医保基金省级统筹的可行性探索.pdfVIP

Revie综述

CHINAHEALTHINDUSTRY

DOI：10.16659/ki.1672-5654.2022.12.253

医保基金省级统筹的可行性探索

时涛，张秀梅，牟凌霄，岳凌宇

山东第一医科大学(山东省医学科学院)医疗保障学院，山东济南250117

［摘要］提高统筹层次有利于提高医疗保障的公平和效率，也是深化医疗保障制度改革的发展要求。本文通过搜集我

国各地现行医保基金统筹现状及有关政策文件，梳理医保基金统筹模式及其变迁历程,发现县市级医保基金统筹主

要存在着抵御风险能力低、部分地区医保基金出现财政赤字等问题，这不利于医保基金的持续发展。从政策、理论知

识、现行经验等多个角度分析医保基金省级统筹的可行性，并提出对策建议，为优化医保基金的统筹模式提供理论支

持。

［关键词］医保基金;省级统筹;基金管理；医保改革

［中图分类号］R1；C93［文献标识码］A［文章编号］1672-5654(2022)06(b)-0253-04

FeasibilityExplorationofProvincialLevelCoordinationofMedicalInsur­

anceFunds

SHITao,ZHANGXiumei,MOULingxiao,YUELingyu

SchoolofMedicalInsuranceShandongFirstMedicalUniversity(ShandongAcademyofMedicalSciences)JinanShandong

Province250117China

[Abstract]Improvingtheoveralllevelisconducivetoimprovingthefairnessandefficiencyofmedicalsecurityandisalso

thedevelopmentrequirementfordeepeningthereformofthemedicalsecuritysystem.Bycollectingthecurrentsituationof

medicalinsurancefundco-ordinationandrelevantpolicydocumentsinvariouspartsofmycountrythispapersortsoutthe

modeofmedicalinsurancefundco-ordinationanditschangesandfindsthattheco-ordinationofcountyandcity-level

medicalinsurancefundsmainlyhasproblemssuchaslowabilitytoresistrisksandfinancialdeficitsofmedicalinsurance

fundsinsomeareaswhichisnotconducivetothesustainabledevelopmentofthemedicalinsurancefund.Fromtheper­

spectivesofpolicytheoreticalknowledgeandcurrentexperiencethefeasibilityofprovincialco-ordinationofmedicalin­

surancefundsisanalyzedandcountermeasur