基层经办管理机构能力建设的治本之道——基于北京市朝阳区医保中心的实践探索

The Fundamental Solution in the Capacity Building of the Grass-roots Management Agencies——Practice Exploration Based on Beijing Chaoyang District Medical Insurance Center

北京市朝阳区医保中心在提升经办管理能力、加强队伍建设中,首先抓好领导班子建设;作为首都的一个基层经办机构,把做好经办服务工作与讲政治、讲大局、讲首都意识紧密联系起来;把党风廉政建设责任制引入基金风险防控体系和队伍的专业化建设中,充分发挥党员的先锋模范作用;建立比较完善的基金风险防控的组织体系、制度体系和监督检查体系,用制度规范经办行为,等等。这些都是提升经办能力的治本之道。朝阳区医保中心经办服务的满意度达到95%,是坚守治本之道取得的成果。医保医师制度的率先建立、"双随机一公开"医疗费用审核机制的创新、对全区43个街道(乡镇)实行单元网格式服务,引入第三方评价经办服务,等等,这些创新举措说明朝阳区医保中心实现了坚守与创新的统一。

In the process of promotion handling management ability and strengthening the team building, Chaoyang District Medical Insurance Management Center begins with the construction of leading team. As a grass-roots management agency in the capital, the Center closely links up the service ability with the politics, the overall situation and the capital consciousness. At the same time, the Center emphasizes giving full play to the exemplary role of Party members. The Center has also established a relatively perfect system to regulate the handling behavior, such as fund risk prevention and control system, supervision and inspection system,etc.. These all are the fundamental solutions to promoting the handling capacity. The satisfaction level of service of the Center has reached 95%. The Center has established medical insurance physician system, innovated the medical expense audit mechanism, and introduced third party evaluation service,etc..These innovative measures show that the Chaoyang District Medical Insurance Management Center has achieved the unity of insistence and innovation.