The Impact Of Reforming Provider Payment Of Medical Insurance Of Chongqing To The Core Stakeholders’ Behavior

Medical expenses are too high or rising too fast is a common phenomenon in today ’sworld, health system reform has become the key topics and problems. With the fullimplementation of medical insurance,it slows down “sees a doctor difficulty,to see a doctorexpensively”. The medical needs of the people becoming more and more.At the same time,Health care providers (hospitals, physicians, etc.) profit space has been further expanded.Butthe supply-side focus only on the volume and intensity of medical services in fee-forservices. International experience has fully proved:fee-for-services is one of the mainreasons that lead to medical costs rising rapidly. Therefore, reforming provider payment isthe main tasks of complete the basic health safeguard system.Provider and demand-side both are the core Stakeholders. Medical treatment decisionswill directly affect the efficiency of the two medical resources: quantity and quality, and thenfurther affect the cost and efficacy of the entire health care system. Demand-side responseis very important because they are the recipients and direct beneficiaries, and directlyimpacts on the system lasting and stable development. people usually revolve around thequality and cost of medical services when they analyze the pros and cons of differentpayments.payments have an impact on the medical practices of the Stakeholders, costcontrol, resource allocation, and the quality of medical care and health services, efficiency,equity oriented or restraining effect.Researchs Increasingly concern about behavior ofproviders and demand-sides.Reforming provider payment of medical insurance started relatively late,and needsto continue to promote and improve. its depends on the stakeholders balance of interests or areasonable the external environment if a payment is able effectively implemented inpractice.However, Reforming provider payment is also facing some difficulties andproblems, including a rapid increase in medical expenses,the premiums hard to increade,the misallocation of medical resources,and worrisome quality of medical care.Based on the foregoing discussion of medical environment in the medical insurance andthe associated many problems, to understand the impact of payment on doctors and patients.this study adopted literature analysis method, summed up the advantages and disadvantagesof domestic and international payment methods, and analyzed the payment reform process,analyze the impact of the behavior of both doctors and patients the main factors, as well asthe payment method on behavior.Based on these, this study adopted in-depth interview,questionnaire survey.From their perspectives,I explored how the health care environment,thedoctor-patient relationship and the policy of hospital management affedt their practices.Howthey balance these conflicting effects?How it affects the patient’s health-seeking behavior.This paper consists of six parts,which are shown as follows:Part one: IntroductionIn this part,theoretical basis of the research and problems to be solved were elaborateupon.The purpose,the content and the method of the study were also described，and researchideas and clues were introduced.Approaches applied in this study were comprehensivelyutilized,which include literature analysis,in-depth interview, questionnaire survey.Part two:Theoretical basis of Reforming provider paymentGovernments around the world have taken various measures to reform the medicalpayment for reducing in medical expenses, there have. so many different payment so far.Different payments have their advantages and disadvantages,and should face differentproblems, challenges and pressures. we should find out our current problems throughcomparative and analysis payments. When we study the experiences of other countries,what can we learn from each other?and solve our own problems according to Chinesecharacteristics.Part three: The impact of Reforming Provider Payment on the coreStakeholders’ behaviorBehavior is one of "control knobs." of health-sector reform, These five cate-gories coverthe mechanisms and processes that reformers can adjust to im-prove system performance. Thefive control knobs are financing,payment,organization,regulation,behavior,they They affecteach other,Behavior includes efforts to influence how individuals act in relation to health andhealth care, efforts to change behavior influence how individuals respond to health-sector organizations. Therefore, the behavior is the core of the health policy research. This chapteranalyzes the main factors of patient behavior, understand the doctor-patient behavioralchange in the payment reform, Investigate changes behavior from the macro and micro whenthe system ChangesPart four: Empirical Research of Impact on Physician Behavior of ReformingProvider PaymentThis part adopted qualitative research methods,the in-depth interview, questionnairesurvey,and use diagnostic tree to analyze.the study is to understand the impact on physicianbehavior, to identify the problems in the payment reform,and improve the design of thepayment reform.results:1.Health-care system:the attending physicians strongly believe thea the system can notbe terminated.they hence change their attitudes and behaviors go fit the environment.so wecannot only rely on dotors’conscious and ethics to correct the mentioned problems,the entiresystem may need to restructure.for example,physician examination fees should be increased.2.organization、 regulation： Payment reform to some extent regulate physicianbehavior, reduce non-essential treatment, the quality of medical care has increased to someextent, but the main reason is due to the unity of the clinical pathway. Monitoring of thequality of care should be more reasonable. Clinical path management limit the doctors’professional autonomy to some extent.If hospital management is more flexible,the it is morefeasible foe both hospitals to control medical expenditures and for doctors to maintain qualityof medical care.3.doctor-patient: Payment reform contributes to patient communication, doctorsstrengthen cost-conscious and security awareness because the pressure of controlling fees.Part five: Empirical Research of Impact on Patient hysician Behavior of ReformingProvider PaymentThis part adopted questionnaire survey and qualitative study.the results follows:Healthcare system: patients do not fully understand reforming provider payment, which will affectthe Utilization of health services. organization、 regulation: it is the best way to increase therate of medical treatment of patients to Regulate physician behavior and improve the qualityof medical care. Part six: Policy implications and thinkingThis chapter is based on the five control knobs of the health system, including financing,payment, organization, regulation, behavior,we make the following recommendations:Financing:increase government subsidies, and gradually establish tax-led multi-modeof financing, try community financing. Payment: calculate the reasonable rate of pay,improve the level of payment; organization: build a stable policy planning, improve theincentive compensation mechanism,build rational regulatory system, increase the degree ofsocial participation. behavior: strengthen the management of their own health.physicianshould have a more positive attitude toward the reforming payment.