保险公司对大病保险费用管控的实践与思考

发布时间：2018-03-12 12:35

本文选题：大病保险　切入点：费用管控　出处：《卫生经济研究》2017年03期 　论文类型：期刊论文

【摘要】：通过对广东MJ市大病保险调研发现:保险公司通过介入居民健康管理,创新医护人员薪酬绩效指标体系,搭建"商社医"信息共享平台,建立"三位一体"费用管控机制,使医保审核效率有效提升、患者医疗费用支出降低、大病保险赔付支出得到控制,提高了居民医疗保障水平和健康风险预防水平,对我国其他地区开展保险公司管控大病保险费用有一定借鉴意义。
[Abstract]:Through the investigation and investigation of the serious illness insurance in MJ City, Guangdong Province, it is found that the insurance company establishes the "trinity" cost control mechanism by intervening in the residents' health management, innovating the salary performance index system of the medical personnel, setting up the information sharing platform of "business society and medicine", and establishing the "trinity" cost control mechanism. So that the efficiency of medical insurance audit can be effectively improved, patients' medical expenses will be reduced, and the expenses of insurance compensation for serious illness will be controlled, thus raising the level of medical security and health risk prevention of residents. Other regions of our country to carry out insurance companies to control the cost of serious illness insurance has certain reference significance.
【作者单位】：广东技术师范学院;
【分类号】：R197.1;F842.6

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