基于职能MDT理念的DRGs医保绩效管理模式应用实践

The application of DRGs medical insurance performance management model based on executive department MDT concept

医保局的成立及其职能划定,标志着医院管理进入"卫健委+医保局"新时代,为了顺应新形势及医保支付方式改革的到来,在历经近半年的筹备及试运行后,2019年1月广西医科大学第一附属医院基于职能MDT理念的DRGs医保绩效管理模式正式投用于绩效考核,截至2019年6月各项指标正向运行,取得预期效果。笔者介绍了当前形势下推行医保绩效考评制度改革的必要性以及医院将临床MDT理念应用于医保管理工作中,建设DRGs为引导的医保绩效管理模式的历程,并对运行效果进行分析,以期不断完善。

The founding and duties of healthcare security administration,marking that the hospital management have entered a new age of"Health Commission+Healthcare Security Administration".After preparation and trial operation for nearly half a year,the DRGs performance management model based on executive department MDT concept was formally used in performance appraisal In January 2019 for adapting to the new situation and the reform of medical insurance payment.As of June 2019,the indicators are running well.This paper introduces the necessity of reforming the performance evaluation system of medical insurance under the current situation and the development process of our hospital DRGs medical insurance performance management model based on executive department MDT concept,and analyzing the operation effect for progressing.