大病保险转外就医风险管理实证分析——以江苏省海门市为例

Empirical Analysis on Risk Management of Serious Illness Insurance for Out-of-town Medical Treatment

转外就医管理是大病保险业务风险管控的重要环节,是保障医保基金安全、提升基金使用效率的重要手段。本文通过对大病保险异地转诊风险的实证分析,对管理制度、管理方法和举措分析评鉴,提出了多管齐下探索转外就医风险管控的新模式。

Management on insurance, it also plays an important empirical analysis on serious illness endemic medical treatment is a critical part oi controlling role in guarantee the funds＇ safety and improve the efficiency. Along with insurance for out-of-town medical system, methodology and related acts, and proposed a new model of risk for out-of-town medical treatment with multiple measures. treatment, we evaluated the managerial management of serious illness insurance