摘要
本文通过借鉴国外医保支付健康管理服务的经验,总结我国医保支付健康管理服务的探索,提出了我国将健康管理服务纳入医保支付的支付对象、支付主体、支付方式。本文提出:医保支付以社区健康管理服务为重点;在条件成熟的地区结合医保统筹基金对医疗机构的总额预付或按人头预付的付费方式支付健康管理服务;在条件尚不成熟的地区通过个人账户或门诊统筹基金支付健康管理服务;积极鼓励补充医疗保险的创新。
The paper analyzes the experience of foreign medical insurance paying for health management services, summarizes the exploration of medical insurance paying for health management services in China, proposes the payment object, payment subject and payment method of medical insurance paying for health management services in China. The following suggestions that medical insurance pays for health management services are raised in this paper： focus on community health management services; prepay by Global Budget or Capitation of medical co-ordination fund in areas where conditions are ripe, pay by per- sonal account or outpatient co-ordination fund in areas where conditions are not ripe; en- courage the innovation of supplementary medical insurance.
出处
《价格理论与实践》
CSSCI
北大核心
2017年第11期78-81,共4页
Price:Theory & Practice
基金
国家中医药管理局中医药政策研究项目"中医医疗服务价格政策体系研究"(项目编号:ZYYP-2015(6-6))
江苏省社科基金一般项目"新医改背景下社区卫生服务机构行动逻辑模型构建及其困局破解"(项目编号:16ZHB006)阶段性研究成果
关键词
健康管理服务
医疗保险
医保支付
Health management services
Medical insurance
Medical insurance payment
