Study on the incentive and coordination mechanism of tumor healthcare alliance based on evolutionary game

The healthcare alliance (HA) of malignant tumor specialist can promote the integration and development of tumor medical resources and play an important role in safeguarding people's health. Nevertheless, conflicting interests between the involved stakeholders in the alliance impede the implementation of HA with effect. This paper divided the study of incentive coordination mechanism of supply chain in HA into two basic games, that is, under the government and medical insurance institution intervention, we respectively constructed the evolutionary game model between the tumor HA and patients, tertiary hospitals (TH) and member hospitals (MH) that are low utilized (eg. Secondary and Primary hospitals) within the alliance. Then the evolutionary stable strategies for two participants of each game are discussed and the influence of key parameters on the evolution trajectory are analyzed. Finally, numerical simulations are conducted to verify the theoretical results. The results found that "differentiated reimbursement rates for medical insurance", "increasing government subsidies", "enhancing the reputational impact of the different strategies of the HA" and "reducing the support costs of HA to MH" are conducive to improving primary medical service capabilities and guiding patients to go to PH for the first diagnosis. In addition, "increasing government subsidies", "reducing sharing spillover effect caused by unilateral cooperation" and "reducing the costs of cooperation" can promote both sides to collaborate with each other to form a community of interests. Moreover, the initial strategy proportion of stakeholders would affect the evolutionary trajectories.