The Performance Evaluation Of The Medical Insurance Pool Fund Payment

The core mechanism of operation of the medical insurance fund is the fund raising, using, scheduling and hedging. The income of medical insurance fund for urban workers is assigned to individual medical account and pooling funds of two parts. The fund expenditure mainly for the local designated medical institutions, accounting for 75% of the total fund as a whole. The remaining 25% is mainly used for remote medical treatment. At present, China has established a supplementary medical insurance for urban workers’ medical insurance, urban residents’ medical insurance, new rural cooperative medical system, the urban and rural medical assistance and medical security system has been basically completed. With the rapid development of the global economy, rising living standards, health needs and adapt to the human is increasing day by day. But the aging of the population, disease spectrum and changeable, medical service monopoly problems, that leading to the rising costs of health care rate and has far exceeded the speed of economic development, a serious impact on human health demand; "medical treatment is difficult and expensive" phenomenon has become the bottleneck of restricting economic development and affect social stability. Implementation of the new health insurance reform, the guiding ideology and objectives of the new medical reform, all over the country to actively carry out the reform and practice of the system of payment. Advance from the traditional, single payment to the composite payment method suitable for the actual. But if you just want to change the payment method, and the lack of effective performance evaluation method for cost, cost control, the medical service quality effect is greatly reduced, patients and families still face serious economic burden. Therefore, the health departments to implement of fine management can establish a scientific, objective and fair to reflect the payment method the effect of the performance evaluation system, make payment management performance evaluation management and running effect of medical treatment insurance agency orgnaization of important basis. In this context, to explore the construction of pay management performance evaluation index system and research to explore the payment system reform of system, the system design and improvement of the performance management becomes necessary.Therefore, in this paper, the first chapter put forward our country should accelerate the reform of medical insurance payment mechanism of purpose and meaning; The second chapter mainly on medical insurance as a whole fund pays for theoretical research, comparative analysis; The third chapter expounds the overseas medical insurance as a whole fund pays, draw lessons from advanced experience at home and abroad;The fourth chapter according to the experience of the reform practice at home and abroad, choosing scientific and reasonable evaluation index to construct the performance evaluation system, and the use of analytic hierarchy process for performance evaluation index system building, and using the constructed the performance evaluation system of city 2009-2012 the implementation of the reform of medical insurance for urban workers as a whole fund pays effect was evaluated;Finally the fifth chapter in view of the problems related to perfect the medical insurance as a whole fund pays improved leather countermeasure has carried on the feasible suggestions.