Prediction of the Income and Expenditure Risk of Social Medical Insurance Fund Based on ARIMA Model

2020 ◽  
Keyword(s):  
Arima Model ◽  
Medical Insurance ◽  
Insurance Fund ◽  
Social Medical Insurance

Environmental pollution, population aging and social medical insurance fund expenditure

2021 ◽  
Vol 8 (1) ◽  
pp. 599-609
Author(s):  
XU SI
Keyword(s):  
Health Care ◽  
Environmental Pollution ◽  
Health Care Cost ◽  
Population Aging ◽  
Clean Energy ◽  
Medical Insurance ◽  
Health Care Expenditures ◽  
Insurance Fund ◽  
Social Medical Insurance ◽  
The Impact

Although China's economy has maintained rapid growth since 21st century, the problem of environmental pollution has become increasingly serious. Environmental pollution has a serious impact on people in all aspects of clothing, food, housing and transportation. Based on the panel data of 31 provinces and regions in China from 2005 to 2017, this paper establishes a fixed-effect model and divides China into three regions of central, east and west and analyzes the impact of environmental pollution and the population aging on the expenditure of China's social medical insurance funds (SMIF). The study found that the more severe environmental pollution, the worse health status of the residents, then induces the higher SMIF; the more serious aging of population, the higher risk of disease and cause higher SMIF. It is recommended to innovate clean energy technologies, increase environmental governance, in order to reduce health care expenditures and restrain the increase of the health care cost.

scholarly journals Fiscal Decentralization, Local Competitions and Sustainability of Medical Insurance Funds：Evidence from China

2019 ◽  
Vol 11 (8) ◽  
pp. 2437 ◽  
Author(s):  
Qian ◽  
Cheng ◽  
Lyu ◽  
Zhu ◽  
Li
Keyword(s):  
Financial Aid ◽  
Local Governments ◽  
Central Government ◽  
Fiscal Decentralization ◽  
Medical Insurance ◽  
Negative Influence ◽  
Insurance Fund ◽  
Spatial Autoregression ◽  
Insurance Funds ◽  
Social Medical Insurance

Local governments are responsible for the management of social medical insurance for urban and rural residents in China. Under the background of fiscal decentralization between the central government and local governments, the strengthening of supervision on medical insurance funds by local governments leads to a reduction in the expenditure of the medical insurance fund, which contributes to its sustainability. By employing the provincial level panel data during 2004–2014, we used a fixed effect model and a spatial autoregression model to investigate whether fiscal decentralization has had a negative influence on the expenditure of China’s new rural cooperative medical system (NCMS) fund. We found that fiscal decentralization has had a significant influence over its per capita expenditure. Our results also indicate that higher fiscal decentralization leads to higher financial aid in the NCMS provided by local governments. Additionally, the expenditure of the NCMS and the local financial aid are influenced by nearby governments. Our results suggest that appropriate fiscal decentralization, which helps to maintain the sustainability of social medical insurance funds, should be encouraged.

scholarly journals Methods to assess the efficiency of local budget performance of the compulsory medical insurance fund in the Volga Federal District

2018 ◽  
Vol 16 (6) ◽  
pp. 1014-1027
Author(s):  
N.T. Yashina ◽  
◽  
E.A. Khansuvarova ◽  
L.A. Chesnokova ◽  
E.S. Malysheva ◽  
...  
Keyword(s):  
Federal District ◽  
Medical Insurance ◽  
Insurance Fund ◽  
Local Budget

Reforming Payment Methods for Basic Medical Insurance to Accommodate Traditional Chinese Medicine (TCM) in China : A Case Study of Shaanxi Province

2020 ◽  
Author(s):  
FANG ZHOU ◽  
XIAOHAO ZHANG ◽  
ZHIGUO MA
Keyword(s):  
Medical Insurance ◽  
Diagnosis And Treatment ◽  
Shaanxi Province ◽  
Insurance Fund ◽  
Payment Methods ◽  
Treatment Services ◽  
Basic Medical Insurance ◽  
Medical Institutions ◽  
Insurance Funds ◽  
Basic Medical

Abstract Background: Traditional Chinese medicine (TCM) attaches importance to the philosophy of holism and disease prevention. Meanwhile, costs arising from TCM diagnosis and treatment services are relatively low. Such features cater to the needs of less developed countries and regions to increase the equity and accessibility of medical services and to save basic medical insurance funds. However, China’s current payment system for basic medical insurance fails to fully regard these features, thus unable to incent the demand for and supply of TCM services. Methods: Based on the analysis of the features or rather the advantages of TCM, the article, taking Shaanxi Province located in central China as an example, studies the status quo of economic development, coverage of TCM diagnosis and treatment services by basic medical insurance, implementation of payment methods for basic medical insurance in TCM medical institutions, and aims to explore the reformation of payment methods for basic medical insurance. Results: Statistics have shown that the economic power of Shaanxi Province is below average in China, as a result of which, Shaanxi Province is confronted with a general lack of basic medical insurance fund. On the other hand, the present payment methods for basic medical insurance fail to accommodate the features of TCM. Besides, only a very limited number of TCM medical institutions, service items and medicines are covered by basic medical insurance. Consequently, the advantages of TCM are not exploited to the full in a country that has always treasured TCM. Therefore, reformation in payment methods is pressing. Conclusion: In view of the economic and social development of Shaanxi Province, this article proposes to reform the payment methods for basic medical insurance by introducing a new medicinal-effect-based payment method to accommodate TCM. This payment method has the following four features. Firstly, it advocates strengthening process supervision of diagnosis and treatment activities in medical institutions, establishing a rating system for therapeutic or prophylactic effects, and implementing a reward and punishment mechanism accordingly. Secondly, special audit standards for TCM services shall be determined by the health care department of the people’s government together with the relevant TCM administrative department, more TCM institutions, service items and medicines shall be covered by basic medical insurance, and the negotiation mechanism with medical insurance institutions shall be adjusted. Thirdly, in pricing the fees and standards for TCM services, the price control administrations of the people’s government shall consult TCM experts, and dynamic price adjustments based on costs and professional technical values shall be made. Last but not least, outpatient diagnosis and treatment services shall be covered by basic medical insurance fund, a practice which will not only give full play to the advantages TCM services, but also help reduce the financial burden on patients and save medical insurance funds.

