Thoughts and Practice of DRGs-based Multi-Faceted Payment Reform in Xixian, Henan Province

doi:10.7664/CHE20171009

Abstract：Discussions in terms of spending control-based payment methods were raised upon the rapid increase of medical expenditure in recent years.Diagnosis Related Groups(DRGs) has been considered as one of the most promising choices among the blending payment mechanisms.In recent decade,an efficient DRGs-based payment model in Xixian had been established with potential of generalizability.In this model,three features were included:the medical services were purchased through government contracts,the reimbursement amount was pre-decided with classification and severity of diseases,and the performance evaluation was quality-oriented.The core strategy of the multi-faceted payment reform was that the payment was based on a clear classification of clinical pathways and quality-oriented process supervision.Based on the principle of DRGs and the reform practices of Xixian,it clearly defined the prerequisites for generalizing the Xixian multi-faceted payment model,discussed the transition of role concerning different stakeholders including the medical insurance administrators,the health administrators,the medical institutions and the providers.It made conclude that the model may contribute to completing the comprehensive reforms in rural communities and promoting the hierarchical medical system.