医保分肥与监管体制的变革  

Divide Booty of Medical Insurance Fund and Reform the Supervision System

作　　者：张功震[1] 

机构地区：[1]新乡医学院社科部新乡医学院人文社会医学研究中心,河南新乡453003

出　　处：《中国卫生事业管理》2017年第3期169-171,共3页Chinese Health Service Management

基　　金：2016年度河南省软科学研究项目"城市公立医院协同补偿机制研究"(编号:162400410461)

摘　　要：目的:为减少医保套保事件,保障基金安全提供建议。方法:归纳分析法、文献分析法和描述分析法。结果:医保基金套保的主要原因是医患合谋的败德行为,医保基金监管手段的滞后和支付方式的缺陷。结论:在医保监管体制的变革中,应增加医保部门的监管动力,增强医保部门的监管实力,变革医保部门的监管手段,更新医保部门的支付方式。Objective In order to ensure the security of the fund,this paper provides some suggestions to reduce the events of cheating medical insurance fund. Methods Inductive research,literature research and descriptive research were used. Resuhs The main reasons were moral hazard behavior of doctor-patient collusion,the lagging of supervisory means, and the defects of payment methods. Conclusion We should reform the medical insurance supervision system with increasing the power of supervision, strengthening the supervision, changing the supervisory means and updating the payment methods.

关 键 词：医疗保险基金 监管体制 监管手段 支付方式 

分 类 号：R197.1[医药卫生—卫生事业管理]