Establishing Appropriate Agency Relationships for Providers in China

Liu, Yu; Saltman, Richard B.

Of course, to design and implement an independent physician reimbursement system would require a substantial administrative and legal framework, for example, establishing billing and collection processes, and comprehensive malpractice insurance for physicians if they are practicing independently, all of which are public hospitals' responsibility in the current situation. We recognize the significant investment of time and funding necessary to implement an independent physician reimbursement system for senior physicians at tertiary public hospital level; however, given the current situation in China, the advantages of such a major reform outweigh the disadvantages, especially considering the expected long-term effects on efficiency and quality of service within the health care delivery system. In addition, as the function, goal, and financial sources for health care facilities in rural areas, and also for secondary level and community-based primary care systems in urban settings, are very different than those of tertiary-level public hospitals, 17 physicians practicing at these lower intensity health care facilities should be paid using the current approach until the Chinese version of RBRVS is operating and mature.