老年人对养老服务和医疗服务的双重需求不仅对传统的医疗资源和养老资源配置、供给模式带来挑战,还对医疗保障制度的保障政策及其治理体系和治理能力提出了新的要求。本文在总结我国医养结合的主要模式特征和发展现状基础上,分析对我国医疗保障政策及治理体系的挑战,提出我国医养结合初步形成养中办医、医中办养以及基层医疗机构办医养等运行模式,这对门诊和社区全科医疗服务的医疗保障水平有更高的需求,对医保治理能力和监管能力有更高的要求,同时需要与长期护理保险划清边界、相互协同。

The dual demand of elderly people for elderly care services and medical services not only challenges the traditional allocation and supply model of medical resources and elderly care resources, but also puts forward new requirements for the security policies, governance systems, and governance capabilities of the healthcare security system. Based on the main characteristics and development status of China's medical and elderly care integration model, this article analyzes the challenges of China's healthcare security policies and governance system, and proposes that China's medical and elderly care integration has initially formed operational models such as running hospitals in elderly care institutions, running elderly care institutions in hospitals, and running medical and elderly care in primary medical institutions, which means demands for better healthcare security of outpatient and community general medical services, as well as requirements for better healthcare security governance and regulatory capabilities. Meanwhile, it is necessary to draw a clear line with and coordinate with long-term care insurance.