基本医疗保险绩效管理:理念、目标与策略的思考

The Performance Management of the Basic Medical Insurance:Policy Idea,Goals and Strategy

基本医疗保险绩效管理的核心在于实现"人人享有基本医疗"的政策目标。由于对"基本医疗"认识的分歧和难界定导致了医保管理实践中政策的不可操作性。进而使得政策执行过程和行为缺乏控制,面临着政策目标偏移和保险"小农意识"的政策陷阱,严重影响了基本医疗保险制度的绩效。因此,应该从政策理念、制度设计、过程管理和激励机制四方面来进行系统改革。

The core of the performance management in basic medical insurance is to achieve the policy objectives that ＂Everyone will have access to basic medical and health services＂. Because of the differences understand and difficult to define ＂basic health＂ , it led to Medicare policy not operational in management practices .Thereby making the process of policy implementation and behavior are lack of control, faced with the policy trap that the objectives offset in insurance policy and the ＂petty-farmer consciousness＂, seriously affected the performance of basic medical insurance system. Therefore, we should do the system reform in four areas from the policy concept system design process management and incentives.