Study On Total Control Payment Method Of Medical Insurance

In recent years,per capita medical expenses in major developed countries have continued to rise.The growth of medical expenses has become a trend issue.How to control the increase of medical expenses under the premise of guaranteeing the medical needs of the people is an urgent problem to be solved.Since 2012,China has clearly proposed that the total amount of medical insurance should be controlled under the basic principle of "guaranteeing basic,scientific and reasonable,open and transparent,encouraging and restraining and strengthening management",aiming to slow down the growth of medical insurance fund expenditure in our country.Taking the total amount of medical insurance as a starting point to control the payment mode,exploring the practical effect of the total amount control payment method helps to deepen the reform of the medical insurance payment mode and contributes to the construction of the medical insurance system.Therefore,the total amount of medical insurance control payment is worth further study.In this study,we take the total amount of medical insurance to control the payment method as the research object,and grasp the basic situation of the implementation of the payment method of medical insurance in area A by means of empirical research.And through the questionnaire survey,Through the questionnaire survey of the insured,starting from three aspects of hospital-efficiency,insured person-effect,health insurance management-benefit,Explore the efficiency of the reform of payment methods from the economic cost of the hospital,from the perspective of the insured person on the effect of the medical insurance service satisfaction after the reform of the medical insurance payment system and from the fund expenditure of medical insurance agencies to explore the benefits of 6ayment methods Situation,a comprehensive analysis and evaluation of the implementation of the total amount of medical insurance control payment methods.It points out that there are a lot of problems such as lack of effective control of patient diversion mechanism,urban workers becoming the main object of total amount control,lack of effective supervision mechanism and encouragement mechanism in the' process of implementing the total medical insurance control payment.Therefore,we should pay attention to tihe problem of patients' mobility and make rational use of medical resources.Accelerate development supervision and quality tracking system,establish supporting linkage mechanism;Continuously optimize the total control index and promote DRGs;We will strengthen the government's functions,strengthen the publicity of the reforam policy of the total amount of control payment,and improve the refonn of the payment method of the total medical insurance.