市级统筹下的医保基金总额预算和控费管理实践  

Practice of Total Budget and Cost Control Management of Medical Insurance Fund at Municipal Level

作　　者：卢金奇 夏颖 LU Jin-qi;XIA Ying(Medical Security Bureau of Zhejiang Zhoushan,Zhoushan Zhejiang 316021,China)

机构地区：[1]浙江省舟山市医疗保障局,浙江舟山316021

出　　处：《卫生经济研究》2021年第12期44-46,共3页

摘　　要：介绍浙江省舟山市在“省管县”财政体制下实施全市统一的医保基金总额预算和控费管理的做法及成效,在此基础上提出建议,包括实施门诊统筹,加强资源整合,建立智能监管预警系统,完善绩效评估体系等,为市级统筹下实行医保基金总额预算管理提供有益经验。This paper introduces the practice and effect of implementing the city-wide unified total budget and cost control management of medical insurance fund in Zhejiang Zhoushan under the financial system of"province governing county".On this basis,some suggestions are put forward,including implementing outpatient pooling and strengthening resources integration,establishing an intelligent supervision and early warning system,and improving the performance evaluation system,so as to provide useful experience for implementing the total budget management of medical insurance funds at municipal level.

关 键 词：市级统筹 医保基金 总额预算 控费管理 

分 类 号：F840.684[经济管理—保险]