成渝地区双城经济圈建设背景下优化医保跨省异地结算路径研究
Research on Optimizing Cross-Provincial Settlement Path of Health Insurance in the Context of the Construction of Shuangcheng District Economic Circle in Chengdu and Chongqing

深化基本医疗保险跨省异地就医直接结算改革是推进社会医疗保险制度改革的重要内容，党的二十大报告指出，要“深化医药卫生体制改革，促进医保、医疗、医药协同发展和治理，促进优质医疗资源扩容和区域均衡布局”。成渝地区双城经济圈建设是习近平总书记亲自谋划、亲自部署、亲自推动的国家重大区域发展战略，医保跨省结算作为“双圈建设”的重要内容，对推进川渝医保战略合作、提升两地医保服务共建共享水平和减轻参保人经济压力具有十分重要的意义。本文从优化两地医保跨省结算路径的角度出发，简要分析了“双圈”内医保异地结算的现状和问题，并从优化备案流程、完善统筹沟通协调机制等方面提出针对性建议。
To deepen the reform of basic medical insurance and direct payment for medical treatment across provinces is an important part of promoting the reform of social medical insurance system. The report of the 20th National Congress of the Communist Party of China pointed out that we should “deepen the reform of the medical and health system, promote the coordinated development and governance of medical insurance, medical treatment and medicine, and promote the expansion of quality medical resources and the balanced distribution of regional distribution”. The construction of the Chengdu-Chongqing Twin Cities Economic Circle is a major national regional development strategy personally planned, deployed and promoted by General Secretary Xi Jinping, and the cross-provincial settlement of medical insurance, as an important element of the “Twin Circles Construction”, is of great significance in promoting the strategic cooperation between Sichuan and Chongqing in medical insurance, enhancing the level of shared medical insurance services between the two places, and alleviating the economic pressures on the insured. From the perspective of optimizing the inter-provincial settlement path of medical insurance in the two places, this paper briefly analyzes the current situation and problems of the remote settlement of medical insurance in the “double circle”, and puts forward specific suggestions from the aspects of optimizing the filing process and improving the overall planning, communication and coordination mechanism.