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由于新农合不同管理模式所涉及的主要利益相关者及战略利益诉求不同,其支付方式必然有适宜性选择。以利益相关者理论为基础,经对常见五种医保支付方式及新农合3种管理模式涉及的主要利益相关者与利益诉求比较分析,从国家战略诉求及多方均衡利益最大化的视角,研究提出卫生部门主管并经办模式,门诊应选择按人头付费方式,住院按病种付费+服务单元付费组合方式;劳保部门主管并经办模式,门诊应选择总额预付制方式,住院按总额预付制+病种付费组合方式;政府委托商业保险机构经办模式,门诊应选择总额预付制+服务单元付费,住院按总额预付制+服务单元付费的组合方式。
As the different types of management of the NCMS involve the main stakeholders and the different demands of strategic interests, the payment method must have a suitable choice. Based on the theory of stakeholder, after comparing and analyzing the five main health care payment methods and the main stakeholders involved in NRCMC’s three management modes, from the perspective of national strategic appeal and multi-party equilibrium interest maximization, Proposed the head of the health department and mode of operation, out-patient should choose to pay according to their own way, the hospital payment by type of payment + service unit pay combination; labor insurance department in charge of and mode of operation, outpatient should choose the total pre-paid system, + Disease payment combination; the government commissioned the commercial insurance agency handling mode, out-patient should choose the total prepayment system + service unit pay, hospital total prepayment + service unit pay combination.