二级医院医疗保险精益管理与环节控制探讨

Lean Management and Process Control of Medical Insurance for the Secondary Hospital

要提高医院医疗保险管理水平、降低医疗成本,可引入精益管理和环节控制管理模式来做好医保基金的合理使用。阐述了二级医院通过医疗保险管理制度和政策宣教、医保定额精益管理、信息化立体网监管控制、医疗保险管理成效与考核评价体系、医疗保险基金监管与稽核、创新医疗保险环节控制等多方面齐头并进措施,将医院医疗保险工作提升到新的管理和服务高地。

The aim of promoting medical insurance management level and lowing medical cost can be achieved by introducing lean management and process control mode for a reasonable utilization of the medical insurance funds.This article discussed about measures like propaganda of medical insurance regulation and policies,lean management of medical quota expense,informative network supervision,performance appraisal system for medical insurance management,supervision and audit of medical insurance funds and innovative process control carried out in secondary level hospital synchronously.And all these measures help to promote the management and service of medical insurance in hospital into a higher level.