支付改革双城记

2011年5月底,人社部颁布《关于进一步推进医疗保险付费方式改革的意见》,首次给出了一个医保付费方式改革目标的官方纲要：结合基金收支预算管理加强总额控制,探索总额预付。在此基础上,结合门诊统筹的开展探索按人头付费,结合住院门诊大病的保障探索按病种付费。10月底,人社部再发通知,在重申这一改革目标的同时,圈定了包括北京在内的40个首批医保付费方式改革的试点城市。

Tale of Two Cities in Health Insurance Reform

On one hand, after being pushed back for several times, DRG payment pilot projec t has nally been carried out in some hospitals in Beijing last October. On the other hand, the global budget is going to full-scale implementation in 2012 in Shanghai after three-year pilot project. Thus, the two models have been established in China. However, how do the two pilot cities design their reform strategy that ts their distinctive conditions? What preparations should they make before the reform? The relevant experien...