医疗保险资金管理模式研究:以A市为例

The research of health insurance fund management model:a case from A City

在全国几乎统一的管理模式下,A市经过多年探索和实践,建立了一套与全国其他地区不同的城镇医保资金管理模式。本文从A市医保资金管理模式形成、目前管理模式实施情况和各方对管理模式运行的评价与意见几方面对管理模式进行具体介绍。本文运用定性访谈方法重点对管理模式为什么形成,为什么能顺利运行,管理模式的优势和劣势进行了分析和讨论。本文认为应当挖掘A市的医疗保险资金管理模式的"精髓",切实建立一个多部门协调的平台。

After years of exploration and practice,A City establishes a health insurance fund management model which is different from other cities and towns in the context of unified management model in China. This paper mainly introduces the health insurance fund management model,the current management situation and the stakeholders＇ views about the management model. It employed the qualitative method to discuss why the management model formatted,why the management model operated smoothly,the strengths and weaknesses of the management model. The paper recommends that to learn from the city health insurance fund management model＇s essence,and to build a platform of multi-sectoral coordination.