| China’s urban residents’ medical insurance system is part of the social insurance system which is set up in order to guarantee urban residents’medical needs, since it is implemented in 2009, it has basically achieved full coverage, the combination of medical insurance system for urban residents and medical insurance for urban workers weaved a safety net of medical and health for the whole urban population.Since the foundation of the system, due to the impact of population aging, the growth of residents’ health demand and some other factors, and methods of payment, supervision and management is not in place, the expenditure of urban residents’ medical insurance has been rising rapidly, the fund of urban residents’ medical insurance in some places is shoestring, facing serious payment difficulties.It is fundamental to any medical insurance system’s safe and stable operation to effectively control the medical cost of rapid expansion and guarantee the full payment ability of funds, the medical insurance for urban residents is no exception. The domestic and foreign research and practical experience have shown that the third party payment of medical insurance is the most direct and effective cost control mode. Especially the prepaid payment methods represented for capitation payment and DRGs have shown significant effect in terms of controlling cost, saving the health insurance fund, optimizing the allocation of health resources and enhancing the medical service and management efficiency. At present, several third party payment methods from both domestic and international have shown some success in exploring across our country for controlling the excessive expansion of the medical costs. But simply performing a single sort of payment method has also brought some problems, such as the problem of moral hazard, cost control problems, efficiency problems and system operation problems, which shows that the current third party payment methods is not perfect, there are still some problems.Through a comparative study of the similarities and differences of different places of our country, comparing the payment methods, absorbing advanced experience, pointing out the problems and shortcomings, and at the same time, according to the foreign institutional arrangements, proposing the common payment methods which suit the situation of our country, and on this basis, putting forward the concrete policy recommendations. |