Research About The Hybrid Payment Of Social Medical Insurance In Changsha City

Rapid growth of medical costs is always a important factor that restricts our health development, so, Deepening health system reform is the trend. These contents of the reform involve a number of aspects. Payment for medical insurance reform is an important and difficult part. Throughout the reform situation, Medicare payment reform in various regions shows diversify, The payment for medical insurance reform in Changsha is also explored in advance since the basic medical insurance system for urban workers had been established in2000, What has been achieved for Changsha in the Medicare payment reform process? and what are the problems? and how to solve it? These issues are worthy to research. And also it has a certain practical significance. This article makes the Medicare payment reform in Changsha as an entry point, researches the effectiveness of Changsha in Medicare payment reform process and problems, on this basis, we want to build the future direction of the reform of the Changsha Medicare Payment.This article is based on the research of the literature at home and abroad, Firstly, making an economic analysis on a variety of common Medicare payment methods, based on principal-agent theory proposed that budget Medicare payment is the right direction, Secondly, Being based on an accurate grasp of the medical insurance business development in Changsha, we analyze the results achieved and problems in the Medicare Payment in reform at Changsha, Then, By drawing on the experience of the typical foreign countries and our typical areas of Medicare payment reform, we build the Mix-Medicare Payment for the reform of Changsha. The main conclusions of the research are as follows.First. In the process of Changsha Medicare payment reform, the effectiveness is as follows:the smooth operation of medical insurance pool fund, the decline in the proportion of the personal burden of medical expenses, the reduction in doctors burden patients, and the average drop in both the cost and length of hospital stay after taken by the DRGs.Second. In the process of Changsha Medicare payment reform, the problems include that the pool fund expenditure growth rate is higher than the revenue growth, the proportion of DRGs is too small, the high proportion of drug costs in medical expenses, and the role of the primary health care sector does not fully reflects. Third. Building the Mix-Medicare payment in Changsha includes three aspects, implement a total prepaid, continue to expand the proportion of DRGs, the implement the Essential Drugs List zero sales slip systems.