社会医疗保险基金支付监管的难点与对策:以浙江省为例

摘要

医保基金的不合理支出会造成医疗资源的浪费,也影响了医疗服务的公平性和可及性,因此控制医疗费用的不合理增长已成为医保管理工作的核心问题.对医保基金支付环节监管是否有效对医疗费用的控制具有最直接的作用.通过对浙江省医保基金支付监管情况的调研,分析医保基金支付监管存在的难点,总结各地采取的有效措施,并对加强医保基金支付监管提出思考和建议.%Improper payment of social medical insurance fund will cause the waste of medical resources, and also affect Lhe equity and availability of medical service. Therefore, to control the improper growth of medical costs has become the core issue of social medical insurance management. Payment supervision of social medical insurance plays the most direct role in the medical costs. Based on the survey and research of Zhejiang Province, we try to analyze difficulties for payment supervision of social medical insurance, summarize effective measures local governments take, and give considerations and suggestions to the strengthening of payment supervision of social medical insurance.