A Study On Payment Of Medical Insurance Fund In Shenyang City

As a basic medical insurance systerm in China,its fund is mainly operated through the compensatory payment method of medical expenses incurred between medical insurance management agencies,medical service providers and insured persons(patients).In China’s current economic and social development level,a scientific and reasonable medical insurance payment method is conducive to controlling the excessive growth of medical costs,improving the quality of medical services approval,and reducing the pressure of medical care for the insured,thus contributing to the basic medical insurance sustainable defined development of the outpatient coordination.In other words,illness medical treatment insurance payment method is to effectively control medical costs,meet the basic medical needs new technology of the insured,stabilize the balance of the medical insurance fund,and make the relationship between "doctor,patient and insurance" reach a balance.Through a survey of the current situation of Shenyang’s medical insurance fund,this paper focuses on the effects of the implementation of Shenyang’s piloted medical insurance diversified and composite payment methods,especially DRGs.The study mainly obtained the general situation of medical disease insurance payment in Shenyang through research which is literature method and survey method,and specifically analysed the implementation effect of Shenyang’s medical insurance prepayment system competent department of charging by service items and payment by disease type,but in the long run especially the implementation effect of the composite financed payment method formed by disease diagnosis-related groups(DRGs),and the impact of this composite payment method on "The study identifies the problems of medical insurance payment in Shenyang,analyses the causes of these problems,additional incentivesand proposes countermeasures equipment to improve the quality of medical services,sustainable development improve the management mechanism of medical insurance institutions,and strengthen the supervision of the behaviour of medical service providers and insured patients.The study aims to responsibility provide Shenyang’s local experience for the improvement of the medical insurance management system in Shenyang and the sustainable development of the medical insurance system formulated by the state.