The impact of reform of medical insurance payment method on medical service pricing—based on empirical analysis of matched medical finance comprehensive data

Abstract

Background: The medical insurance payment method (MIPM) has an important impact on medical service pricing (MSP) in China. The objective of this study is to examine the impact of medical insurance payment method on medical service pricing with the hope of providing insights into appropriate MSP and resource allocation. Method: From the perspective of information asymmetry, using the matched medical finance comprehensive data of Chengdu City, our study empirically analyzed the effect of fixed payment by disease (FPD) on MSP by the difference in difference (DID) model. Results: The study found that FPD not only optimizes the allocation of medical resources, saves a large amount of medical insurance funds, but also reduces the personal burden of patients. FPD is adjusted by optimizing the structure of medical expenses and medical insurance compensation, which has certain effects on saving medical insurance funds, improving the quality of medical services, and reducing the burden on patients. It has achieved the goal of medical insurance payment method reform, and make the mechanism of MSP relatively more reasonable. Conclusion: This study provided policy implications for the government to implement multiple and compound medical insurance payment method and establish a more scientific and reasonable pricing mechanism for medical services.