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Table 1 Comparison of the medical insurance schemes and its features and differences in integration area and non-integration area

From: Can integration reduce inequity in healthcare utilization? Evidence and hurdles in China

 

integration pilot area

Non-integration area

Model 1

Model 2

 

Specific arrangement

Merged the three existing insurance schemes (UEBMI, URBMI and NRCMS) into a new scheme--USBMI

Only merged the URBMI and NRCMS into a new scheme—URRBMI, UEBMI was kept.

The three existing insurance schemes still run separately.

Population coverage

USBMI covered all population

URRBMI covered urban-rural residents except for urban employees.

UEBMI covered urban employees, URBMI covered urban residents, NRCMS covered rural residents.

Pooling level of fund

USBMI was pooled at municipal level.

URRBMI were pooled at municipal level.

UEBMI and URBMI were pooled at municipal level, while NRCMS was pooled at county level.

Contribution of premium

All urban employees kept the previous percentage of wage for premium contribution which was shared by employees and employers; the remaining urban and rural residents paid the flat rate, which was also shared by local government.

In URRBMI, urban-rural residents paid uniform flat rate and was shared by individual and government, which was adjusted yearly; the premium level of URRBMI were much higher than un-integrated insurance schemes.

In UEBMI, employees paid percentage of wage for premium contribution which were shared by employees and employers;

In URBMI and NRCMS, residents paid the flat rate, which was also shared by local government; the premium level of URBMI was higher than NRCMS

Fund management

All the funds were eventually pooled together and were uniformly managed.

The fund of URRBMI were uniformly managed but were separated from UEBMI.

The fund of three schemes were separately managed

Benefit package

The benefit package was expanded compared to the previous schemes and was unified for all enrollees.

In URRBMI, the benefit package was expanded compared to the previous URBMI and NRCMS and was unified for urban and rural residents.

UEBMI> URBMI>NRCMS

Reimbursement rate

The reimbursement rare was higher than previous schemes and was unified for all enrollees.

In URRBMI, reimbursement rare was higher than previous URBMI and NRCMS and was unified for urban and rural residents.

UEBMI> URBMI>NRCMS