新时代“枫桥经验”助力基层医保基金监管——以诸暨市医保基金监管综合治理为例

杨焕兵

中国医疗保险 ›› 2025, Vol. 0 ›› Issue (1) : 77-82.

中国医疗保险 ›› 2025, Vol. 0 ›› Issue (1) : 77-82. DOI: 10.19546/j.issn.1674-3830.2025.1.010
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新时代“枫桥经验”助力基层医保基金监管——以诸暨市医保基金监管综合治理为例

  • 杨焕兵
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"Fengqiao Experience" Assisting in the Supervision of Grassroot Medical Insurance Funds in the New Era——Taking the Integrated Governance of Medical Insurance Fund Supervision in Zhuji City as an Example

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摘要

近年来我国医保基金管理整体态势有所好转,但基层医保基金监管仍然存在一些薄弱环节。浙江省诸暨市充分发挥“枫桥经验”发源地优势,将新时代“枫桥经验”与基层医保基金监管相结合,探索实践一套包含“一个网格体系、三支枫桥队伍、四大工作机制、八项工作任务”的“枫桥式”医保基金监管综合治理模式,有效提升了基层医保基金监管效率。基于诸暨市实践经验,可以总结出新时代“枫桥经验”助力基层医保基金监管的逻辑:党的领导是核心,基层基础是支撑,数字赋能是抓手,源头防治是关键,共治共享是目标。

Abstract

In recent years, the overall management of medical insurance funds in China has been improved, but there are still certain weak points in the supervision of grassroots medical insurance funds. Zhuji City of Zhejiang Province has fully exploited its advantage as the birthplace of the "Fengqiao Experience", integrated "Fengqiao Experience" in the new era with the supervision of grassroots medical insurance funds, explored, implemented a comprehensive governance model of "Fengqiao-style" medical insurance fund supervision, encompassing "one grid system, three Fengqiao teams, four working mechanisms, eight tasks", effectively enhancing the supervision efficiency of grassroots medical insurance funds. Based on the experience of Zhuji City, the logic of "Fengqiao Experience" contributes to the supervision of grassroots medical insurance funds in the new era can be summarized as follows: the leadership of the Communist Party of China is the core, the grassroots foundation is the support, digital empowerment is the knob, prevention, control from the source is the key, co-governance, sharing is the goal

关键词

“枫桥经验” / 医保基金 / 综合治理

Key words

"Fengqiao Experience" / medical insurance fund / comprehensive governance

引用本文

导出引用
杨焕兵. 新时代“枫桥经验”助力基层医保基金监管——以诸暨市医保基金监管综合治理为例[J]. 中国医疗保险. 2025, 0(1): 77-82 https://doi.org/10.19546/j.issn.1674-3830.2025.1.010
"Fengqiao Experience" Assisting in the Supervision of Grassroot Medical Insurance Funds in the New Era——Taking the Integrated Governance of Medical Insurance Fund Supervision in Zhuji City as an Example[J]. China Health Insurance. 2025, 0(1): 77-82 https://doi.org/10.19546/j.issn.1674-3830.2025.1.010
中图分类号: F840.684    C913.7   

参考文献

[1] 国务院办公厅.关于加强医疗保障基金使用常态化监管的实施意见:国办发〔2023〕17号[EB/OL].(2023-05-30)[2024-10-13].https://www.gov.cn/zhengce/zhengceku/202305/content_6883812.htm.
[2] 冯莉,杨晶.城镇职工基本医疗保险基金可持续性评估——基于延迟退休和全面二孩政策调整的考察[J].财经问题研究,2019(08):122-129.
[3] 于洪满.医保智能化监管和控费审核模式的应用思路[J].卫生经济研究,2016(02):18-19.
[4] 陈俊强,梁冰,林汉城,等.以智能化信息技术促进医院医保精细化管理——以广西某三甲医院为例[J].中国医疗保险,2020(12):57-58.
[5] 芦琳智,郭歆,张庆红.医院医保智能化监管的探索与实践[J].中国医疗保险,2021(04):63-65.
[6] 王淑慧,杨翼帆,杨凡,等.医改大环境下对于医院医保管理新模式的探索[J].中国卫生标准管理,2017,8(13):33-34.
[7] 黄彦英.大数据下医院医保管理模式的现状与改进策略[J].中国卫生标准管理,2020,11(10):19-20.
[8] 张昆,张一申,魏鹏,等.金融科技助力医保基金智能云监管[J].中国金融电脑,2022(03):54-57.
[9] 邓勇.医保法制监管体系构建探讨[J].中国卫生法制,2020,28(06):21-25+33.
[10] 但彦铮.加快《医疗保障法》立法进程全面推进法治医保建设的几点思考[J].中国医疗保险,2022(02):1-4.
[11] 朱刚令.完善医疗保险监管体制的思考[J].中国医疗保险,2018(05):23-26.
[12] 雷咸胜.我国医保基金监管现存问题与对策[J].中国卫生经济,2019,38(08):31-33.
[13] 李辉,王晓华.协同联动系统治理提升医保基金综合监管效能[J].中国医疗保险,2022(05):79-83.
[14] 黄华波.浅议医保基金监管的体制性特点、机制性问题与长效机制建设[J].中国医疗保险,2020(04):20-24.
[15] 新华社.习近平会见全国“枫桥式工作法”入选单位代表[EB/OL].(2023-11-06)[2024-12-12].https://www.gov.cn/yaowen/liebiao/202311/content_6913790.htm.
[16] 陈文清:坚持和发展新时代“枫桥经验”提升矛盾纠纷预防化解法治化水平[J].社会与公益,2023(11):7.

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