Researches On Payment Method In Terms Of Payment Per Disease Scoring In Yangjiang Guangdong Province

The reform of the medical and health system has entered the deep water zone,and we must adhere to the implementation of the "medical,medical insurance,medicine" three-medicine linkage reform.The medical security system,as one of the supporting reform measures,plays a pivotal role.The medical security system is one of the most important people's livelihood work and an important part of a national social security system.It is not only related to social stability,national health,but also has a major impact on social and economic development.With the continuous growth of China's economy after the reform and opening up policy,the rise in health care expenditure has reached to an alarming levels,even surpassing economic growth.The reform of the medical security system is an universally acknowledged worldwide problem,among which the control of medical insurance expenditure is a tough one to be solved.The payment method is an important link in the medical insurance management,which is related to the protection of the rights and interests of the insured personnel,the balance between income and expenditure of the medical insurance fund,the quality of medical services and the rational allocation of medical service resources.Under the background of the comprehensive promotion of the payment method of value-based payment based on specific disease in Guangdong Province,this paper conducts a comprehensive case study on the payment of disease-based value in Yangjiang City,focusing on the background,system design,operation process,implementation of its reform,existing problems,as well as operation effects,etc.,and also tries to explore the new payment methods that are linked to the “decentralized value” of medical insurance,hospital “earnings value”,hospital income and total expenditure fund and “point value”.Whether the leverage of quality and control costs can balance the interests of the health care sector,medical institutions,and insured persons.Meanwhile,in terms of the existing problem in paying for the value of disease type in Yangjiang City and combined with the current reform of the medical and health system,this paper puts forward its own suggestions from the aspects of system construction,medical insurance supervision and internal management of hospitals,which is of great practical significance to promote the application of payment by disease value.