2016Zhonghua yiyuan guanli zazhiRequires access

Progress and proposal of reforming medical insurance payment system at public hospitals in China

Wenbin Cui, Cheng Huang, Xiangrong Liu, Guangjun Yu

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Abstract

This article elaborated the connotation of public hospital medical insurance payment system and the importance of reform, summarizing and analyzing the practical exploration of promoting medical insurance payment system reform in the localities.Then it moved on to introduce new progress of medical insurance payment system reform abroad and the emerging mode of medical insurance payment, such as pay for performance, payment by results, and bundled payment.In the end, the authors put forward policy suggestions to improve medical insurance payment system at public hospitals in China, namely to build a modern healthcare payment system in line with the needs of medical service system.Such a system should be guided by comprehensive performance, restrained by cost budgeting, based on a diversified payment mode, and supported by information technology.In addition, it should have scientific payment standard and modern governance mechanism, and keep interactive development with commercial health insurance. Key words: Public hospitals; Payment system; Medical insurance; Payment mode; Quality and efficiency

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What this paper is about

This article elaborated the connotation of public hospital medical insurance payment system and the importance of reform, summarizing and analyzing the practical exploration of promoting medical insurance payment system reform in the localities.Then it moved on to introduce new progress of medical insurance payment system reform abroad and the emerging mode of medical insurance payment, such as pay for performance, payment by results, and bundled payment.In the end, the authors put forward policy suggestions to improve medical insurance payment system at public hospitals in China, namely to build a modern healthcare payment system in line with the needs of medical service system.Such a system should be guided by comprehensive performance, restrained by cost budgeting, based on a diversified payment mode, and supported by information technology.In addition, it should have scientific payment standard and modern governance mechanism, and keep interactive development with commercial health insurance. Key words: Public hospitals; Payment system; Medical insurance; Payment mode; Quality and efficiency

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Available abstract

This article elaborated the connotation of public hospital medical insurance payment system and the importance of reform, summarizing and analyzing the practical exploration of promoting medical insurance payment system reform in the localities.Then it moved on to introduce new progress of medical insurance payment system reform abroad and the emerging mode of medical insurance payment, such as pay for performance, payment by results, and bundled payment.In the end, the authors put forward policy suggestions to improve medical insurance payment system at public hospitals in China, namely to build a modern healthcare payment system in line with the needs of medical service system.Such a system should be guided by comprehensive performance, restrained by cost budgeting, based on a diversified payment mode, and supported by information technology.In addition, it should have scientific payment standard and modern governance mechanism, and keep interactive development with commercial health insurance. Key words: Public hospitals; Payment system; Medical insurance; Payment mode; Quality and efficiency

Key concepts: Payment, Business, Payment service provider, China, Actuarial science, Payment system, Corporate governance, Finance

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Progress and proposal of reforming medical insurance payment system at public hospitals in China — Research Paper | ScholarLens