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Design and Management of Medical Insurance

发布时间:2012-09-25   浏览量:
  
主讲人:Jiri Remec
时间:Sept. 24 -26 
地点:后主楼2026
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医疗保险设计与管理

Design and Management of Medical Insurance

 

授课人/Guest Lecturer:Jiri Remec. Jiri Remec是前捷克医疗保险公司的CEO,专业是Informatics。在捷克,亲自主持了DRG的开发、使用,专长于医疗保险受益包的设计,精算、医保内部的绩效管理、对医院支付方法改革与医疗费用控制。是德国EPOS咨询公司高级咨询专家,中欧社会保障改革项目的医疗保险核心专家。

 

 

授课地点/Location:后主楼2026室(2026 The North Main Building)

 

授课时间和内容/Schedule

 

Monday, Sept. 24 9:00am-12:00pm

1.    Introduction:  Principles of social medical insurance

l  Comparison of social and private medical insurance

l  Principle of equivalence

l  Collecting of insurance premiums

l  Solidarity issues

l  Drivers for health care costs

 

Monday, Sept. 24, 2:00pm-6:00pm

2.    Design of benefit package  

l  Components of a benefit package

l  Criteria for design of benefit package

l  Cost sharing

l  Examples of benefit packages

 

Tuesday, Sept. 25, 9:00am -12:00pm

3.    Cost containment strategies

l  Objectives and limitations

l  Measures at providers’ side

l  Measures at insuree’s side

l  Examples of successful approaches

 

Tuesday, Sept. 25, 2:00pm-6:00pm

4. Remuneration by capitation

l  Principles and application area

l  Risk adjustment

l  Blending with other remuneration methods

 

Wednesday, Sept. 26, 9:00am-12:00pm

5. DRG and its applications (3 hours)

l  Case-mix classification systems and DRG

l  Prospective payment systems

l  Sustainability issues