将健康管理纳入基本医保的可行性及策略研究——基于纳入北京市医保的模式设计和策略分析

Study on the Feasibility and Strategy of Integrating Health Management into Basic Medical Insurance——Model Design and Strategy Analysis Based on Integrating into Beijing Basic Medical Insurance

随着慢性病高发和老龄化步伐的加快,"重治疗、轻预防"的传统医疗保险制度设计无法从源头上控制参保人的疾病风险,同时也加大了医保基金的财务风险。因此,我国传统医疗保障制度在长期内可逐渐转型为预防和治疗并重的健康保障制度。将健康管理纳入基本医疗保障体系,推动以事后补偿为中心的医疗保险制度逐步转变为以预防治疗为主的社会健康保险制度,有助于实现全民健康的目标,确保我国医疗保障制度的可持续发展。

With the high incidence of chronic diseases and the rapid population aging, this ＂superiority of treatment over prevention＇ system cannot control the disease risk from the origin and increase the financial risk of medical insurance fund at the source. Therefore, the traditional Chinese medical security system have transformed gradually to a health care system which focus on both treatment and prevention. By incorporating health management into the basic medical insurance system, and promoting compensation later in center of the medical insurance system into the social health insurance system aimed at prevention, this help to achieve the goal of the national health and can ensure the sustainable development of the medical insurance system of China.