北京航空航天大学学报(社会科学版) ›› 2016, Vol. 29 ›› Issue (2): 1-7.DOI: 10.13766/j.bhsk.1008-2204.2015.0577

• 本期特约专家稿件 • 上一篇    下一篇

购买机制如何影响医疗服务价格——以美国医疗保险为例

王虎峰1, 赵斌2   

  1. 1. 中国人民大学 医改研究中心, 北京 100872;
    2. 人力资源和社会保障部 社会保障研究所, 北京 100029
  • 收稿日期:2015-12-14 出版日期:2016-03-25 发布日期:2016-03-28
  • 作者简介:王虎峰(1964-),男,河北武邑人,教授,博士,研究方向为卫生政策、卫生事业管理和卫生医疗体制改革.

How does Pricing Mechanism Affect Health Service Price:A Case Study of U.S. Health Insurance

WANG Hufeng1, ZHAO Bin2   

  1. 1. Department of Health Policy and Management, Renmin University of China, Beijing 100872, China;
    2. Research Institute for Social Security, Ministry of Human Resource and Social Security, Beijing 100029, China
  • Received:2015-12-14 Online:2016-03-25 Published:2016-03-28

摘要:

从分析价格形成的三种基本机制入手,对美国不同的医保项目的支付方式进行分类研究,特别是对其定价机制进行了研究,得出了两点结论:美国以支付方式为纽带,通过服务购买谈判方式进行医疗服务定价;医院则依据购买者议价能力,采用不同定价策略,从而形成了支付价格。因而得出:协商谈判在未来是中国医疗服务价格形成的一个重要机制,同时,应改进支付标准的形成机制和建立适合价格谈判的政策环境。

关键词: 购买机制, 医疗服务价格, 医疗保险, 价格谈判, 美国, 医疗改革

Abstract:

This paper analyzes three basic mechanisms of price formation, payment methods of different medical insurance schemes in America, especially the pricing mechanism. There are two conclusions: the price is formed by the bargaining between purchaser and providers, and hospitals adopt different strategies based on their bargaining power. The article considers that the negotiation is an important mechanism for the formation of China's medical service price in future; at the same time, we should improve the formation mechanism of payment standard and establish the policy environment for the price negotiation.

Key words: purchasing mechanism, health service price, health insurance, price bargaining, America, healthcare reform

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