宿迁市城镇医保按病种分值付费绩效分析

摘要

宿迁市学习借鉴淮安经验组织实施的按病种分值付费，使医疗费用得到合理控制，医保基金收入、支出、结余实现“三增加”，基金绩效明显提升，新医改提出的让老百姓“看得起病”的目标圆满实现。宿迁的实践再次证明，按病种分值付费对于落实总额控制目标、发挥基本医保对医疗服务的激励约束作用等效果凸显。%By learning the experience of insurance payment by disease–scores from Huaian, the medical expenses of Suqian has been reasonably controlled; the medical insurance fund collecting, expenditure and balance have achieved the goal of "three-increases"; the performance of insurance fund has been signifi cantly enhanced; and the aims of "affordable" medical care proposed by the new medical system reform has been fully achieved. The practice in Suqian once again proved that the payment by disease-scores has prominent effects on the implementation of total budget control and makes basic health insurance playing incentive and restraint roles in medical services.