are wider. It benefited 265,438+10,000 insured units and 3.4 million payers in the city, and simultaneously reduced the contribution rate of flexible employees, benefiting more than 500,000 people.

The reform of DRG payment method was formally implemented, and the average hospitalization expenses of insured patients decreased 13.42% year-on-year.

On June 65438+1 October1day, 2022, Nanjing officially implemented the reform of DRG payment method. Judging from the situation of 5438+ 10 June, the operation process was smooth and orderly.

The effect of fee control has initially appeared. The hospitalization expenses of 98 participating medical institutions in the city decreased by 6.87% year-on-year, and the total payment of medical insurance fund decreased by 9.8 1% year-on-year.

The patient's burden is lightened. The average hospitalization expenses of insured patients decreased 13.42% year-on-year. According to the reimbursement rate of basic medical insurance, the personal burden of patients decreased by 650 yuan/time.

The monthly payment settlement has been significantly accelerated. We will speed up the uploading of medical records, grouping of cases, settlement of expenses and disbursement of funds, and complete the settlement about 7 days before the reform to support the development of medical institutions.

Support the inheritance and development of traditional Chinese medicine. It is the first in the country to define 5 1 DRG disease group with China characteristics, which inclines to support Chinese medicine in the number of disease groups.

Promote the development of graded diagnosis and treatment. Determine 36 basic disease groups, adapt to the requirements of grading diagnosis and treatment reform, and guide inpatients with common diseases, frequently-occurring diseases and difficult diseases to secondary medical institutions with conditions. For example, in Pukou Central Hospital, the number of inpatients in the basic disease group increased by 33 cases in June 438+ 10, an increase of1%.

Promote the improvement of hospital management level. In Nanjing "Medical Insurance High-speed Railway" mobile phone cloud platform, the DRG regional module was opened, which dynamically displayed more than 20 DRG reform-related indicators such as grouping, payment, efficiency and ranking of medical institutions according to different dimensions such as management level, institution level and time span, providing a powerful tool for promoting the integration of medical insurance management and hospital management.

* * * Adjust the price of 76 clinical diagnosis and treatment items, involving 5 specialties.

20 19 Since the establishment of Nanjing Medical Insurance Bureau, the management reform of drugs and medical consumables has been further promoted, the national and provincial centralized procurement achievements have been implemented, the municipal negotiation mode has been innovated, and the governance pattern of fast circulation, reasonable price and standardized use has been promoted. By the end of 20021,Nanjing had saved nearly 5 billion yuan in the procurement cost of drugs and consumables, and the leading group for deepening the reform of medical and health system in the State Council affirmed the effectiveness of Nanjing's reform.

In accordance with the requirements of the country, province and city to deepen the reform of medical security system, Nanjing has promoted the optimization of medical service price structure in an orderly manner. This adjustment is a unified medical service price adjustment in the province, and the adjustment project is closely related to the centralized procurement of pharmaceutical consumables in recent years.

Based on the principle of ensuring the affordability of the medical insurance fund and the overall burden of the masses, Nanjing adjusted the prices of 76 clinical diagnosis and treatment items, involving 5 specialties, including 9 orthopedics, 20 general surgery, neurosurgery 15, cardiothoracic surgery 12 and 20 obstetrics and gynecology. We adjusted and focused on the service items with great technical difficulties and high risks, including 68 surgical items of Grade III and above, accounting for 89.5%, which truly reflected the value of technical services of medical staff. The medical insurance payment category of 65 projects is Class A, which is fully borne by the medical insurance fund, accounting for 85.5%. At the same time, this adjustment involves seven maternity insurance payment items, simultaneously adjusts the maternity insurance treatment level of insured persons, raises the upper limit of full payment of maternity insurance for employees, and increases the proportion of fund payment of tertiary medical institutions to ensure that the personal burden of childbearing age population is basically not increased.