数字赋能信用医保建设——绍兴市医保信用数字化监管建设经验

Digital Empowerment of Credit Medical Insurance Construction—Shaoxing City’s Experience in Digital Supervision and Construction of Medical Insurance Credit

自2019年绍兴作为国家医保基金监管信用体系试点城市,其在2年的建设时间内取得诸多成效。在国家医保局的正确指导下,充分结合绍兴地方经验,以医保数字化建设为内驱,以医保定点机构为突破口,成功建设“1 + 3 + 1”的医保基金监管信用体系,并创建三大监管模式对下辖各区县进行医保实时监管,确保医保基金使用的规范与公平,现介绍绍兴医保信用数字化监管现况,为浙江建设共同富裕示范区提供助力。

Since 2019, Shaoxing, as a pilot city of national medical insurance fund supervision and credit system, has achieved many results in two years of construction. Under the correct guidance of the National Medical Insurance Bureau and in full combination with the local experience of Shaoxing, we have successfully built a “1 + 3 + 1” medical insurance fund supervision and credit system from the digital construction of medical insurance as the internal drive and the designated institutions of medical insurance as the breakthrough, and created three supervision modes to carry out real-time supervision of medical insurance in all districts and counties under our jurisdiction, so as to ensure the standardization and fairness of the use of medical insurance funds. This paper introduces the current situation of digital supervision of medical insurance credit in Shaoxing, so as to provide help for the construction of common prosperity demonstration area in Zhejiang.