A Study On Basic Medical Insurance Payment Mode Reform Of Urban Employees In Nanchang

In recent years,as the coverage of medical insurance expanded gradually and the number of insured people grew increasingly,the medical insurance has become the powerful guarantee for residents to see the doctor and the vital content of national people's livelihood.Now the medical insurance has turned into a world problem gotten stuck in its payment method.So how to break through the difficulty,find a set of effective payment method and promote the scientific management of designated medical institutions has been the key research point of medical insurance handling organizations.Payment method is a kind of economic means and the effective way by which the medical insurance handling organizations implement performance management on the provider of medical service.It can not only meet the basic medical needs of insured people but also balance the medical insurance fund payment position and build a harmonious trilateral relation among doctors,patients and insurance agencies.Since 2001,the basic medical insurance of urban workers in Nanchang city has been carried for fifteen years.During this period,the number of insured people kept increasing and the total fund kept expanding,but the original medical payment has been unable to meet the real needs today.Because the tendency of unreasonable medical expenses grows straightly,medical insurance fund management difficulty rises gradually and the contradiction among doctors,patients and insurance agencies is deepened,the medical insurance handling organization of Nanchang city bears large amounts of management pressure and it is imminent to reform the payment method of medical insurance.Putting the medical insurance payment method of urban workers in Nanchang city as the study objective,this paper will research on its reform status based on the analysis of relevant data.This paper is divided into five parts,whose main contents are as followed:The first part is introduction.It briefly introduces the research background,ideas and methods and explains,the importance and necessity of researching on the reform of medical insurance payment method.The second part is the theory.It introduces the related theory,basic types and experience of the medical insurance payment method,which has provided necessary theoretical support and experience for the reform of medical insurance paymentmethod in Nanchang city.The third part is the development process.It briefly introduces the present situation of the medical payment reform in Nanchang city and state the reform reason and process.The fourth part is the reform effect analysis.It focuses on the reform framework,system design and effect analysis of the method that paying according to different kinds of disease.The fifth part is the study conclusion and discussion.Through three years 'reform practice,the reform of medical insurance payment method in Nanchang city has been implemented smoothly and enjoyed obvious effects,but there still exists room for further improvement.Therefore,aimed at the existing problems,I put forward the countermeasures and suggestions from the aspects of optimizing the budget system,detailing the assessment index and strengthening the supervision and management.