Research On The Payment Mode Of Medical Insurance In Heyuan City Under The New "Three Medical Linkage" Mode

The reform of medical insurance payment mode in China is a major reform measure to improve the level of public service and benefit the country and the people.According to the theory of public goods and the theory of stakeholders,this paper studies the respective functions of the payment methods in the field of medical insurance in our country,studies the direction of the adjustment and reform of the payment methods of medical insurance and the of the payment reform,and discusses how to determine the function orientation of the payment methods of medical insurance,and how to position the role of the medical security system mechanism in the medical service activities of medical insurance payment in our country And the relationship between medical institutions and medical insurance agencies,which can give the reform of medical insurance payment mode and content rationality of micro-discussion suggestions,for our country to improve the reform of the field of medical and health to provide a certain theoretical reference.The source city has carried on the basic medical insurance payment method reform,from the previous after-payment system medical insurance payment method which mainly pays for the service item to the total budget,the multivariate compound payment method coexists.However,the reform of medical insurance payment method is not accomplished overnight,and the road of reform is long and tortuous.Although the reform of medical insurance payment method in Heyuan City has achieved some results in the control of medical expenses,there are also many problems in the reform.At present,although the payment method of Heyuan City is in the form of "total budget" prepaid system,but in essence,the post-payment system represented by service item payment is still the main payment Method:Heyuan city requires comprehensive promotion of medical insurance payment by disease,but the proportion of payment by disease is too small,implementation is difficult;although the implementation of the reform of medical insurance payment has evaluation and scoring,but lack of perfect evaluation indicators and regulatory system.In this paper,based on our country’s medical and health reform work to promote the implementation of the environment,to study the rationality of medical insurance payment methods,using literature induction,case analysis,and combined with case studies,the current implementation of medical insurance payment methods and existing problems in Heyuan City,Guangdong Province,by referring to the comparison of China’s Beijing,Shanghai,Zhenjiang and other cities in the reform of medical insurance payment methods,to explore the optimization and improvement of Heyuan City medical insurance payment methods constructive scheme.It is hoped that through the study of this paper,we can provide theoretical aspects for the reform of medical insurance payment method in China’s medical and health field.