医保支付制度改革的“浙江范式”  

The"Zhejiang Paradigm"of Medical Insurance Payment System

作　　者：徐伟伟 胡振产 XU Wei-wei;HU Zhen-chan(Zhejiang Medical Security Bureau,Hangzhou Zhejiang 310005,China)

机构地区：[1]浙江省医疗保障局,浙江杭州310005

出　　处：《卫生经济研究》2021年第12期3-6,10,共5页

摘　　要：浙江省医疗保障系统紧紧围绕“共同富裕示范区”建设战略定位,立足“三医联动”“六医统筹”和战略性购买新起点,2019年启动新一轮医保支付制度改革,探索建立总额预算管理下的多元复合式医保支付体系。2020年,着力建设赋能医保,率先以省为单位全面推行住院医疗费用按疾病诊断相关分组(DRG)点数支付,激发供方自主控费内生动力,促进医疗、医保、医药“三医联动”,实现政府、医院、患者、市场等多方共赢,创建了医保DRG支付方式改革“浙江范式”,为国家层面医保支付制度改革提供了浙江经验。Zhejiang Province's medical security system is closely focused on the strategic positioning of"common prosperity demonstration area",based on the"medical-insurance-medicine linkage","six medical coordination"and a new starting point for strategic purchases,a new round of medical insurance payment system reform is launched since 2019,and explore to establish a diversified compound medical insurance payment system under the total budget management.In 2020,we will focus on building empowered medical insurance,and taking the lead on implement payment of hospitalization medical expenses according to diagnosis-related groups(DRG)by nationwide with the province as the unit,in order to stimulate the endogenous motivation of suppliers to independently control costs,and promote medical insurance,and medicine to form the"three-medicine linkage",achieve a win-win situation for the government,hospitals,patients,the market,and etc.,create the"Zhejiang Paradigm"for the medical insurance DRG payment reform,and provide Zhejiang experience for the national medical insurance payment system reform.

关 键 词：医保支付制度改革 总额预算 DRG点数支付 浙江 

分 类 号：R197[医药卫生—卫生事业管理]