ABSTRACT
Objective To analyze the performance of the combination of "Countywide Medical Community" combine with "Capitation Prepayment". Methods We collected the new rural cooperative medical system ( NRCMS ) data of Funan county ( with "Countywide Medical Community" introduced in 2015, along with Capitation Payment) and Yingshang county (without"Countywide Medical Community"), both in Anhui province, from 2014 -2016. With such data, a longitudinal comparison was made on the performance of Funan "Countywide Medical Community" before and after, and a horizontal comparison on Funan county and Yingshang county regarding the merits and weakness of the Community. Results 2014-2016 witnessed a year-by-year decline of the outside-county proportion of the expenditure, man-time of inpatients, hospitalization expenses and hospitalization reimbursement by NRCMS in Funan county, and an increase of such proportion within the county. Furthermore, these proportions of Funan county were better than those of Yingshang county, proving "Countywide Medical Community" a success. Conclusions The performance of the combination of "Countywide Medical Community" and "Capitation Payment" proved a success.
ABSTRACT
This paper analyzed and concluded successful experience and mechanisms of regional global per capita budget implemented since 2015 in Anhui province,including the formation of mutual incentive and restraint mechanism, the mechanism of controlling expenses spontaneously and resource allocation efficiently.After the reform, flow of hospitalized patients was more rational, and the financial burden of patients was alleviated, while the capacity of medical institutions was improved notably in pilot counties.The successful experience of Anhui province can put forward corresponding suggestions to guide the future work in other areas.
ABSTRACT
Objective To analyze the performance of the combination of "Countywide Medical Community" combine with "Capitation Prepayment". Methods We collected the new rural cooperative medical system ( NRCMS ) data of Funan county ( with "Countywide Medical Community" introduced in 2015, along with Capitation Payment) and Yingshang county (without"Countywide Medical Community"), both in Anhui province, from 2014 -2016. With such data, a longitudinal comparison was made on the performance of Funan "Countywide Medical Community" before and after, and a horizontal comparison on Funan county and Yingshang county regarding the merits and weakness of the Community. Results 2014-2016 witnessed a year-by-year decline of the outside-county proportion of the expenditure, man-time of inpatients, hospitalization expenses and hospitalization reimbursement by NRCMS in Funan county, and an increase of such proportion within the county. Furthermore, these proportions of Funan county were better than those of Yingshang county, proving "Countywide Medical Community" a success. Conclusions The performance of the combination of "Countywide Medical Community" and "Capitation Payment" proved a success.
ABSTRACT
Objective:By analyzing the benefits of hospitalization and outpatient of New Rural Cooperative Medical System (NCMS) in Anhui, to provide suggestions for further improving NCMS. Methods: The peasants in Anhui were surveyed by analyzing relevant data to get and analyze the benefits of peasants under the changes of NCMS. Results: The actual compensation ratio of hospitalization and the actual outpatient compensation ratio are all increased, the actual outpatient compensation ratio also increased, the coverage of benefit has expanded, but the average self-pay costs did not decrease significantly due to increase of medical expenses. Conclusion: To further improve the benefit of the peasants, it needs to broadly spread the policy, strengthen the supervision of medical institutions and implement the Catastrophic Medical Insurance Policy.
ABSTRACT
Objective To refrain the medical costs from out-of-control increase, and identify a per-disease payment mode suitable for New-CMS.Methods Case studies were conducted on all the data of five diseases in the course of three years, in a field study of the pilot counties for NRCMS in Anhui Province.Results This system of per-disease "pay by segmentation and quota" is composed of five parts: choice of diseases, measurement of payment criteria, method of settlement, method of compensation, and methods of supervision.Conclusion This system is an effective way to keep the medical costs in the NRCMS under control, given an effective play of the five supportive measures including the clinical pathways for individual diseases.