| dc.description.abstract | The financial revenue and expenditure of health insurance is the key to the survival of the hospital, and the rationality of the design of the health insurance payment system has a huge impact on the operation of the hospital. Policies such as price adjustment have many impacts on hospital operation.
At present, most of the studies only focus on the implementation effect of the total budget system, the impact of hospitals on the operation of medical institutions after the implementation of the total budget, or the responses taken, and more emphasis is placed on the research on regional hospitals, but for regional teaching hospitals and Less attention is paid to the business strategy of the total budget system; it is hoped that this study can provide a reference for the most suitable business model for regional hospital operators, and under the framework of health insurance, medical institutions can get rid of financial difficulties, develop soundly and operate sustainably.
The individual hospitals face common dilemmas such as the total amount of health insurance restricting the growth of hospital business, the serious dilution of health insurance point value and the low payment, the profit margin of drugs being adjusted and compressed by the annual drug price difference, making it unprofitable, etc., as well as individual dilemmas such as taxation. Heavy burden, continuous loss of health insurance benefits and high rental costs, etc.; the operation of the individual hospital is limited by various health insurance system shackles and operational difficulties, from the face of business crisis, through continuous business analysis and adjustment, find the most suitable business model:( 1) Reduce the number of outpatient visits and improve the problem of decapitation in health insurance benefits (2) Increase self-pay income (3) Control physicians’ medication (4) Redistribution of health insurance quotas by department (5) Negotiations on rent increases and reductions. The case hospital finds the optimal business model, such as the hospital′s financial revenue and expenditure, which brings stable profits to the hospital and also handed over a beautiful report card for the hospital management.
In the future, it is suggested that the government should review the health insurance rates at actuarial costs, review the partial burden of major injuries and illnesses that are no longer fully paid, increase the partial burden of patients, and review the policy of returning foreigners to health insurance status, so as to reduce the waste of health care resources and make health insurance more affordable. Financially sound and able to continue operating. | en_US |