“互联网+”医疗服务纳入医保支付后的风险及管控建议

"互联网+"医疗服务纳入医保支付后,将会在很大程度上促进线上诊疗服务的开展,更好地推动分级诊疗落地、均衡配置医疗卫生资源、有效控制医疗费用不合理增长。但同时也存在一定的风险,如医疗质量和患者安全风险、医疗信息和隐私泄漏风险、医患双方道德和医保基金风险等。建议加快法律制度和标准规范建设、建立医疗服务监管平台、合理设置医保控制总额、做好医保基金风险管控,促进互联网医疗服务健康可持续发展。

Risks and management suggestions after"Internet+"medical services are included in medical insurance payments

The inclusion of"Internet+"medical services in medical insurance payment will greatly promote the development of online diagnosis and treatment services,better promote the implementation of hierarchical diagnosis and treatment,balance the allocation of medical and health resources,and effectively control the unreasonable increase in medical expenses.But at the same time,there are certain risks,such as medical quality and patient safety risks,medical information and privacy leakage risks,the ethics of doctors and patients,and the risks of medical insurance funds.It is recommended to speed up the construction of legal systems and standards,establish a medical service supervision platform,rationally set the total amount of medical insurance control,do a good job of medical insurance fund risk management and control,and promote the healthy and sustainable development of Internet medical services.