Research On The Reform Of Payment Mode Of Basic Medical Insurance In Changsha

Reports of the 19 th National Congress of the Chinese Communist Party built such a people’s livelihood system with a richer connotation covering education,employment and income,social security,poverty alleviation and healthy China establishment,which has enriched the contents of livelihood projects with Chinese characteristics.The establishment of a healthy China,including medical system reform,has become an important part of China’s people’s livelihood system.In 2017,the pilot comprehensive reform of urban public hospitals was fully implemented,the modern hospital management system was initially established,the capability of medical service system was significantly promoted,and the order applying for medical service was improved,the proportion of general outpatient visits in urban tertiary hospitals in the total number of medical institutions was significantly reduced;the unreasonable increase in medical expenses was effectively controlled,and the increase of total health expenses was in line with the increase in the GDP of the region;the satisfaction of the public is significantly improved,and the burden of medical expenses is significantly reduced,overall,the proportion of personal health expenditure in the total health expenditure has decreased to 30% even below.As one of the basic medical insurance payment reform to further improve the medical service behavior and guide the rational allocation of medical resources of economic levers to become an important link in deepening reform,the appropriate payment method can not only guarantee fund of insurance of primary medical treatment of running smoothly,also can to supervision and standardize the medical service behavior,position the top-level design effect of regional medical center,and protect the rights of the insured.In the new era,public hospitals should take the initiative to adapt to the reform of payment mode of basic medical insurance,improve the level of refinement of medical insurance management,and attach importance to the research on payment mode of basic medical insurance.This study focus on the most critical issue in the current medical insurance management system: the basic medical insurance payment method.We introduced several common basic medical insurance payment methods,analyzed the implementation and the cost situation of Changsha basic medical insurance payment method reform via literature survey,data analysis.This paper summarized the issuesand reasons in the reform of basic medical insurance payment mode in Changsha,discuss the main influencing factors of the current reform of basic medical insurance payment methods and analyzed the experience of different payment methods of medical insurance in China and abroad.Results shows that after reform of the basic medical insurance payment in Changsha,the number of appointed hospital medical insurance settlement and total health expenses keep increase,the risk of medical insurance fund expenditure decrease,and the secondary average cost,the average time stay in hospital and the percentage of drug expenditure of the insured decrease,the most important thing is the promotion of consciousness to active control medical expenses,which update the management of hospital medical insurance.However,there are still influences from policy,information system and hospital implementation in the carry out process.Based on my own experience in medical insurance management,this paper puts forward countermeasures and suggestions for the problems in the reform of basic medical insurance payment methods in Changsha.We should combined complex multiple payment methods,establishing reasonable disease score table and guideline used in clinical diagnosis and treatment,We should reinforce the knowledge in appointed hospitals,improve the top-level design,promote the abilities of medical insurance management refinement via the establishment of effective incentive mechanism and strengthen information system construction,we should improve supporting measures of the basic medical insurance payment reform,strengthen the supervision of medical institutions,establish mechanism for the negotiations.