从治理现代化视角推进医院医保管理——“完善医院医保管理研讨会”观点综述

Promoting Medical Insurance Management in Hospitals from the Perspective of Governance Modernization——A Summary of the Seminar on Improving the Management of Hospital Medical Insurance

医院医保管理体系是新型基本医保制度改革的产物,并随着医保制度的改革发展而不断发展壮大,已成为医疗机构与医保经办机构加强联系的纽带。完善医院医保管理,需从治理现代化视角,明确医院医保办的职能定位,科学配置医保办的专业人员,为医院医保管理人员的职业发展创造良好条件。同时,还应将医院医保管理研究与公立医院管理体制改革、医保制度改革发展、医保经办服务体系建设等联系起来,打破仅从医院内部管理来研究医保管理的局限。

The hospital medical insurance management system is the product of the reform of the new basic medical insurance system.With the reform and development of the medical insurance system,the system has been growing,and has become a link between medical institutions and medical insurance agencies.From the perspective of governance modernization,we should clearly defi ne the functional orientation of medical insurance institutions in hospitals and scientifi cally deploy professionals.At the same time,the research of hospital medical insurance management should be connected with the reform of the public hospital management system and the reform and development of the medical insurance system,so as to break the limitations of the study of the medical insurance management only from the internal management of the hospital.