As a typical country with a mature commercial medical insurance system, the United States' medical insurance management costs can better reflect the efficiency of commercial insurance companies. Based on the integrated statistics of the data related to the management costs of various medical insurance projects in the United States, this paper analyzes and summarizes the characteristics and reasons of the level of management costs of commercial insurance companies, with a view to providing some practical information for China to reasonably design the investment of medi cal insurance management costs and improve the construction of medical insurance management service system.
Key words
medical insurance /
healthcare security model /
U.S.A
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] 严娟.提升医保治理能力,加强经办管理与公共服务建设[J].中国医疗保险,2021,No.159(12):17-18.
[2] 华颖. 中国医疗保险经办机制:现状评估与未来展望[J].西北大学学报(哲学社会科学版),2020,50(03):157-166.
[3] 刘凯,和经纬.激励机制、资源约束与监管成本——医保经办机构组织能力影响医疗费用增长的实证研究[J].公共行政评论,2018,11(02):114-136+192.
[4] 朱梓荣,颜建周,邵蓉.美国基本医保委托经办管理制度研究及其对我国的启示[J].中国药房,2020,31(15):1793-1798.
[5] HELLANDER I, HIMMELSTEIN D U, WOOLHANDLER S.Medicare overpayments to private plans, 1985-2012: shifting seniors to private plans has already cost medicare US$282.6 billion[J]. Int j health serv, 2013,43(2):305-319.
[6] 华颖. 中国医疗保险经办机制:现状评估与未来展望[J].西北大学学报(哲学社会科学版),2020,50(03):157-166.
[7] 李春厚,龙微月,刘阳,等.美国医疗保险承包商管理对我国基本医保经办管理的启示[J].中国卫生经济,2018,37(12):113-116.
[8] 宋大平,崔雅茹.商业保险机构参与基本医疗保险经办服务:国际经验、国内现状与机制完善[J].中国卫生经济,2019,38(01):27-31.
[9] 李吏,华迎放.医保委托商业经办管理问题探析[J].中国劳动,2015,No.355(07):8-12.