总额预付制度下加强医院医保往来款管理的对策

Countermeasures for Strengthening the Account Management of Hospital Medical Insurance under Total Prepaid Payment System

医保付费制度的改革是医药卫生体制改革的一项重要内容,总额预付制度的推行改变了医保资金原有的管理模式,对医院医保往来款管理提出了新要求。文章分析了总额预付制度对医院医保往来款管理的影响,并具体从岗位设置、对账机制、细化核算、预警机制、沟通反馈、加强考评六个方面提出了管理对策。

Medical insurance payment system reform was important content of medical and health system reform.The implementa-tion of total prepaid system had changed the original medical insurance funds management,which proposed new demand for hospitalmedical insurance funding management.It analyzed the impact of the total prepaid system for hospital insurance account manage-ment,and specifically proposed management countermeasures from the aspects of job settings,reconciliation mechanism,detailedaccounting,early warning mechanisms,communication and feedback and strengthening evaluation.