"First see a doctor and then pay" is not so much called health care policy as called hospital, commercial insurance market strategy

Text . . Code Wanxuan recently, the National Health And Wellness Commission Statistical Information Center released the first half of 2020 national medical services, there were "three declines" in the number of patients, discharges, bed use;
January-June 2020, hospital bed uity rate was 68.4%, down 17.5 percentage points year-on-year, community health service centers were 42.5%, down 11.1 percentage points year-on-year, and township hospitals were 51.4%, down 11.6 percentage points year-on-year.
affected by the outbreak of neo-crown pneumonia, the overall income of the medical industry has declined, and the competition between public hospitals and private hospitals, public hospitals above level 2 and above and primary hospitals has become more intense.
Even if the above-mentioned medical and health institutions have medical associations, medical community pilot system there are still cooperative efforts, but private hospitals, primary hospitals to thoroughly and continuously develop, "iron still need their own hard."
this article, we take the "first to see a doctor and then pay" this recently seen in the newspaper's innovative behavior of medical services, to do some strategic discussion.
"First to see a doctor and then pay" ten years do not see the beginning of the system model of "first to see a doctor after payment" to start in Jining City, Ganzhou Central Hospital, and this model was created in the original intention of not "public welfare" factors, but the hospital in order to get rid of the operating difficulties of marketing measures.
In this mode, patients do not have to pay an inpatient deposit when they go through hospital procedures, as long as the medical guarantee, ID card or copy of the hukou copy to the inpatient office, signed the "inpatient treatment fee settlement agreement" can be hospitalized.
who cannot afford hospitalization, they may sign an agreement with the hospital to pay the medical expenses in inssality or eventually one lump sum over a period of two years.
2010, the annual revenue of The Central Hospital of Zhangzhou City was 46 million yuan, and in 2011 it almost doubled, exceeding 90 million yuan.
the end of 2011, the number of outpatients at the Central Hospital in Zhangzhou Increased by 85.28 percent over the same period last year, the number of inpatients increased by 73.28 percent, and the number of 500 beds was full.
Since the second half of 2011, Hebei, Henan, Shandong and other places have implemented the "first to see a doctor, pay" system pilot, the vast majority of the county-level and county-level primary hospitals, and rarely large and medium-sized cities to implement this public policy.
The main difficulties include, but are not limited to: First, the insured patients suffering from serious and serious diseases and seeking medical treatment in different places, the amount of out-of-patient payment is not good to control; The construction of credit files of natural persons is not perfect; fourth, the pilot projects carried out by individual hospitals and regions often shrink after being single-man and lacking support; and the principle of people-centered, health-centered and patient-centered has not been clearly established at that time.
all these, so that we once thought that "first to see a doctor after payment" theoretically can have, the reality is everywhere risk, it is likely to do better than not to do.
After all, the benefits of this model are limited: first, to save patients' medical time, omit some intermediate payment links;
are also hidden shortcomings and risks: hospitals such as overtreated are more likely to commit crimes.
The model of "credit plus insurance" brings new ideas," according to the Beijing Daily, Beijing Shijingshan's Beijing University Shougang Hospital officially launched the "credit medical treatment" model, "credit medical treatment" introduced credit commitments and insurance mechanisms, eliminating patients in the registration, inspection, testing, drug withdrawal and other links repeatedly queue to pay trouble, the future will also open hospital deposit advance payment.
Previously, according to the Qianjiang Evening News, on New Year's Day, a sanjia hospital in Ningbo overnight to treat a high-risk mother, successfully saved adults and children;
according to hospital regulations, 20% of the arrears to be borne by the department, several doctors shared more than 4000 yuan of medical expenses.
" compared with these two cases, it is more clear that the "first to see a doctor and then pay" model for ten years did not make a real change.
the early model represented by Luzhou Central Hospital, when, in addition to the social medical insurance system, the local ecological scene lacked the support of commercial insurance tools, such as: commercial health insurance, credit insurance, medical liability insurance and so on.
in the above-mentioned "credit plus insurance" model, hospitals, related patients, underwriting institutions between the formation of ecological, benefit-win situation, and may ensure that the social health insurance system, hospitals, the interests of the relevant insured patients.
is similar to the social health-care fund's willingness to adopt a pay-to-care reform of the total prepaid system.
what can we get from insurers that emphasize the "credit plus insurance" model? On the one hand, insurance companies and related hospitals, patients, and related information systems, tool applications closer to improve market penetration, influence;
categories such as China Ping An integrated financial services three-tier jump: from capital-driven, to "finance and access" channels, to "finance and ecology" strategic intentions, insurance companies themselves and their surrounding ecology should realize: in the context of healthy China, "patients have their own medicine" feasible necessity, commercial insurance and health insurance, in addition to disease, but also according to the cost.
, patients can apply for "credit access" services in the hospital through WeChat Public Number and hospital self-service machine.
the application, patients can "one visit at a time to pay", exempt from registration, inspection, testing, drug withdrawal and other links in line to pay.
through face recognition, big data analysis technology, patients" credit medical applications can achieve second-level approval.
patients to complete the settlement of medical insurance costs can leave the hospital, the amount of personal out-of-the-money within 48 hours to pay by mobile phone, but also to inquire about medical expenses.
" specific examples: based on face recognition, credit data, big data analysis technology, health insurance companies with an integrated financial platform in addition to the orderly exploration of commercial medical insurance business, but also can explore personal or family medical credit business.
such credit business is both for-profit and public welfare, supporting patients to enjoy medical insurance treatment earlier and more, and supporting the treatment of serious and serious diseases.
"first see a doctor and then pay" the latest applicable conditions are in private hospitals, primary hospitals are the most applicable.
These hospitals adopt the "pay-as-you-go" model supported by "credit and insurance", which has the advantages of: first, these hospitals have generally experienced excessive inpatient beds, too idle, and second, these hospitals are adversely or beneficially affected by the deepening of the new medical reform, but are always in a passive position; The single amount charged by project is relatively limited, the risk of escape is relatively small, fourth, the total number of these hospitals is large, the competition specificity is small, it is urgent to be able to use the service label to stand out, fifth, the exploration effectiveness of these hospitals is quickly copied by competitors in the same situation, may pull the rapid progress of graded diagnosis and treatment, and the second-level public hospitals often have their own motivation.
is not only in the clinic, but also in the inpatient department.
First of all, outpatient, three-level public hospitals affected by the reform of inpatient DRG payment, there is a large outpatient business volume, Internet medical business volume of subjective will, so do not rule out in some information base conditions, credit insurance products penetration of good cities, sanjia hospitals will also explore the "credit and insurance", "credit and health insurance" and other support under the "pay-to-see" model.
Again, in terms of hospitalization, first, the poor may enjoy health and poverty alleviation policies, in some places are allowed to "see a doctor before paying", and second, some hospitals can be in the "credit and insurance" model to "first see a doctor after payment" to "first see a doctor, the process after payment", not only to reduce the risk, but also to enable the sick people to enjoy certain benefits.
need to be clarified that "pay-per-view" is not necessarily free medical care.
However, the form of post-payment or process-segmented post-payment helps to stimulate service competition and awareness renewal among medical and health institutions, to explore the reform of medical treatment and medical insurance payment under the current national conditions, and to move from multi-level medical security to energy-efficient social health ecology.