四中全会精神在基层丨医保结算：从按月结到按日付

Core Insights - Zhengzhou has implemented a groundbreaking medical insurance fund instant settlement reform, significantly reducing the reimbursement time from an average of 30 days to just 1 day, enhancing cash flow for hospitals [1][2] - The reform integrates the settlement process into a streamlined "instant acceptance and approval" model, eliminating previous steps and improving efficiency [2] - A new intelligent reconciliation platform has been launched, facilitating real-time data synchronization between medical institutions and insurance agencies, thus ensuring accurate and timely fund allocation [2][3] Group 1 - The instant settlement reform was initiated by Zhengzhou Medical Insurance Bureau, making it the first in the country to adopt such a system [2] - The previous "post-payment" model placed a heavy financial burden on medical institutions, leading to slow fund circulation [2] - The new process includes a scientific mechanism to ensure fund security while enhancing efficiency, with 70% of inpatient expenses being audited and paid promptly [2] Group 2 - Since the system's launch on January 15, over 251 designated medical institutions have participated, completing more than 27,000 settlements and disbursing a total of 11.792 billion yuan [3] - The initiative aligns with national goals to improve the coordination of medical, insurance, and pharmaceutical services, aiming for further reforms such as direct and synchronous settlements [3]