Study on the Problems and Countermeasures in Reforming the Outpatient Co-payment Protection Mechanism of Basic Medical Insurance for Urban Workers Policy
- VernacularTitle:职工医保门诊共济保障机制改革的问题及对策研究
- Author:
Xinyu LIU
1
;
Yuhan NIU
;
Zaixiang TAN
Author Information
1. 徐州医科大学公共卫生学院 江苏 徐州 221004
- Keywords:
basic medical insurance for urban workers;
outpatient coordination;
mutual-aid mechanism
- From:
Chinese Health Economics
2024;43(3):7-9
- CountryChina
- Language:Chinese
-
Abstract:
The process of establishing and improving the Employee Health Insurance Outpatient Co-payment Protection Mecha-nism is one of the major livelihood projects to deepen the reform of China's medical insurance system.The implementation of the mu-tual-aid mechanism for covering outpatient bills in each coordinating region is accompanied by the risks of squeezing outpatient medi-cal resources,the prevalence of fraud and deception,the increase of the government s economic burden and the lack of public ac-ceptance.In this regard,suggestions are made to improve the policy:open source and cut costs to make up for the shortage of funds,linkage of three medical institutions to build a medical security pattem,coordinated supervision to maintain the stability of medical insurance funds,and optimized policies to promote the reform of medical insurance payment methods.
