Exploration on the integration policies of DIP payment and total budget payment of close medical community

Corresponding author: XIANG Li, D202281851@hust.edu.cn

DOI: 10.12201/bmr.202305.00002

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  Abstract: Abstract Based on the policy framework of DIP, explore the integration mode of DIP payment and the total budget payment of close medical community, and analyze the impact of each mode on the service behavior of medical community. This research applies game theory to build game models under three combination modes from the two levels of government and the close medical community, the close medical community and medical institutions, namely, external payment mode and internal distribution mode. It is found that when DIP payment is used for both external payment and internal distribution, expanding service volume is the optimal strategy, which is easy to lead to internal and external competition in the medical community. When it is only used for external payment, not for internal distribution, it still continues to expand its service externally. The design space of internal distribution system is insufficient. When it is not used for external payment but only for internal distribution, it is helpful to weaken the disorder competition of the medical community outside by paying according to the total head amount. At the same time, through the DIP payment rules, different point values in the region are applied to regulate the unreasonable behavior of medical institutions to maliciously expand the service volume.

  Key words: DIP; Payment method of medical insurance; Total budget payment; Close medical community

  Submit time: 9 May 2023

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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