Health Provider Payment Reforms in China
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Washington, DC
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This paper examines health provider
payment reforms in China the present system and how it
evolved, and changes that will improve it in the context of
ongoing health reform. The paper begins with a brief
introduction and background discussion followed by two
substantive sections experiments with case-based payment
systems, and experiments with alternative government budget
payment methods. This is followed by an examination of what
has worked in China and elsewhere. The concluding discussion
considers lessons for China and next steps. Many policy
instruments and reforms have been implemented to use
National Cooperative Medical System (NCMS), Basic Medical
Insurance (BMI), and government health budgets more
efficiently. These include alternative payment systems,
reduced drug prices, essential drug lists, controlled use of
high technologies, and strengthening the primary healthcare system.
Palabras clave
ACUTE CARE, ADMINISTRATIVE MANAGEMENT, AGED, AMBULATORY CARE, AMBULATORY SURGERY, BASIC HEALTH CARE, BASIC POPULATION, BLOCK CONTRACTS, BLOCK GRANT, BUDGET ALLOCATION, CAPITATION, CAPITATION FEE, CAPITATION PAYMENTS, CARE PURCHASERS, CASE MANAGEMENT, CHILD HEALTH, CHRONIC CONDITIONS, CHRONIC DISEASE, CHRONIC DISEASES, CITIES, CITIZEN, CLEAN WATER, CLINICAL TEAMS, CLINICS, COMMUNITY HEALTH, COMMUNITY HEALTH CARE, COMPETITIVE ENVIRONMENT, COMPLICATIONS, CONTRACTUAL ARRANGEMENTS, COST ANALYSIS, COST CONTROL, COST OF HEALTH CARE, COST SHARING, COST-EFFICIENCY, DELIVERY SYSTEM, DIABETES, DIAGNOSIS, DIAGNOSTIC SERVICES, DISEASE CONTROL, DOCTORS, DRUGS, ELDERLY CARE, EMPLOYMENT, EQUAL ACCESS, ESSENTIAL HEALTH CARE, EXPENDITURES, FAMILIES, FEE FOR SERVICE, FEE SCHEDULE, FEE SCHEDULES, FEE-FOR-SERVICE, FEE-FOR-SERVICE BASIS, FINANCIAL INCENTIVES, FINANCIAL MANAGEMENT, FINANCIAL RISK, FLAT RATE, FLAT-RATE FEE, GENERAL PRACTICE, GENERAL PRACTITIONERS, GLOBAL BUDGETS, GOVERNMENT AGENCIES, HEALTH BUDGETS, HEALTH CARE, HEALTH CARE INSTITUTIONS, HEALTH CARE ORGANIZATIONS, HEALTH CARE PROVIDERS, HEALTH CARE QUALITY, HEALTH CARE SYSTEM, HEALTH CARE SYSTEMS, HEALTH CARE USE, HEALTH CARE UTILIZATION, HEALTH CENTERS, HEALTH CONDITIONS, HEALTH EDUCATION, HEALTH EXPENDITURES, HEALTH FACILITIES, HEALTH INSURANCE, HEALTH INSURANCE SCHEMES, HEALTH MAINTENANCE, HEALTH MAINTENANCE ORGANIZATION, HEALTH OUTCOMES, HEALTH POLICY, HEALTH PROMOTION, HEALTH PROVIDERS, HEALTH REFORM, HEALTH SECTOR, HEALTH SERVICE, HEALTH SERVICES, HEALTH SYSTEM, HEALTH SYSTEMS, HEALTH WORKERS, HEALTHCARE, HEALTHCARE SECTOR, HEALTHCARE SYSTEM, HEART SURGERY, HMO, HOSPITAL ADMINISTRATION, HOSPITAL ADMISSIONS, HOSPITAL BEDS, HOSPITAL CARE, HOSPITAL CONSULTANTS, HOSPITAL COSTS, HOSPITAL FUNDING, HOSPITAL INPATIENT, HOSPITAL MANAGEMENT, HOSPITAL PATIENTS, HOSPITAL SECTOR, HOSPITAL SERVICES, HOSPITALISATION, HOSPITALIZATION, HOSPITALS, HUMAN RESOURCES, IMMUNIZATION, INCOME, INCOME GROUPS, INDIVIDUAL HEALTH, INFECTIOUS DISEASE CONTROL, INFORMATION ASYMMETRY, INFORMATION SYSTEM, INFORMATION SYSTEMS, INPATIENT CARE, INPATIENT HOSPITAL, INPATIENT HOSPITAL SERVICES, INSURANCE, INSURANCE SYSTEM, INSURANCE SYSTEMS, INSURERS, INTERNATIONAL LABOR ORGANIZATION, LABORATORY SERVICES, LAWS, LEGAL ADVICE, MANAGEMENT SYSTEMS, MARGINAL COSTS, MEDICAL CARE, MEDICAL CARE COSTS, MEDICAL CARE EXPENDITURES, MEDICAL COLLEGE, MEDICAL COSTS, MEDICAL EQUIPMENT, MEDICAL EXPENDITURE, MEDICAL EXPENDITURES, MEDICAL INSURANCE, MEDICAL PERSONNEL, MEDICAL SERVICES, MEDICAL SYSTEM, MEDICAL TREATMENT, MEDICARE, MENTAL HEALTH, MINISTRY OF HEALTH, MORAL HAZARD, NATIONAL DEVELOPMENT, NATIONAL HEALTH, NATIONAL HEALTH SERVICE, NURSES, NURSING, NURSING CARE, NUTRITION, OCCUPATIONAL HEALTH, OUTPATIENT CARE, OUTPATIENT SERVICES, PATIENT, PATIENT CHOICE, PATIENT COST, PATIENT SATISFACTION, PATIENTS, PHYSICIAN, PHYSICIAN SERVICES, PHYSICIANS, POCKET PAYMENTS, POLICY DOCUMENT, POLITICAL SUPPORT, POOR FAMILIES, POOR QUALITY CARE, PRESCRIPTIONS, PRIMARY CARE, PRIMARY HEALTH CARE, PRIVATE HOSPITALS, PRIVATE SECTOR, PROGRAMS FOR HEALTH, PROVIDER PAYMENT, PROVISION OF HEALTH CARE, PUBLIC HEALTH, PUBLIC HEALTH CARE, PUBLIC HEALTH POLICY, PUBLIC HEALTH SERVICES, PUBLIC HOSPITAL, PUBLIC HOSPITAL SYSTEM, PUBLIC HOSPITALS, PUBLIC PROVIDERS, PUBLIC SECTOR, PURCHASER-PROVIDER SPLIT, QUALITY ASSURANCE, QUALITY OF CARE, QUALITY OF HEALTH, QUALITY OF HEALTH CARE, REFERRALS, RESOURCE USE, RURAL COMMUNITIES, RURAL COUNTIES, RURAL POPULATION, RURAL RESIDENTS, SICKNESS FUNDS, SMOKERS, SMOKING, SMOKING CESSATION, SOCIAL HEALTH INSURANCE, SOCIAL INSURANCE, SOCIAL SECURITY, SOCIAL WELFARE, SURGERY, TRANSPORTATION, TREATMENTS, URBAN AREAS, URBAN COMMUNITY, URBAN POPULATION, USE OF RESOURCES, USER FEES, VACCINATION, VISITS, WORKERS, WORKING CONDITIONS