医保支付方式改革对医院财务管理的影响及对策  

The Effect of Medicare Payment Reform on Hospital Financial Management and the Related Countermeasures

作　　者：符文[1] 钟波[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院,湖北武汉430030

出　　处：《中国社会医学杂志》2015年第6期424-426,共3页Chinese Journal of Social Medicine

基　　金：财政部重点科研课题项目(2013X2 2013001)

摘　　要：医保支付方式改革用"预付制"代替"后付制",提高了服务效率,方便了参保患者,但在实施的过程中必然会出现一些新问题、新矛盾,如医院应收账款(包括应收省医疗保险款、应收新农合医疗保险款)不能及时收回、医院与医保信息不对等、医院无法全额回款等,增大了医院财政压力。结合医院实际情况,提出了医保部门和医院应对医保支付方式改革的思考、对策与建议,力求寻找解决办法,探讨如何建立良性循环,让医保支付方式改革真正实现医院与医保双方的双赢,实现医院、医保、患者之间的三方共赢。Instead ＂ Prepaid Medicare Payment System＂ with ＂ Post-pay Medicare Payment System＂ could improve service efficiency and bring convenience to the insured patients,but inevitably new problem and new contradictions would appear in the process of implementation,such as hospital accounts receivable（accounts of provincial health insurance,accounts of NCMS）could not be retracted,information asymmetry existed between hospital and medical insurance,and the funds of hospital cannot be full reclaimed,etc,which would increase the pressure of hospital finance.In this regard,this article based on the actual situation,proposed the thoughts,strategies and suggestions for medicare departments and hospitals in response to medicare payment reform,and strived to find solutions,explored how to create a virtuous circle and achieve three wins of hospitals,medicare and patients.

关 键 词：医保支付方式 改革 医疗收入 思考与对策 

分 类 号：R197.32[医药卫生—卫生事业管理]