An Innovative Research On The Cooperative Medical Insurance Payment For Urban And Rural Residents In Chongqing,which Based On The Risk Prevention And Control Of Medical Insurance Fund

The third plenary session of the 18^th CPC central committee proposed a more equitable and sustainable social security system,and required definitly to integrate basic medical insurance system for urban and rural residents as soon as possible.To be one of the forerunners,Chongqing had integrated the New Rural Cooperative Medical System and the Medical Insueance for Urban Residents into the Cooperative Medical Insurance for Urban and Rural Residents in 2009,which indicated the framework of the basic medical insurance system that covers urban and rural residents has been formed basically,and has been achieved the goal of medical insurance for all in the system.However,as the number of insured people grows,and the security level improves year by year,following a sharp rise in medical costs and fund risk,causes a“difficulty and expensive in seeing a doctor”situation to the insured,and increasing frequency of medical insurance funds deficit,how to control the increase of medical expenses and avoid the risk of insurance fund become an important issue to be solved urgently.From the medicaremanagement aspects,to seek for a balance between ensuring medical service quality and controlling medical expenses,innovative payment is an effective?imperative measure to insurance fund risk prevention and control.This paper takes medical insurance for urban and rural residents as the innovative studies,through contrast analyze,aims to discuss the fund risk and causes under current medical insurance payment method theoretically,bases on the domestic and international advanced practical experience,combines with actual running of medical insurance for urban and rural residents system in Chongqing,explores a payment method which suits social economic development level and medicare management requirement of Chongqing,meanwhile,put forwards suggestions and countermeasures to innovate the medical insurance for urban and rural residents payment method.