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无论怎样的医保结算办法,都各有优缺点。“到底该选择怎样的结算方式?”这一问题始终困扰着医疗保险经办管理。江苏省淮安市医保中心在10年前开始探索“按病种分值结算”办法,被形象地比喻为“医保定分值、医院挣工分”。这一办法虽然是“迷你型”的按病种分组付费,却融合了总额控制的理念。
No matter what kind of medical insurance settlement, all have their own advantages and disadvantages. “In the end how to choose the settlement? ” This problem has always plagued the medical insurance management. Huai’an City, Jiangsu Province, Medicare Center began to explore 10 years ago, “according to the disease species score settlement ” approach, was vividly metaphor “Medicare fixed value, the hospital earned points ”. Although this approach is “mini ” according to the disease grouping, but combines the concept of total control.