Healthcare Supply Chain Network Coordination Through Medical Insurance Strategies with Reference Price Effect

Abstract

China has established the universal medical insurance system and individual out of pocket costs have decreased, however, the average healthcare expenditure of the Chinese population and the expenses of the whole society have increased substantially. One major challenge which impedes the progress of attaining sustainable development of the social healthcare system in China is that the number of hospital admissions is disproportionate. Superior hospitals are overcrowded, whereas subordinate hospitals are experiencing low admissions. In this paper, we apply the game theory model to coordinate the healthcare supply chain network, which is composed of the government, medical insurance fund, superior hospitals, subordinate hospitals and patients. Especially by taking the reference price effect into account, this paper analyzes different medical insurance reimbursement strategies and their influence on patient choice and the healthcare supply chain network. The result shows that the reference price effect increases the leverage of medical insurance, guides patients’ choice, optimizes the allocation of medical resources and reduces the medical expends. In comparison to a decentralized decision- making strategy, a centralized decision- making strategy can stimulate both superior hospital and subordinate hospital’s cooperative intentions which benefits the social healthcare system.

Impact of the National Health Insurance Coverage Policy on the Utilisation and Accessibility of Innovative Anti-cancer Medicines in China: An Interrupted Time-Series Study

“…On average, the price of innovative medicines was reduced by 44%. Among the 36 new medicines, 15 innovative anti-cancer medicines were included in the "National Basic Medical Insurance, Work-Related Injury Insurance and Childbirth Insurance Medicine List (Category B)" (25), which was an important step toward facilitating access to expensive anti-cancer medicines (26).…”

How to Make Primary Healthcare More Popular: Evidence from the Middle-Aged and Elderly in China

“…The reimbursement rate of PCIs in many provinces is higher than that of tertiary medical institutions, so patients may be inclined to choose to go to a PCI [ 22 ], which indicates that there may be a positive relationship between medical insurance and PHC. At the same time, the price mechanism of medical insurance can aid the allocation of medical resources [ 23 ]. Health departments usually use different insurance policies to allocate resources.…”

Price Decision-Making in Dual-Channel Healthcare Services Supply Chain Considering the Channel Acceptance, Price Ceiling, and Public Welfare

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