总额预付下医联体医保支付实践现状分析

Status quo of medical insurance payment in medical alliance based on global budget

我国各医联体实践地区的医保支付方式以总额预付为主,根据各地实际情况结合其他付费方式。推进医联体医保支付建设进程中仍存在配套政策不协调、激励机制不完善等问题,文章通过分析镇江京口医联体、深圳罗湖医疗联合集团、安徽天长医联体、福建省尤溪县医联体等典型医联体实践地区现行医保支付实践现状,在总结实践地区措施及有益经验的基础上挖掘医联体医保支付体系建设存在的问题,针对性提出对策建议。

At present,the payment method of medical insurance in the areas of China where medical alliance is practiced is mainly based on global budget in combination with other payment modes according to local situation.In the process of promoting medical insurance payment in medical alliance,there are still some problems,including mismatched supporting policies and imperfect incentive mechanism.This paper analyzed the status quo of medical insurance payment in medical alliance,such as Zhenjiang Jingkou Medical Alliance,Shenzhen Luohu Medical Alliance Group,Anhui Tianchang Medical Alliance and Fujian Youxi Medical Alliance,explored the problems existing in the construction of medical insurance payment system in medical alliance based on the practice and experience,and put forward corresponding countermeasures and suggestions.