Research on the Payment Method of Medical Insurance—A Case Study of Chiping County in Liaocheng City

Abstract

Since the reform and opening up, medical insurance system in China has made great achievements. As the focus and difficulty of medical insurance management and reform, the payment method of medical insurance has attracted increasing attention. Based on the semi-structured interview data of chiping county, the status quo and development trend of the payment method of medical insurance in China are discussed. It is found that the current payment method of medical insurance in China is mainly based on the payment by service items, which belongs to post payment system. The development trend of payment method is changing from single payment method to mixed payment method, changing from post payment system to prospective payment system, emphasizing and promoting payment by disease type and increasing the application of diagnosis related groups-prospective payment system. Late payment and insufficient payment restrict the payment method from post payment system to prospective payment system. The payment method of medical insurance determines the level of medical expenses, the flow of medical resources, the income of medical institutions and the quality of medical services, which will be one of the key factors affecting the success or failure of medical insurance system in China.