Research on medical insurance data sharing mode based on " City-customized Medical Insurance"
10.3760/cma.j.cn111325-20220824-00744
- VernacularTitle:基于"惠民保"的医保数据共享模式研究
- Author:
Yang LIU
1
;
Yazi LI
;
Minjiang GUO
;
Xiaojuan ZHANG
;
Yuan YE
Author Information
1. 中国医学科学院医学信息研究所健康与医疗保障中心制度研究室，北京 100020
- Keywords:
Insurance, health;
"City-customized Medical Insurance";
Multi-level medical security system;
Medical insurance data sharing;
Stakeholder
- From:
Chinese Journal of Hospital Administration
2022;38(12):901-905
- CountryChina
- Language:Chinese
-
Abstract:
With the explosive growth of " City-customized Medical Insurance" products, the voice of commercial health insurance needs medical insurance data support is increasing.The authors took " City-customized Medical Insurance" as the representative of commercial health insurance, analyzed the demands and motivations of stakeholders in medical insurance data sharing through the power-interest matrix model, and summarized the medical insurance data sharing path at the commercial insurance product design end and claim settlement end. It is suggested to strengthen the top-level design, build the implementation path of standardized sharing of medical insurance data and the operation mechanism of hospital data docking, to realize the value increment of all stakeholders.
