嘉兴市建立标准化第三方监管的实践与思考

Practice and Thinking of Establishing Standardized Third Party Supervision in Jiaxing

《国务院办公厅关于推进医疗保障基金监管制度体系改革的指导意见》明确:积极引入信息技术服务机构、会计师事务所、商业保险机构等第三方力量参与医保基金监管,建立和完善政府购买服务制度,推行按服务绩效付费,提升监管的专业性、精准性、效益性。嘉兴市于2019年起,以购买服务方式引入第三方力量参与医保基金监管,有效缓解了各地医保基金监管队伍力量薄弱和专业人才缺乏的现实困境。

In The Guiding Opinions on Promoting the Reform of the Supervision System of Medical Insurance Fund,it is required to actively introduce information technology service institutions,accounting fi rms,commercial insurance institutions and other third parties to participate in the supervision of medical insurance fund.At the same time,we should establish and improve the government purchase service system,promote the payment according to service performance,and improve the professionalism,accuracy and effi ciency of supervision.Since 2019,Jiaxing has introduced a third party to participate in the supervision of medical insurance funds by purchasing services,which eff ectively alleviates the practical dilemma of weak supervision team and lack of professionals.