国内外互联网医疗服务定价与医保支付政策对比分析  

Comparative analysis of domestic and foreign Internet medical service pricing and medical insurance payment policies

作　　者：丁甜甜 钱爱兵 谈在祥 DING Tiantian;QIAN Aibing;TAN Zaixiang(School of Health and Economics Management,Nanjing University of Chinese Medicine,Nanjing,Jiangsu Province,210023,PRC)

机构地区：[1]南京中医药大学卫生经济管理学院,江苏省南京市210023 [2]徐州医科大学附属医院,江苏省徐州市221006

出　　处：《中国医院》2022年第9期10-13,共4页Chinese Hospitals

基　　金：国家社科基金一般项目(20BTQ053)。

摘　　要：阐述国内互联网医疗发展的政策支持基础、互联网医疗服务价格政策沿革与现状,分析互联网医疗医保支付存在的问题。介绍美国在互联网医疗服务定价及医保支付领域的主要做法和经验。在此基础上,提出明确互联网医疗服务项目及定价机制、完善互联网医疗服务医保报销范围及模式、优化老年人的慢性病医疗保险制度、健全外部支持体系,加强监管能力的建议,以期为互联网医疗保险服务及互联网医疗服务发展提供决策支持。Explains the policy support basis for the development of Internet healthcare in China,the evolution and current status of the policy on the pricing of Internet healthcare services,and analyses the problems in the payment of Internet healthcare health insurance.The main practices and experiences of the United States in the field of pricing and medical insurance payment for Internet medical services are introduced.On this basis,recommendations are made to clarify the Internet medical service items and pricing mechanism,improve the scope and mode of medical insurance reimbursement for Internet medical services,optimize the chronic disease medical insurance system for the elderly,improve the external support system and strengthen the regulatory capacity,with a view to providing decision-making support for the development of Internet medical insurance services and Internet medical services.

关 键 词：互联网医疗 医疗服务 价格制定 医疗保险支付 

分 类 号：R197.3[医药卫生—卫生事业管理]