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一直以来,医疗保险协议管理的目标不外乎两个,一是规范医保服务行为,为基金支付管理构筑堤坝;二是圈定医疗保险定点服务机构,充分满足参保人员的基本治疗需要。前者应为协议管理的最高目标,后者为基本目标。笔者认为,协议管理要在充分保障基本目标的前提下进行,基本目标与最高目标须协同推进。可
All along, there are no more than two objectives for the management of medical insurance agreements. The first is to standardize the health insurance service and construct dikes for fund payment management. The other is to delineate medical insurance designated service agencies to fully meet the basic treatment needs of insured persons. The former should be the highest goal of agreement management, which is the basic goal. The author believes that the agreement management should be carried out under the premise of fully guaranteeing the basic objectives, and the basic goals and the highest goals must be promoted jointly. can