Policy Review And Effect Research On The Catastrophic Disease Insurance Of New Rural Cooperative Medical Scheme In China

Objective:to clarify the mechanism and summarize the policy execution status of the catastrophic disease insurance policy of China New Rural Cooperative Medical Scheme (NRCMS) use quantitative analysis to evaluate the effect of this policy and provide policy suggestions. Method: A qualitative research method was used on catastrophic disease insurance policy implementation analysis, and descriptive statistics analysis, single factor and multiple factors analysis method was used on data analysis. Results:Since2010, the catastrophic disease insurance was launched within NRCMS, the provinces’covering number of diseases and policy contents conform to requirement, the benefit rate is12.45/1Omillion, and higher in east regions; the average actual reimbursement rate was65.39%while some diseases treatment still lead to high medical costs; the reimbursement rate is significantly higher in Hainan province where the Case-based payment method has been implemented than in Beijing and also higher in lower level medical institutions; to ensure that each patient’s out of pocket payment do not exceed8000yuan,20%of the total amount of NRCMS funds raised will be costed. Conclusion:The implement of the policy was well and it achieved the basic goal of this policy, but the disparity between regions should be noticed; Some diseases patients still had a heavy economic burden; the Case-based payment reform effect is obvious but lacking of diversity; the pattern grading diagnosis and treatment has not been formed, also policy’s sustainable development is facing challenges. Suggestion:To use different means to improve the benefit of the catastrophic disease insurance policy; give priority to Case-based payment while exploring various payment forms; clearly define positions of medical institutions; establish perfect regulatory responsibilities and examination mechanism.