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Point医保费用支付总额控制(或者叫医保费用支付总额预算)是医保部门与医疗机构磨合出的控制过度医疗、遏制医疗费用过快增长的有效措施。目前,总额控制有两种模式,一是对每家医院的总额控制,如某医院某年的医保支付控制总额是8000万元,那医保对该医院超过8000万元以上的部分将不予支付。二是对统筹区域内医疗费用的总额控制。假定在某省本级医保经办范围内,某年的医保支付控制总额是10亿元,
Point Medicare total payment control (or total Medicare payment total budget) is an effective measure taken by medical insurance departments and medical institutions to control over-medical care and curb excessive growth of medical expenses. At present, there are two modes for total amount control. One is total amount control for each hospital. For example, the total amount of medical insurance payment control in a certain hospital in a certain year is 80 million yuan, and the part of the medical insurance that exceeds 80 million yuan in the hospital will not be paid . Second, the total amount of medical expenses within the overall co-ordination control. Assuming that in a province-level medical insurance coverage, the total amount of medical insurance payment in a certain year is 1 billion yuan,