Study On Medicare Cost Containment Countermeasures Under The Total Budget System

As the economic development of China,the Chinese health care system has achieved tremendous success after several revolutions.With an aging population,disease profile mutations and improvement of medical technology led to continous increase of medical expenses.Difficulties and high expenses arose from medical care have been becoming prominent social issues.Nowadays,Total budget system has been the dominant approach for the medical expenses management,in which,all the appointed hospitals share the debt risk and prompted to involve in the expenses management.Therefore,motivation of employees in expenses management,improve ment of productivity without loss of service quality,effective restriction of the medical service cost and decline of medical expenses will be the major problems that all of the appointed hospitals have to overcome in the future.Based on theoretical and empirical research approaches,the influence of Total budge system in medical expenses management and the advantage and drawback of various payment methods were evaluated in this paper by comparing the capacity of those payment methods in the restriction of inappropriate medical expenses increase.As a result,we believe that,based on local developing situation,reform of unique payment method and development of complex payment method will be the trend of Total budget system in the future.On the other hand,the interior strategies of expenses management established by appointed hospitals under Total budge system were investigated based on the study of restriction of the medical insurance-inpatient reported by a tertiary special hospital in Tianjin and respectively effect evaluation.In addition,the paper reported that the appointed hospital under Total budge system had built a couple of high quality and efficiency methods through optimization of medical cost calculation,modification of efficiency examination and enforcement of medical insurance administration,which may be applied in medical insurance expenses restriction.Gradually realize the medical insurance control to fine,standardized,systematic management mode change.