2013-2015年，濮阳市本级职工医保出现了住院医疗费用、慢性病门诊费用、异地就医医疗费用、退休人员医疗费用全面上涨的风险，但医保基金运行依然实现了总体持续平衡、略有结余的管理目标。其中，起付标准、报销比例、支付限额“三条线”的合理设置发挥了关键性作用。建立收支平衡的基金管理机制，需要在扩大增量与激活存量、正确处理异地就医与本地就医、加强医保管理等方面下功夫。%During the year of 2013-2015, there was risk in overall increasing of expenses in hospitalization, outpatient treatment for chronic disease, remote health care, and health care for retired employees. But the health insurance fund still achieved a goal of overall balance with a slight profit. In them, the reasonable setting of "three lines", i.e., -the payment standard, the reimbursement ratio, the payment limitation-has played the key role. We have made efforts on establishing a fund management mechanism to balance the income and expenditure by extending increments and activating stocks, properly handling remote medical treatment and local medical treatment, and strengthening the management of medical insurance.
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