Challenges and countermeasures faced by leading units of county medical alliance under the background of overall payment of medical insurance / 中华医院管理杂志

ABSTRACT

Leading units of county medical alliance had difficulties in financial management and resource distribution after social medical insurance took the whole alliance as the payment subject. The authors summarized and analyzed the problems faced by the leading units of medical alliance in typical areas after the implementation of the overall payment, such as the high risk of fund overspending, the high risk of extra medical treatment, and the difficulty in the management of special funds. Then put forward some solutions, such as the unification of interests and responsibilities, the decentralization of medical insurance settlement rights, the refinement of medical insurance payment, and the pricing reform of primary medical services, so as to improve the medical insurance payment policy and promote the development of county medical alliance.