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Beginning in 2007, fixed reimbursement was adopted to cap the reimbursement ceiling for caesarean delivery.
In Xichuan county, there was a reimbursement ceiling (50 RMB per capita) for outpatient service in village clinics, but not at THCs.
For example, in reforming UEBHI, high deductable and co-insurance payment, as well as reimbursement ceiling was introduced as early as in late 1980s.
For three counties in Shandong without FSAs, the NCMS covered 10-15% of drug expenditure for outpatient service in village clinics and township health centres, with a reimbursement ceiling of around 80 Yuan per member per year.
To avoid excessive costs, a reimbursement ceiling was established, and the village clinics were monitored in areas such as outpatients, pharmaceutical consumption and the intensity and rationality of prescriptions.
According to our results, modifications of the copayment structure of the BHI, such as eliminating the reimbursement ceiling, or changes in other attributes, such as including portability, could increase population coverage.
Similar(48)
Reimbursement ceilings on inpatient care were set in all counties.
Table 3 lists the generosity of cost-sharing within 32 BPCDO according to the number of selected chronic diseases, deductible line, reimbursement percentage, ceiling, the maximum days per prescription and the reimbursement frequency.
Counties determine the deductible, ceiling, reimbursement ratio, medical saving account (MSA).
The Bureau of National Health Insurance imposes a threshold (ceiling reimbursement) for each outpatient visit, highest for medical centers and lowest for the clinics.
Another explanation might be the shortcomings of the health insurance policy design for the low reimbursement rate or ceiling of the out-patient services.
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