Discussion on the effect of medical insurance payment system reform on promoting the construction of medical alliance
10.3760/cma.j.cn111325-20201202-02176
- VernacularTitle:医保付费制度改革推进医疗联合体建设的探讨
- Author:
Qingli TAN
1
;
Daiheng LIN
;
Jingyi CHEN
Author Information
1. 广东药科大学医药商学院，中山 528400
- Keywords:
Health care coalitions;
Medical reform;
Diagnosis-related groups;
Diagnosis-intervention packet;
Tiered medical system
- From:
Chinese Journal of Hospital Administration
2021;37(8):631-635
- CountryChina
- Language:Chinese
-
Abstract:
The reform of medical insurance payment system could promote the transformation of medical services from price medical care to value medical care, which is very important to promote the construction of medical alliance. The authors discussed the reform of medical insurance payment system to promote the construction of medical alliance, and the order of medical alliance covering medical services and seeking medical treatment.For medical service providers, the reform of medical insurance payment system helped to promote the construction of closer medical alliance, guided the sinking of high-quality resources, helped to form a smooth referral mechanism, and strengthened the supervision and assessment of medical behavior. For the demanders of medical services, the differentiated medical insurance reimbursement proportion policy within the medical alliancewas more conducive to attracting the first consultation at the grass-roots level. At the same time, patients had a wider choice of medical treatment and more freedom of choice. In view of the problems existing in practice, the authors suggested that a variety of medical insurance payment and performance systems with value-based medical care as the core should be implemented to deepen the development of medical alliance, the medical insurance system and municipal subsidies should jointly undertake the salary subsidies for sinking medical personnel, and integrate the grass-roots fragmented health care business with the help of medical insurance payment tools, and promote the coverage expansion of the medical insurance reform of the medical alliance based on policy guidance.
