Quantitative evaluation of China's new health insurance payment policy based on the policy modeling consistency (PMC) index model.

Abstract

Background: Establishing an efficient health insurance payment mechanism is a core objective of China's healthcare reform. The Chinese government has introduced numerous policy documents to refine the health insurance payment system. However, research on these new payment methods primarily relies on economic analysis such as cost-effectiveness and econometric studies, and has not systematically assessed the internal design and consistency of policy texts.

Methods: This study uses text mining methods and the Policy Modeling Consistency (PMC) Index model to construct a policy evaluation framework, which includes 9 primary variables and 39 secondary variables. The framework is used to conduct a quantitative evaluation of China's new health insurance payment policies.

Results: The themes of China's new Health insurance payment policies are focused and continuously refined. Quantitative results from the PMC Index model show that the overall policy design is reasonable, although significant differences exist among them. Of the 9 policies, 1 is rated excellent, 4 are rated good, and 4 are rated acceptable.

Conclusions: The overall evaluation of health insurance payment policies is positive, though there is room for optimization between individual policies. Strengthening top-level design, improving policy effectiveness, timeliness, and the use of policy tools, as well as promoting localized and standardized reforms, are crucial to fostering high-quality development in healthcare.