25 Years of Reform in China's Medical Insurance Payment System:Achievements,Problems,and Prospects
The medical insurance payment system and its mechanisms are critical to the governance of the medical insurance scheme and the allocation of medical insurance funds,significantly impacting insured individuals'access to medical services and the efficient utilization of funds.This paper provides an overview of the achievements in payment reform over the past 25 years since the inception of basic medical insurance in China.It traces the evolution of payment methods during this period and conducts a comprehensive analysis of the current status and prevalent issues in medical insurance payment reform.Additionally,five strategies are proposed for the future development of China's medical insurance payment system reform:transitioning from a post-payment to a pre-payment model,shifting from global control to a global budget approach,incorporating a blend of Chinese and Western elements,adopting a mix of multiple payment methods,and transitioning from quantity-based payment to value-based purchasing.Finally,policy recommendations are offered for prospective reform,emphasizing the establishment of a unified medical insurance payment system with Chinese characteristics,covering aspects such as coordinated mechanisms,payment policies,and the overall system.
medical insurance paymentcoordinated healthcare reformDiagnosis Related Groups(DRGs)Diagnosis-Intervention Packet(DIP)public hospital reform
万方数据
维普
