ABSTRACT
This paper introduced the comprehensive reform of the medical insurance payment practice, featuring day/bed payment and clinical visits payment, in Jian′ou city of Fujian province. This reform established a new pattern of "two full coverage", i. e. , covering all designated medical institutions and all outpatient/inpatient diseases within the city. Centering on population healthcare, such a payment practice encourages changes of the medical institutions, namely to shift from profit drivers to cost control. It also pushes the designated hospitals to improve their quality of care and service efficiency based on a rational limit of medical expenses. These measures have lessened the financial burden of patients, achieving a win-win outcome.
ABSTRACT
This paper introduced the comprehensive reform of the medical insurance payment practice, featuring day/bed payment and clinical visits payment, in Jian′ou city of Fujian province. This reform established a new pattern of "two full coverage", i. e. , covering all designated medical institutions and all outpatient/inpatient diseases within the city. Centering on population healthcare, such a payment practice encourages changes of the medical institutions, namely to shift from profit drivers to cost control. It also pushes the designated hospitals to improve their quality of care and service efficiency based on a rational limit of medical expenses. These measures have lessened the financial burden of patients, achieving a win-win outcome.