基本医疗保险绩效管理理念、目标与策略的思考.pdfVIP

观察思考 基本医疗保险绩效管理: 理念、目标与策略的思考 梁 鸿 贺小林 （复旦大学社会发展与公共政策学院 上海 200433） 【摘要】 基本医疗保险绩效管理的核心在于实现“人人享有基本医疗”的政策目标。由于对“基本 医疗”认识的分歧和难界定导致了医保管理实践中政策的不可操作性。进而使得政策执行过程和行为缺 乏控制，面临着政策目标偏移和保险“小农意识”的政策陷阱，严重影响了基本医疗保险制度的绩效。 因此，应该从政策理念、制度设计、过程管理和激励机制四方面来进行系统改革。 【关键词】 基本医疗保险；绩效管理；政策理念 【中图分类号】 文献标识码 文章编号 F840.684 C913.7 【 】 A 【 】1674-3830(2012)2-15-4 doi:10.369/j.issn.1674-3830.2012.2.5 The Performance Management of the Basic Medical Insurance : Policy Idea, Goals and Strategy Hong Liang, Xiaolin He (School of Social Development and Public Policy, Fudan University Shanghai, 200433) 【 】 The core of the performance management in basic medical insurance is to achieve the policy Abstract objectives that Everyone will have access to basic medical and health services. Because of the differences understand and difficult to define basic health , it led to Medicare policy not operational in management practices .Thereby making the process of policy implementation and behavior are lack of control , faced with the policy trap that the objectives offset in insurance policy and the petty-farmer consciousness, seriously affected the performance of basic medical insurance system. Therefore, we should do the system reform in four areas from the policy concept system design process management and incentives. 【 】basic medical insurance, performance management, policy idea Key words 1医保绩效管理的政策理念 乎是非常清楚的，即以“人人享有 效用三个维度的指标来测量。从制 基本医疗”为核心目标。检验是否 度维度看，主要关注医保的覆盖面、 从理论上看，现阶段中国医保 达到改革目标的政策工具似乎也是 保