以健康管理为突破口 深化医保支付制度改革

Deepening health insurance payment system reform with health management as the breakthrough point

基本医疗保险支付方式是医保制度的核心组成部分。目前国内现行医保基金支付制度并未将健康管理支出纳入支付范围,仍以医疗管理模式运营,与"预防为主""防范于未然"等疾病防治理念相悖,也不符合经济发展和人民群众健康需求。通过分析健康管理和医保基金支付方式的现状,提出突破限制,将健康管理纳入医保支付的改革观点,并以较充分的证据论证了这种改革的必要性和可行性,进一步优化医保供给侧服务,全面实现医保制度保障人民健康的初心。

The basic medical insurance payment method is the core component of the medical insurance system.However,the current medical insurance fund payment system in China,health management expenditure is not involved into the payment scope.Medical insurance system still focuses on medical treatment which is contrary to the idea of prevention first and does not match the economic development and people's health needs as well.Through analysis the current situation of health management and the payment mode of medical insurance fund,this paper puts forward a reform viewpoint to break through the restrictions and involve health management into the medical insurance payment scope according to the necessity and feasibility analysis to further optimize supply side and promote people’s health.