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Web of Proceedings - Francis Academic Press
Web of Proceedings - Francis Academic Press

Does DRGs Reform Help to Alleviate the Moral Hazard of Medical Insurance? —From the Perspective of Game Theory

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DOI: 10.25236/ichess.2023.015


Lingyao Meng

Corresponding Author

Lingyao Meng


Using the method of game theory, this paper respectively discusses the moral hazard of the supplier under the medical insurance post payment system and the DRGs payment system. The study found that medical institutions have the motivation to conduct excessive medical treatment, and reducing the review cost of medical insurance institutions, increasing the punishment for excessive medical treatment, and improving the operation efficiency of hospitals will reduce the probability of excessive medical treatment. At the same time, the study found that the use of DRGs medical insurance payment can effectively inhibit the behavior of medical institutions to induce demand and excessive medical treatment. On this basis, some policy suggestions are put forward to control the moral hazard of medical insurance, such as the reform of medical expense payment method, the use of "Internet + medical reform" and the establishment of reasonable review reward and punishment mechanism.


Moral Hazard, Excessive Medical Treatment, Medical Insurance Payment, DRGs Reform