scholarly journals Healthcare Supply Chain Network Coordination Through Medical Insurance Strategies with Reference Price Effect

2019 ◽  
Vol 16 (18) ◽  
pp. 3479
Author(s):  
Gao ◽  
Wang
Keyword(s):  
Decision Making ◽  
Supply Chain ◽  
Healthcare System ◽  
Reference Price ◽  
Medical Insurance ◽  
Patient Choice ◽  
Insurance Fund ◽  
Supply Chain Network ◽  
Price Effect ◽  
The Social

China has established the universal medical insurance system and individual out of pocket costs have decreased, however, the average healthcare expenditure of the Chinese population and the expenses of the whole society have increased substantially. One major challenge which impedes the progress of attaining sustainable development of the social healthcare system in China is that the number of hospital admissions is disproportionate. Superior hospitals are overcrowded, whereas subordinate hospitals are experiencing low admissions. In this paper, we apply the game theory model to coordinate the healthcare supply chain network, which is composed of the government, medical insurance fund, superior hospitals, subordinate hospitals and patients. Especially by taking the reference price effect into account, this paper analyzes different medical insurance reimbursement strategies and their influence on patient choice and the healthcare supply chain network. The result shows that the reference price effect increases the leverage of medical insurance, guides patients’ choice, optimizes the allocation of medical resources and reduces the medical expends. In comparison to a decentralized decision- making strategy, a centralized decision- making strategy can stimulate both superior hospital and subordinate hospital’s cooperative intentions which benefits the social healthcare system.

scholarly journals Does Social Medical Insurance Achieve a Poverty Reduction Effect in China?

2022 ◽  
Vol 9 ◽  
Author(s):  
Ji-Le Sun ◽  
Ran Tao ◽  
Lei Wang ◽  
Li-Min Jin
Keyword(s):  
Utility Maximization ◽  
Poverty Reduction ◽  
Positive Impact ◽  
Medical Insurance ◽  
Causal Link ◽  
Insurance Reform ◽  
Insurance Reimbursement ◽  
Reduction Effect ◽  
Social Medical Insurance ◽  
The Impact

This paper aims to explore the impact of social medical insurance (SMI) on poverty reduction (PR) in China. Considering the time-varying characteristics of factors, this paper uses the bootstrap Granger full sample causality and subsample rolling window model to find the relationship between SMI and PR. The results highlight that in some periods, there is a bidirectional causal link between SMI and PR. Influenced by the medical insurance reform and medication measures. Social medical insurance does not have a positive impact on poverty reduction in some periods. These results are supported by the Utility Maximization Model of Insurance Consumption, which highlights that individuals make utility maximization choices when choosing insurance. The effect of medical insurance on poverty alleviation depends on whether an individual's investment in medical insurance can maximize its utility. If the proportion of social medical insurance reimbursement is too low, individuals will give up buying social medical insurance. Thus, the anti-poverty effect of social medical insurance is difficult to achieve. Therefore, authorities need to pay attention to specific contexts and social medical insurance policies and further improve the social medical insurance system to promote the realization of the anti-poverty of social medical insurance.

scholarly journals Regional adaptation of the federal model of reimbursement for medical assistance based on clinical statistical groups: hospitalization of patients in need of genetically enginered biological preparations

2018 ◽  
Vol 11 (2) ◽  
pp. 44-52
Author(s):  
M. V. Sura ◽  
T. N. Ignatova ◽  
N. S. Rudneva ◽  
Yu. N. Sukhanova ◽  
N. G. Ulyanova ◽  
...  
Keyword(s):  
Day Care ◽  
Medical Insurance ◽  
Genetically Engineered ◽  
Insurance Fund ◽  
Medical Assistance ◽  
Medical Organization ◽  
Inpatient Facility ◽  
Regional Adaptation ◽  
The Russian Federation ◽  
Insurance Model

The existing model of financial support of medical assistance for clinical-statistical groups (CSGs) in 2018 provides for the reimbursement for hospital stay expenses by the compulsory medical insurance fund in patients claiming the need for genetically engineered biological products (GiBP) during their stay in a day-care or 24-hour inpatient facility. The payment is made to CSG no. 121 in a day care and to CSG no. 316 in a 24-hour inpatient facility. The heterogeneity of the expenses for therapy with GiBP necessitates further division of the Federal CSGs into subgroups located in the constituent parts of the Russian Federation. This process has been initiated in some parts of the country, and it is seen as a way of regional adaptation of the Federal Medical insurance model. The proposed subdivision of the Federal CSGs allows for setting the tariffs reflecting the real expenses incurred by a local medical organization due to the therapeutic use of GiBP. The models of such specific CSGs proposed by RF subjects (after an expert evaluation) can be taken as a basis for updating the Federal CSG model, taking into account the differences in the costs of different drug therapy regimens.

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