关于医保经办机构与定点医疗机构之间建立谈判机制的探讨

摘要

Based on the purpose of improving medical service quality and insuring reasonable payment of social insurance fund, establishment of negotiation mechanism between medical insurance agencies and designated medical institutions is becoming one of focuses in the process of new medical reform, which means a lot to motivate medical quality of medical institutions, promote payment system and protect public health more effectively. The setablishment of negotiation mechanism between medical insurance agencies and designed medical institutions attaches great importance to stimulating medical quality in medical institutions, promoting the perfection of payment, and insuring people who have medical insurance more effectively. In the paper, establishment of negotiation mechanism is studied from the aspects of background, subjects, premise, content and objectives.%基于提高医疗服务质量和确保医保基金合理支付的目的,医保经办机构与定点医疗机构之间谈判机制的建立在新医改进程中逐渐成为关注的焦点之一.医保经办机构与定点医疗机构之间谈判机制的建立,对于激励医疗机构医疗质量的提高、促进支付制度的完善以及更有效地保障参保人群健康有重要意义.文章从谈判的背景、主体、前提、内容和目标等方面对谈判机制的建立进行了探讨和研究.