基本医保支付方式内在逻辑关系与改革路径选择

The Internal Logical Relationship and the Reform Methods' Selection of Basic Medical Insurance Payment

基本医保支付方式改革是整个医药卫生体制改革的重要组成部分。我国已经形成了以总额预算管理和约束为基础,多元支付方式协同共治的基本医保支付格局,不同的支付方式之间形成了从粗放型管理到精细化管理的内在逻辑关系演进。文章首先分析了我国基本医保支付方式改革的基础,其次分析了各医保支付方式的内在逻辑关系,最后分析了基本医保支付方式改革的路径选择,并对我国基本医保支付方式改革的前景进行了展望。

Basic medical insurance payment reform has been operating simultaneously as a significant component of the reform of health care. The basic medical insurance payment pattern of global total budget based and multivariate provider payment worked has formed in our nation. There is a trend among provider payments of evolving from extensive management to sophisticated management. This paper analyzes the basis of the basic medical insurance payment mode reform in China firstly, then analyzes the internal logical relationship between medical insurance payment methods, and finally analyzes the path choice of the reform of basic medical insurance payment mode, and shows the prospect of the reform of the basic medical insurance payment mode in our country.