医疗保障基金是人民群众的“看病钱”“救命钱”,其使用安全关涉广大群众的切身利益,关系医疗保障制度健康、可持续发展。本文以南宁市医保基金监管信用体系建设为例,总结归纳其建设经验、主要亮点成效,并提出探索医保基金监管的创新优化策略。实践表明,南宁市建立的以“医保信用管理”为基础的基金监管体系,以及搭建的“1中台+4系统”的医保基金监管平台,实现了医保部门牵头、各方相互监督并自觉规范的运行机制,形成了基于信用管理的创新型医保基金监管“南宁模式”,为推动行业发展提供了有益借鉴。

Healthcare security fund is the people's medical treatment money and life-saving money. Its use safety is related to the vital interests of the masses and the healthy and sustainable development of the healthcare security system. Taking the construction of healthcare security fund supervision credit system in Nanning as an example, this paper summarizes its construction experience, main highlights and achievements, and puts forward innovative and optimization strategies to explore healthcare security fund supervision. Practice shows that the fund supervision system based on healthcare security credit management established in Nanning and the healthcare security fund supervision platform of 1 middle platform plus 4 system have realized the operation mechanism led by the healthcare security department, mutual supervision and self-conscious standardization. In practice, an innovative healthcare security fund supervision mode based on credit management has been formed, which provides a useful reference for promoting the development of the industry.