[1]曾望峰.基本医疗保险省级统筹的基金管理制度研究[J].卫生经济研究,2026,43(06):49-52.
　ZENG Wangfeng.Study on the Fund Management System for Provincial-Level Pooling of Basic Medical Insurance[J].Journal Press of Health Economics Research,2026,43(06):49-52.
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基本医疗保险省级统筹的基金管理制度研究

卫生经济研究[ISSN:1004-7778/CN:33-1056/F]

卷:
43
期数:
2026年06期
页码:
49-52
栏目:
医疗保障
出版日期:
2026-06-03

文章信息/Info

Title:
Study on the Fund Management System for Provincial-Level Pooling of Basic Medical Insurance
作者:
曾望峰1
1.中共湖南省委党校（湖南行政学院）国家治理教研部，湖南 长沙 410006
Author(s):
ZENG Wangfeng
Department of National Governance, Party School of the Hunan Provincial Committee of C.P.C. (Hunan Administrative Institute), Changsha Hunan 410006, China
关键词:
基本医疗保险; 省级统筹; 基金管理制度
Keywords:
basic medical insurance;  provincial-level pooling;  fund management system
分类号:
F840.684
文献标志码:
A
摘要:
医保省级统筹的基金管理有“统收统支”和“统筹调剂”两种模式，且各具特色。为了合理划分风险责任，以及防止“鞭打快牛”和“吃大锅饭”的问题，需要构建科学、规范的医保省级统筹基金管理制度体系，包括基金收支预算管理制度、基金绩效管理制度、基金风险调整机制、基金风险预警机制、医保筹资动态调整机制和基金长效监管机制，从而真正实现医保省级统筹“控风险、促公平、提效率”的政策目标。
Abstract:
There are two models for fund management under provincial-level pooling of medical insurance: the "unified revenue and expenditure" model and the "pooling and adjustment" model, each with its own characteristics. In order to reasonably allocate risk responsibilities and prevent the problems of "punishing the efficient" and "eating from the same big pot", it is necessary to establish a scientific and standardized fund management system for provincial-level medical insurance pooling. This system mainly includes budget management system for fund revenue and expenditure, fund performance management system, fund risk adjustment mechanism, fund risk early warning mechanism, dynamic adjustment mechanism for medical insurance financing, and long-term fund supervision mechanism, thereby truly achieving the policy goals of provincial-level pooling: risk control, equity promotion, and efficiency improvement.

参考文献/References:

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更新日期/Last Update: 2026-06-03