我国新农合基金运行过程中的风险与对策研究.pptVIP

我国新农合基金运行过程中的风险与对策研究Research on Risks and Countermeasures of NRCMS’ Fund Operation in China 首都医科大学 Capital Medical University 高广颖 Guangying Gao 目录 outline 新农合运行基本情况 The general operation of NRCMS 新农合基金运行中的风险 The risks of NRCMS’s fund 新农合基金运行的对策与建议 The suggestions and countermeasures of NRCMS’ Fund 3.新农合基金使用率the rate of fund’s utilizing 二、新农合基金存在的风险和问题The problems and risks of the operation of NRCMS’s funds 主要的环节:Main stages of funds 基金的筹集:collection of funds 基金的存储:accumulating of funds 基金的支付:utilizing of funds （一）基金筹资阶段 fund collection stage 1.农民缴费基金不能及时进专户 the money paid by peasants was not be entered into the accounts of NRCMS fund in time; 2.县财政补助不及时，特别是贫困地区 the county level fiscal subsidies is not put in place timely, especially in poverty-areas 3.中央财政资金省内滞留 The national subsidies were stay in the sub-national fiscal sectors for a long time. 1、新农合资金并没有单独开设基金专户，专户不专 There was no separate special account for NRCMS fund 2.机构设置和岗位职责不合理 Constitution of NCMS institution and position duties of accountant were irrational 3.会计人员素质低，新农合基金不做账或做账不完整 Accountants were not professional enough，e.g. some of them do not keep accounts or keep accounts incompletely  （三）基金资金使用阶段fund utilizing stage 1.新农合基金不合理使用,参合农民出租出借新农合证，医患合谋： the fund was used unreasonably, e.g. enrolled peasants rented out or lent their NRCMS cards to others, and sometimes doctors and patients make a deal to cheat together; 2.参合农民套取新农合基金： enrolled peasants cheat NRCMS fund illegally; 3.门诊转住院 outpatients changed to be inpatients 4.定点医疗机构费用增长过快，导致补偿基金支出激增；the NRCMS reimbursement funds increase too fast due to the expenditure of contracted hospitals rising quickly 5.病人流向不合理，县域外病人流向明显增加，乡镇卫生院病人流向减少，导致大量资金外流；The patients’ floating was unreasonable, with the obvious increase of patients out of the county and the reduce of township health centers’ patients, which caused plenty of money float out of the area; 6.住院率增长过快。The increase of inpatient rate was too fast; 7.全国新农合基金超支明显。The NRCMS fund wa