淄博市城镇职工基本医疗保险付费方式改革探析-analysis on the reform of payment mode of basic medical insurance for urban workers in zibo city.docxVIP

淄博市城镇职工基本医疗保险付费方式改革探析 淄博市城镇职工基本医疗保险付费方式改革探析 4 4 statistics yearbook. And studying and learning from foreign medical insurance of the relevant medical fees control systems in basic medical insurance payments, improves the way the notion of cost constraints to establish a mechanism to provide the scientific basis. Combining main kinds of medical insurance for the payment way to the pros and cons analysis, researching the disadvantage of existing way, put forward the direction to improve payment method and the supervision and management menthod to assort payment method. Our basic medical insurance system for urban employees are still in its infancy. Ten years later national reform , how to choose propriate payment way to the regions, further improving the basic medical services, carrying out the basic medical insurance policies, preventing medical insurance funds risk, and ensuring the rights of people who take part in the medical insurance,will be the important topics to all levels of management, experts and scholars. At present, nonstandard medical events, extracting medical insurance fund occurs frequently in Zibo and other areas. And most of the area remains post-paid settlement of accounts, lacking of data decision-making, technical support and risk prevention. Therefore, from the realities of Zibo, using for reference the domestic and international medical insurance payment method and management measures, summarizing the payment of basic medical insurance fund periodically, choosing the right payment and management of the basic medical insurance fund, establishing the basic medical insurance funds operation, risk management and preventive mechanisms, ensuring that the basic medical insurance for city and towns residents a steady and sustainable development, have great theory and practice. Key words: the city of Zibo, medical insurance, payment method, analysis PAGE PAGE 10 前 言 随着高新技术、新设备、新药品的使用，疾病谱的改变，慢性病发生率的上升， 人口的老龄化以及大众健康意识的提高，医疗服务提供方诱导