发挥医保支付对医生职业行为激励作用的探讨

An Exploratory Discussion on Incentive Effect of Medical Insurance Payment on Doctors’ Professional Conducts

目前医保支付制度改革推进过程中面临一些问题和挑战,但并不影响其作为调节医疗服务行为、引导医疗资源配置重要杠杆的角色定位。要实现“医生完美代理人”目标,需要全面推进以病种为主的多元复合式医保支付方式改革,还需要医保支付与价格政策协同,与医院收入结构调整挂钩,建立与之相匹配的基金监管模式。

At present,the reform of medical insurance payment system faces some problems and challenges,but it does not affect its role as an important lever to regulate medical service behavior and guide the allocation of medical resources.To achieve the goal of “doctors’ perfect agent”,it is necessary to comprehensively promote the reform of multiple and compound medical insurance payment methods,which are mainly based on diseases.In addition,it is also necessary to coordinate medical insurance payment with price policy,link it with the adjustment of hospital income structure,and establish a matching fund supervision mode.