Sustainable Development Of The New Cooperative Medical Scheme (NCMS) Funds In Three Counties In Ningxia

Objective:On the basis of monitoring the implementation process of the NCMS fund,anaylyze existing problems of fund sustainable development and explore deep reasons of those problems,and provide relative suggestions for adjustment of the NCMS scheme in Ningxia and western regions of China.Methods:1.Literature Review:Relevant literatures were collected and reviewed.2.Policy documents Review:Relevant policy documents of national and three counties in Ningxia were collected and reviewed.3.Quantitative study:Organization data were collected through the questionnaire and analyzed in Excel.4.Qualitative study:In-depth interviews and focus group discussions were organized with policy makers and managers of the NCMS,health providers and the insured.Key findings:1.Financing standards increase year by year,and the insured wishes have been significantly increased.The rate of participation increase year by year,and the difficulty of financing decreased.It has been possible to promoting the self-help financing pattern.2.The reimbursement pattern determined the allocation proportion of reimbursement funds for outpatient and outpatient.Three counties in Ningxia will all cancel out-patient family accounts in 2009.3.Three counties in Ningxia conduct an annual adjustment to inpatient reimbursement scheme from 2005 to 2008.The number of reimbursed people and the benefit rate increase year by year.4.People tend to hospitalize in county -level hospitals,and the township-level hospitals are unattractive.5.Medical expenditure per patient increases over the years and the supervision and cost control of medical institutions mainly through administrative means with little effect.6.Surplus of Co-ordination fund in the same year tends to decrease,but the accumulated surplus remains far too high.Suggestions:1.To implement self-help payment mode based on accountability of village cadres.2.To deplete cash surplus of Out-patient family accounts with fair and reasonable methods.3.To set the allocation proportion of reimbursement funds for outpatient and outpatient with scientific calculations.4.To strengthen the supervision and effective cost control of designated out-patient medical institutions.5.To increase the input of grassroots medical institutions,and improve level of medical treatment of their medical personnel.6.To set the deductible and reimbursement proportion based on reasonable estimates.7.To establish of mixed supply-side payment mechanism to control the growth of medical costs.8.To narrow the gap between formulated reimbursement proportion and actual reimbursement proportion within 5%.