Abstract

Pilot areas have achieved initial success in capitation reform. On the other hand, challenges remain unsolved in terms of practical pathways, change of national medical insurance management system, related measures, incentives and allocative mechanism for implement of the reform. With the concerning on progress, practice, effects and challenges of typical areas, this article established an institutional framework. On such basis, we propose to design and refine a scheme in terms of 5 aspects, namely strengthening the basic medical care packages′ financing, setting contents and standard of the basic medical care packages rationally, establishing effective evaluation system and formulating supporting measures. Key words: Capitation; Payment system reform; Medical insurance; Challenges; Strategies

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