A Study On Supplier Moral Hazard Under The Background Of Reform Of Medical Insurance Payment In China

Supplier moral hazard exists widely in the field of health care because of its high professional service and information asymmetry.Supplier behavior plays a vital role in the operation of health care system.The existence of supplier’s moral hazard seriously damages the safe operation of medical insurance fund and disrupts the social security function in the field of public health.Under the post-payment system dominated by service item payment,the unreasonable increase of medical expenses caused by "excessive medical treatment" has become the main manifestation of moral hazard of suppliers.In order to avoid the "bottom-up" of the medical insurance fund and better play to the fairness of the medical insurance system,China formally launched a new round of "health care reform" in 2009,and stressed in the relevant documents that we should further promote the reform of payment methods.Different payment modes have different restraint and incentive mechanisms.From the post-payment system to the pre-payment system,the moral hazard of suppliers has changed accordingly.In view of this,we must further elaborate and study the changes of supplier moral hazard caused by the reform of medical insurance payment mode.On the basis of introducing the manifestations of supplier’s moral hazard under different payment modes,this paper analyses the mechanism of medical insurance payment modes on supplier’s moral hazard.Combining with the process of payment mode reform in China and the reform practice in typical areas,this paper briefly analyses the changes of supplier’s moral hazard caused by the reform of medical insurance payment modes,and puts forward corresponding hypotheses.At the same time,based on the matching of sample data by propensity score matching method,the double difference model is used to analyze the data of Charls New Cooperative Medical System(NCMS)and verily the hypothesis.The results show that the moral hazard of the main suppliers will change from "excessive medical treatment" to "insufficient medical treatment",and the quality of medical and health services will decline.At the same time,there are moral hazards such as "transfer costs" and"decomposition of hospitalization".Although the risk of "prevaricating severe cases" and "diagnostic escalation" has not been verified in the empirical data,we should pay more attention to it.It is believed that supplier moral risk can be prevented and controlled by improving the supervision mechanism of medical and health service institutions,optimizing the incentive system of medical and health Service institutions,promoting the reform of public hospitals and accelerating the coastruction of medical consortium.