The new stage of medical reform The reform of medical insurance payment method plays a leading role in 4.

Wen . . . Qiu Xiaoxuan's reform of medical insurance payment method is an important proposition of the Opinions of the State Council of the CPC Central Committee on Deepening the Reform of the Medical Security System (hereinafter referred to as "Opinions") and the key to judging the success of medical reform.
the reform of medical insurance payment methods not only refers to the reform of medical expenses payment methods, it will also play a certain role in the medical institutions' medical services, medical workers' compensation system, drug sales business model, etc.
In the face of the new era, the new situation and the new requirements under the new mission, how to reform the payment method of medical insurance plays a leading role in the process of modernization system reform, but also from the following aspects to explore: First, play the function of public welfare resource allocation.
recent years, the "market decisive role" in the field of medical reform has been repeatedly mentioned, medical insurance payment is essentially the medical insurance sector through the market mechanism to pay more attention to the rationality of medical resources and public welfare redistribution.
health insurance fund itself is social welfare in nature and cannot be privatized and marketized, but this does not amount to an anti-market mechanism.
theory of modern economics advocates the use of market mechanisms to solve public welfare problems, so that the masses have a growing sense of access.
, stimulate healthy competition in medical institutions.
the current reform of medical insurance payment methods generally implement the payment mechanism by disease, by head, by bed and by disease diagnosis-related grouping.
to get more surplus, medical institutions inevitably reduce the quality of medical services, so it is necessary to stimulate healthy inter-agency competition.
that under the premise that patients have full freedom of choice, medical institutions with more advantages in the quality of medical services can win more patients.
, innovative health care service governance pattern.
view of the development history of international medical insurance agencies, professional, independent and legal organizations are important guarantees to establish and guide medical service providers to rationally allocation of medical resources payment mechanism.
Opinion also proposed to actively absorb commercial insurance institutions and social organizations to participate in medical insurance management, explore the establishment of a common governance and sharing of health insurance governance pattern.
, and actively introduce external technical support.
The exploration of medical insurance payment method reform can not be separated from data support, while exploring data standardization technology, but also actively introduce mathematical modeling and other technology development, explore the level category of medical institutions, comprehensive strength, service capacity, resource allocation, historical data and other multi-dimensional information comprehensive assessment, establish information data-based digital analysis, management model, explore the use of artificial intelligence technology to research and realize the medical insurance payment standards and payment process of scientific and efficient management.
how the reform of health care payment methods in China sparks the tide of the times, which is an open question for health care departments everywhere.
how to give full play to the advantages of public welfare resource allocation, stimulate healthy competition in medical institutions, innovate the governance pattern of medical insurance services, and actively introduce external technical support are all worthy of our focus on system design.
addition, from the perspective of the regional nature of the system, how to dialectically resolve regional contradictions, conform to the new direction of reform, but also in the establishment of the system based on the overall medical reform, overall design, long-term planning.
: Health care payment method reform needs to continue to promote the modernization of the system.