The Research On The Urban Basic Medical Insurance Payment Mode In HangZhou Under The Background Of New Medical Reform

Since the urban basic medical insurance system was established, the country areactively exploring effective Medicare payment. After the new medical reform in2009,medical insurance payment reform is to become a hot topic of deeping China’spharmaceutical system. Urban basic medical insurance payment have played animportant role in insuring the person’s rights protection, standardizing medical services,controlling the growth of health care costs and promoting the development of medicalinstitutions. In the health care system, urban basic medical insurance payment reformdestined to be given more responsibilities and expectations.Aim to carry out the basic Medicare payment reform are threefold: First, to rebuildmedical services fees and compensation mechanisms; Second, to promote the rationalallocation of health resources and to reduce the irrational behavior of wasting themedical resources; Third, to control the excessive growth of medical costs.This paper is divided into five parts, the first part of the article "difficult andexpensive" the current situation as the entry point, proposed total health costs are toohigh and the background of personal medical are overburdened, medical paymentreforms as deepening the medical system is playing a crucial role as one of the tasks ofreform, in reducing health costs and the burden on individual health. The research usedthe laws and regulations of the literature analysis, case analysis and the statisticsanalysis. Analysis of the laws and regulations of literature, mainly in the inductionbased on the relevant laws and regulations on the medicare payment reform inHangzhou for context finishing. Case analysis uses urban basic medical insurancepayment reform as a case, the statistics analysis set a quantitative assessment to themedicare payment reform in Hangzhou. The second part starts with the medicarepayment theoretical. Through a brief analysis of the pros and cons of different methodsof payments, using correlation diagram between selected payment and insurance feespaid to compare different medicare payment fee effect controlled, quality of serviceresults and management effectiveness. The third part starts with urban basic medicalinsurance payment reform in Hangzhou as a case. Review of the medicare payment withthe two stages of general situation under the new health care in Hangzhou: the newhealth reform carryies out mainly single fee-oriented medicare payment methods in Hangzhou before, according to the project and a single DRGs, capitation paymentmixed as the main method of payment. After the reform has been a qualitative overviewof the medicare payment method in Hangzhou, taken a comprehensive impactassessment about the health insurance fund over calendar year, the per capita health carespending per capita medicare reimbursement rates, personal burden, impact assessmentof the balance of payments and a single hospital DRGs aspect effects like medicarepayment for Hangzhou. Combined with relatively comprehensive medicare paymentqualitative description and quantitative analysis, the assessment results were evaluated,affirmed the positive results under Hangzhou the new health reform medicare paymentsmade. The fourth part draws a template from abroad Germany, Britain, the United Statesand domestic cities such as Shanghai, Beijing, Dongguan payment those have morediversified payment methods, and with the current medicare impact assessmentHangzhou, presenting with a reference at medicare payments for deficiencies inexperience. Finally, the author combined the four most comprehensive basic medicalinsurance for urban Hangzhou, then made a fairly significance to improve the proposal.The main relevance recommendations include five aspects: continue to promote thetotal budget for the core of the hybrid payment roads, the health insurance fund budgetmanagement and supervision need to be strengthened, basic drugs zero sales slip systemneed to be improved, not only to establish a scientific and rational mix of payment, andmore supporting measures to play a peripheral role actively. In this paper, the paper hasbeen concluded and the auther imagines a outlook of medicare payment reform roadmapin the future.The Hangzhou’medical insurance payment reform started in2010, after four years,“the prospective payment”consists mainly of the mixed payment formed a certainscale. But there are not so much studies on the reform of the medical insurance payment.The author belongs to minority in the research of medical insurance payment problemsin Hangzhou. Besides, Data acquisition is very difficult because the confidential natureof the financial information, By working hard to check data made the research to becarried out, And puf forward reform countermeasures and suggestions according to thecurrent medical payment problems.