浙江省医保支付制度改革对“三医”的影响与对策分析

Analysis of Influence and Countermeasures of Medical Insurance Payment Reform on "Medical-Insurance-Medicine Linkage" in Zhejiang Province

医保作为医疗服务购买的“代理者”,在平衡医疗供需的改革中起着关键性作用.2020年,浙江省率先以省为单位全面推行住院医疗费用按疾病诊断相关分组(DRG)点数付费,建立了总额预算管理下的多元复合式医保支付体系.本文结合浙江改革实践,从“三医联动”视角探讨医保支付方式对各个改革主体所起的作用、带来的问题以及面临的压力,并提出相应的建议.

As the"agent"of medical service purchase,medical insurance plays a key role in the reform of balancing medical supply and demand.In 2020,Zhejiang Province took the lead in fully implementing the payment of inpatient medical expenses by disease diagnosis-related grouping(DRG)points on a provincial basis,and established a multi-component medical insurance payment system under the total budget management.Based on the reform practice in Zhejiang,this paper discusses the role,problems and pressures of medical insurance payment on each reform subject from the perspective of"medical-insurance-medicine linkage",and puts forward corresponding suggestions.