新型农村合作医疗运行风险及其防范监控机制

Construction Of New Rural Cooperative Medical Care System Operational Risks Preventing And Monitoring Mechanism

在新型农村合作医疗制度由试点普及向规范持续运行转轨的关键时期,解决医疗服务机构、参合农民、医疗保险机构、政府间的逆选择、道德风险及基金运行风险是合作医疗风险防范监管的核心。可以通过优化管理模式、健全管理机制,强化行政组织监督、社会监督、职能监督机制,健全风险防范的监督管理机制;同时通过基金风险预警机制、医疗服务费用控制、参合农民风险控制,实现风险防范的激励约束机制。

In the crucial period of transition from the experimental to the standard movement of the new rural cooperative medical care system, Solve the adverse selection, moral hazard and funds risk which between the medical service agencies, the farmers, health insurance agencies, are the cooperative medical treatment risk guard supervising and managing cores. May through the optimized management pattern, the perfect management mechanism, the strengthened administration organize the inspector general, the society to su- pervise, the function surveillance mechanism, perfect risk guard management by supervision mechanism. Meanwhile through the fund risk early warning mechanism, the medical service expense control, the senate gathers the farmer risk control, realizes the excitation restraint mechanism that risk keeps watch.