医保诚信体系建设的内涵与路径初探——以无锡市为例

The Connotation and Path of the Construction of Medical Insurance Credit System——Taking Wuxi City as an Example

医保诚信体系建设是推进医保治理体系和治理能力现代化的一项重要内容,是“放管服”改革的要求。国家医疗保障局在关于加强基金监管的文件中提出,推进“诚信体系建设”“探索医保监管诚信体系建设路径”等,并将诚信体系建设试点纳入“两试点一示范”部署中。无锡市先行先试,于2018年启动医疗保障诚信体系建设。本文通过介绍无锡市医疗保障诚信体系架构情况,从新时代医保管理理念角度,重点分析医保诚信体系建设的作用及内涵,以期为我国医保诚信体系建设提供有益借鉴。

The construction of medicare insurance credit system is an important part of promoting the modernization of healthcare insurance management system and management ability,and it is also the requirement of the reform of management service.In the document on strengthening fund supervision,the State Healthcare Insurance Bureau proposed to promote the construction of"credit system"and"explore the path of the construction of Healthcare Insurance Supervision credit system",and included the pilot of credit system construction into the deployment of"two pilot and one demonstration".Wuxi city took the lead and started the construction of healthcare insurance credit system in 2018.This paper introduces the framework of healthcare insurance credit system in Wuxi,and analyzes the role and signifi cance of the construction of healthcare insurance credit system from the perspective of healthcare insurance management concept in the New Era,so as to provide useful reference for the construction of healthcare insurance credit system in China.