Research On The Path Of Establishing The Medical Insurance Physician Management System In Chongqing

With the large-scale coverage of the national medical insurance system for all the population,the scale of the Chongqing medical insurance fund is expanding,and the smooth operation of the medical insurance system is strongly affected by the high medical expenses.How to effectively reduce the illegal medical behavior of medical staff in medical institutions,and gradually extend the supervision of medical insurance funds on the service behavior of medical institutions to the supervision of medical personnel’s personal medical service behavior has become one of the key points in the reform of medical and health systems.Based on the analysis of the necessity of the reform of medical insurance supervision mode in Chongqing,this paper grasps and summarizes the practical exploration of the management system of medical insurance doctors at home and abroad,discusses and summarizes the related concepts of medical insurance doctors through theoretical research,and discusses the medical insurance fund of Chongqing Municipality.The status quo and problems of service behavior supervision are introduced.Inthe practical experience of foreign medical insurance physician management system,it mainly refers to the medical insurance supervision methods of four representative countries,pointing out the comprehensive aspects of medical insurance supervision in the medical insurance supervision system,the degree of government and insurance department functions,and the regulatory indicators.The practical experience of the degree of clarity and the breadth of third-party regulatory applications is instructive.When discussing the basic mode of establishing a medical insurance physician system in Chongqing,from the collaborative management mechanism of the competent government departments,the admission and withdrawal mechanism of medical insurance physicians,the credit evaluation mechanism of medical insurance physicians,the incentive and restraint mechanism of medical insurance physicians,and the information security and monitoring Mechanisms and other aspects explored the basic model and operational mechanism of the medical insurance physician system in Chongqing.Finally,this paper puts forward suggestions on improving the support of medical insurance supervision policy,promoting the reform of medical insurance payment methods,comprehensively carrying out clinical path management,attaching importance to social supervision,and improving information construction.