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自2011年以来,北京市在市属医院中陆续推出了总额预付的医保管理政策,政策给各医院经营管理工作带来了深刻影响。面对挑战,医院应该从优化医保使用合理区间、科学分配科室定额、实施全面质量管理、优化财务管理流程、正确引导患者需求等方面创新医保管理模式。通过医院医保创新管理模式,将进一步加强总额预付管理工作,保障总额预付政策在医院的正确执行并发挥其积极的作用。随着总额预付政策的深入调整和细化,医院医保管理工作尚需进行不断完善。
Since 2011, Beijing Municipality has successively launched a total amount of pre-paid medical insurance management policies in municipal hospitals, which have had a profound impact on the operation and management of hospitals. In the face of challenges, hospitals should innovate the mode of medical insurance management in terms of optimizing the rational use of medical insurance, allocating scientific quotas scientifically, implementing total quality management, optimizing the financial management process, and properly guiding patient needs. Through the hospital’s innovative healthcare management model, the Bank will further strengthen the management of total prepayment and ensure the correct implementation of the total prepayment policy in hospitals and play its positive role. With the in-depth adjustment and refinement of the total prepayment policy, the management of hospital medical insurance needs to be continuously improved.