医保信用无感支付中多元利益主体关系:从合作博弈到激励相容

Multi-benefit Relations in Health Insurance Credit Senseless Payment:from Cooperative Game to Incentive Compatibility

传统就医过程中存在报销流程烦琐、就医看诊效率低下等问题,因此医保信用无感支付成为医保部门和定点医疗机构提高支付效率、改善患者医保服务利用便捷性的方式之一.然而,现阶段医保信用无感支付中的多元利益主体关系仍处于普遍公私合作的"合作博弈"模式,影响医保信用无感支付实施的效果.因此,文章通过对多元利益主体间合作博弈关系的分析,基于激励相容理论构建医保信用无感支付多元利益主体从合作博弈到激励相容的实现路径,形成"合作约束、激励分配、监督问责"的三维机制,促进医保信用无感支付体系的构建及政策目标的实现.

Due to the cumbersome reimbursement process and inefficiency of the traditional medical process,health insurance credit senseless payment has become one of the ways for health insurance departments and designated medical institutions to improve the efficiency of payment and the convenience of patients'utilization of health insurance services.However,at the present stage,the relationship between multiple stakeholders in health insurance credit insensitive payment is still in the"cooperative game"mode of general public-private cooperation,which affects the effect of the implementation of health insurance credit insensitive payment.Therefore,it analyzes the cooperative game relationship between multiple interest subjects,and based on the theory of incentive compatibility,constructs the realization path from cooperative game to incentive compatibility of multiple interest subjects in health insurance credit insensitive payment,forming a three-dimensional mechanism of"cooperation constraint,incentive distribution,supervision and accountability",and promoting the construction of health insurance credit insensitive payment system and the realization of the policy objectives.