| Project Detail |
The purpose of the TA is to strengthen the management and performance of the National Medical Insurance Fund under the diagnosis related group (DRG) payment system, with a focus on improving medical fund supervision in the Peoples Republic of China (PRC). This will be done by conducting robust national assessments and research on the National Medical Insurance Fund under the DRG system, developing guidelines based on best practices nationally and internationally, and then disseminating the draft guidelines. The TA will be aligned to the following impact: National Medical Insurance Fund performance in the PRC strengthened, and the following outcome: National Medical Insurance Fund supervision under the DRG payment system in the PRC improved.
The purpose of the TA is to strengthen the management and performance of the National Medical Insurance Fund under the diagnosis related group (DRG) payment system, with a focus on improving medical fund supervision in the Peoples Republic of China (PRC). This will be done by conducting robust national assessments and research on the National Medical Insurance Fund under the DRG system, developing guidelines based on best practices nationally and internationally, and then disseminating the draft guidelines. The TA will be aligned to the following impact: National Medical Insurance Fund performance in the PRC strengthened, and the following outcome: National Medical Insurance Fund supervision under the DRG payment system in the PRC improved.
Project Rationale and Linkage to Country/Regional Strategy Inefficient health financing methods and practices, especially the lack of effective health insurance, holds back access to health care and adds a financial burden on individuals and on public sector spending. To address this complex issue, many countries, particularly developed countries, use DRG systems to determine an appropriate amount of insurance reimbursement for healthcare services provided to patients in a hospital setting. In 2009, the PRC began a significant healthcare reform initiative aiming to change the way the government reimburses hospitals for their services, moving away from traditional fee-for-service and toward case-based payment systems. Lessons learned from the application of the DRG system will be valuable for other developing member countries in the region, which are beginning health financing and health insurance reforms utilizing innovative DRG systems. ADB, as a knowledge bank, can provide value-added benefits by disseminating lessons via platforms for developing member countries and through regional knowledge forums. The proposed TA is a cost-recovery TA that will be implemented under ADBs country partnership strategy for the PRC, 2021-2025.
Impact
National Medical Insurance Fund performance in the PRC strengthened. |
