SIMULATION STUDY OF REVENUE SHARING IN HEALTHCARE ALLIANCES

摘要

Since the referral system of the Chinese hierarchical healthcare delivery system is still developing, patients can go directly to the specialists for all outpatient care, which results in a significant imbalance of patient flow. To balance the patient flow, the general hospital (GH) and the community healthcare center (CHC) form a healthcare alliance. We propose a two-stage game-theoretic approach to study the operations of the healthcare alliance and employ simulation to analyze the revenue sharing in the alliance. In the first-stage game, two providers negotiate fixed proration rates to share the revenue from referral patients. In the second-stage game, the GH makes the capacity allocation decision and the CHC decides referral rates to maximize their own revenues. We first analyze the Nash equilibrium in the second-stage game through simulation, and then back to the simulation of the first-stage game to investigate the revenue sharing rule's feasibility and efficiency.