Research On The Mechanism Of Internet Based Medical Care Included In Medical Insurance Reimbursement

The combination of modern information technology and medical industry has promoted the vigorous development and popularization of Internet medical care,and the traditional medical service mode has changed,changing people’s medical treatment methods.Patients can get medical information and experience through the Internet medical platform,receive telemedicine services,and avoid wasting a lot of time and energy for medical treatment.It can be said that Internet medical treatment breaks through the time and space limitation,effectively alleviates the problem of"difficult and expensive medical treatment",improves the phenomenon of "three long and one short" in outpatient treatment,and optimizes the allocation of medical resources.To promote the development of Internet medical care,the government has implemented the same reimbursement policy and pricing standard between Internet medical care and traditional hospitals,and patients can use medical insurance to pay on the Internet medical platform.However,the main body in the field of Internet medical care is huge and complex,the homogenization of services is serious,and the uncertainty of telemedicine increases,which leads to patients’ insufficient trust in the service quality of Internet medical care platform.The national policy of incorporating Internet medical care into medical insurance payment has not achieved the expected results.At present,there are many researches on the operation mode of Internet medical care,but few researches on the mechanism of Internet medical care’s inclusion in medical insurance reimbursement.Considering the urgency of effective Internet medical reimbursement mechanism,based on this.this paper combines the problems existing in the medical service supply system,constructs a game mechanism model of Internet medical care’s inclusion in medical insurance reimbursement.establishes a medical service system including an Internet hospital and a traditional hospital,clarifies the interaction and role among patients,Internet hospitals,traditional hospitals and the government,and analyzes the government’s optimal reimbursement mechanism for Internet medical insurance reimbursement.In this paper,based on the concept of Internet medical and health care reimbursement mechanism,using the game theory,the general system theory under the Internet medical and health care reimbursement,social division of labor theory,the classification system of the theory,analysis the problems existing in the current medical service supply system and Internet health into the necessity of insurance reimbursement,at present our country medical treatment resources distribution is not balanced,In addition,there is a structural imbalance in medical and health expenditure.The emergence of Internet medical treatment effectively alleviates the problem of uneven distribution of medical resources.The inclusion of Internet medical treatment in medical insurance reimbursement is conducive to better realize the goal of maximizing medical and social welfare.Then,the medical insurance reimbursement mechanism model based on fixed budget was established,and the backward induction method was used to solve the equilibrium between the designated hospitals and the reimbursement ratio of the government,to make the equilibrium pricing decision between traditional hospitals and Internet medical care,and to obtain the optimal decision of the medical insurance reimbursement ratio,so as to achieve the goal of maximizing social welfare.At the same time,the influence of price difference,health value perception,service quality perception and medical insurance fund budget level on social welfare was studied by numerical simulation.Through the construction of the model and in-depth analysis,the corresponding conclusions can be drawn:moderate reimbursement ratio should be adopted for hospitals,otherwise one of them will exit the market;To achieve the goal of maximizing social welfare,the government should improve the budget level of medical insurance fund,make the optimal decision of reimbursing both hospitals at the same time,and appropriately improve the difference of reimbursement ratio between traditional hospitals and Internet medical platforms.When the perceived health difference between the traditional hospital and the Internet medical platform is large,and the cost gap between the two hospitals is small,the government only needs to reimburse the traditional hospital.In this case,it is the optimal decision for medical insurance reimbursement.Finally,from the perspective of maximizing social welfare goal.combined with Internet medical insurance reimbursement under a fixed budget based optimal decision results,puts forward the implementation of Internet medical into insurance reimbursement mechanism and safeguard measures,to perfect the laws and regulations to ensure the safety of information,strengthen the supervision of Internet medical insurance reimbursement mechanism,Improve the Internet medical payment system to promote the development of new forms of Internet business and promote the sustainable and healthy development of Internet medical treatment.