Research On Off-site Visit Management Of Urban Employee Basic Medical Insurance In Hebei Province

Since the reform and opening up, the rapid development of China's social economy has driven the movement of the labor force, and the cross-regional employment has become the common occurrence. The pooling coverage of China Health Insurance is at low level,and there is policy difference among all regions. The cross-border health services and low pooling level, which together, make the off-site visit management become difficulty of the urban employee basic medical insurance and be worth studying. This research adopts literature research, content analysis and comparative analysis methods. At first, it elaborates the research actuality and research programme. Then it introduces the policy regulations of off-site visit management in Hebei province. Contain the basic situation,the classification of personnel and disease, the prior approval, the cost compensation provision and the reimbursement procedure. Combined with statistical data and related literature, I make the analysis with the influence factors, including the policies and regulations, the geographical position, medical technology level. And then, I also make analysis with the problems existing in the off-site visit management. Finally, I give some advices to off-site visit management of Hebei province: improve the off-site visit policy information transparency; standardize the procedures for the off-site visit; standards for the scope of the transfer of referrals in different places; speed up the immediate settlement of medical care in different places; simplify the settlement requirements;reduce the difference of reimbursement between local visit and off-site visit.