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医保基金业财一体化管理实施路径探究

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目的:通过实现业财一体化促进医保业务流程优化,提高医保管理效率.方法:本文从业财一体化建设角度分析了医保业财分离的原因,探讨业财一体化实施路径.结论:我国医保管理体制和国家医疗保障信息平台的建立为实现医保业财一体化提供了有利条件.建议:医保部门应发挥管理体制优势,在优化内部管理机构、完善基本管理制度、规范医保管理行为的基础上,加强业务程序化、标准化建设,促进医保管理业财融合;分批规范医保基础管理业务,加快完善基本管理制度,分期推进医保信息化建设,逐步实现业财一体化.
Exploration of the Implementation Path of Integrated Management of Medical Insurance Fund Administration and Finance
Objective:The paper attempts to promote the optimization of medical insurance business process and improve the efficiency of medical insurance management by realizing the integration of administration and finance. Methods:This paper analyzes the reasons for the separation of administration and finance in medical insurance,and discusses the implementation path of the integration of administration and finance. Conclusion:The establishment of China's healthcare security management system and national healthcare security information platform provides favorable conditions for the integration of medical insurance administration and finance. Suggestions:The medical insurance departments should give full play to the advantages of the management system,strengthen the construction of business regularization and standardization,and promote the integration of medical insurance management administration and finance on the basis of optimizing the internal management organization,improving the basic management system,and standardizing the medical insurance management behavior. Also,they should standardize the basic management business of medical insurance in batches,accelerate the improvement of the basic management system,promote the construction of medical insurance informatization in stages,and gradually realize the integration of administration and finance.

medical insurance managementintegration of administration and financefinancial management

赵振东、吴菁、张琳

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洛阳市医疗保障局 洛阳 471600

燕山大学公共管理学院 秦皇岛 066000

《中国医疗保险》杂志社 北京 100037

医保管理 业财一体化 财务管理

2024

中国医疗保险
中国医疗保险研究会

中国医疗保险

影响因子:0.492
ISSN:1674-3830
年,卷(期):2024.(12)