摘要
医疗保险协商谈判与协议管理是新时期医保制度完善的关键环节与政策抓手,有利于医保主管部门对医疗服务和药品质量进行有效监管。本研究认为应坚持问题导向,梳理各地在医保协商谈判过程中需要解决的主要问题。在此基础上明确工作路径,进一步完善多元主体参与协商谈判与协议管理的政策保障机制,构建多元主体参与协商谈判的信息共享平台与平等对话机制,加强医保协议管理的严格执行与服务质量的动态监管。
The negotiation and agreement management in medical insurance is the key and policy starting point to improve the health care system in the new era, and they are benefi cial for the medical insurance administrative departments to monitor medical services and the quality of medicines effectively. This research suggests that problem-orientation should be insisted on and the main problems in the health insurance negotiation process are clarifi ed. Based on this, it should make clear the working path, further improve the policy supportive mechanism with multiple subjects involved in negotiation and agreement management, build information sharing platform and equal dialogue mechanism, and strengthen the strict implementation of medical insurance negotiation management and services dynamical supervision.
出处
《中国医疗保险》
2016年第8期16-19,共4页
China Health Insurance
基金
人力资源和社会保障部社保中心委托项目"医疗保险协商谈判机制研究"
上海市长宁区卫计委委托项目"基本公共卫生优化管理与协同服务评估研究"阶段成果
关键词
医疗保险
协商谈判
协议管理
质量监管
health insurance
negotiation
agreement management
quality supervision
