Practice of the compound medical insurance payment system under a ceiling control in Shenzhen / 中华医院管理杂志

ABSTRACT

The paper summarized the compound medical insurance payment system under a ceiling control with Shenzhen characteristics.This practice features ceiling control,prepaid at year beginning,multiple payment methods,monthly payment,year-end closing,and reward for surplus.The following measures have been implemented,namely controlling the total amount,compound payment mode,setting up the scientific and reasonable payment standards and establishing a perfect supervision system.This reform has achieved such outcomes as accessibility of the insured people to primary medical insurance,balance for the medical insurance fund,curbing of rapid rise of medical expenses,progress in the policy of first contact in the community health organization,promoting the development of the health system and raising satisfaction among the insured people year by year.