Objective: The paper explores the status quo, problems and optimization path of China's rehabilitation medical insurance payment policy in the context of population aging and high incidence of chronic diseases, so as to provide reference for improving the effectiveness of medical insurance fund utilization and enhancing the accessibility of rehabilitation services. Methods: Using policy text analysis and international comparison methods, the study systematically combed the common trends and core experience of the rehabilitation medical insurance payment mechanism in the United States, the United Kingdom, Japan and Australia in terms of financing, project scope, institutional collaboration, payment method and evaluation, etc. Combined with the policy documents at the national level and the practice of pilot regions such as Changsha City of Hunan Province, Nanjing City of Jiangsu Province, and Yunfu City of Guangdong Province, the study carried out a comparative analysis of the evolution of policies and models. Results: The study found that the international rehabilitation medical insurance payment reform generally presents a common trend of encouraging commercial insurance to participate and strengthen management, constructing a multifaceted and composite payment system matching the service scenarios, strengthening the continuity of services, and transforming to value-based payment. China's pilot areas have made positive progress in payment method innovation, multi-source financing, and policy integration, but still face challenges such as incomplete diversified payment systems and standards, inconsistent core regulatory indicators, and unintegrated evaluation tools and information platforms. Conclusions: A multifaceted and composite payment system matching the service scenarios should be improved. The service payment chain through the whole cycle of rehabilitation should be perfected to promote service integration and strengthen the guidance of commercial insurance payment. Data standardization and platform construction should be promoted by unifying evaluation standards and quality control, thus guiding the high-quality development of rehabilitation medical services.
Key words
rehabilitation medical insurance payment /
international comparison /
local practice /
optimization strategy
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