医保经办管理与时俱进的几点意见——基于建立“四更”全民医保推进健康中国建设的思考

Several Points of View on the Management of Medical Insurance——Based on the Establishment of "Four More" National Health Insurance to Promote the Construction of Health China

医疗保险经办管理在建设全民医保,推进健康中国建设中肩负着贯彻落实党和政府的决策部署、制度政策的重大使命,发挥着基本保障、筹资、推进支付改革和创新管理等重要作用。当前,经办管理面临着医疗需求旺盛,医疗费用快速上涨,医保基金收入增速下降,经办能力、服务水平、监管措施有待提高等方面的严峻挑战;经办管理任重道远,需要加快推进城乡基本医保整合经办管理工作,基本医保全国联网和异地就医结算工作,加强医疗服务管理,全面提升医保经办管理服务质量和效率。

Medical insurance management carries a great mission to implement government’s policies and deployment in building National Health Insurance and promoting the achievement of Health China. It also plays important roles in basic security, fund raising, and promoting payment reform and innovating management. Currently, medical insurance management is facing the challenges of prosperous medical service demands, fast medical cost increasing, rapid medical insurance fund decreasing, and inability in medical insurance management, service and supervision measure. Medical insurance management has a long way to go. We should accelerate the integrating management of urban and rural basic medical insurance, nationwide network of basic insurance, and remote insurance settlement, and intensify medical service management, to comprehensively increase the quality and e？ciency of medical insurance management.