Evaluation of the Implementation Effect of Medical Service Price Reforms: A Case Study of Assisted Reproductive Services in China
Author(s)
Xiaonan Wang, Master candidate, Boya Zhao, PhD, Pinan Chen, PhD candidate, Jing Wu, PhD.
Center for Social Science Survey and Data, Tianjin University, Tianjin, China.
Center for Social Science Survey and Data, Tianjin University, Tianjin, China.
OBJECTIVES: China is advancing medical service price reforms, to address provincial disparities of items from previous regional management. The reform reorganizes items and establishes a unified national catalog. Focusing on assisted reproduction(AR), this study evaluates the policy's effects on item setup, price adjustments, service volume, expenditure, and patient burden to inform national promotion.
METHODS: Using EHR data (Feb 2023-Jan 2025) from 9 qualified hospitals in Inner Mongolia, pre- (Feb 2023-Jan 2024) and post-policy (Feb 2024-Jan 2025) periods were compared. The reform integrated 38 original AR items into 12 streamlined ones with price adjustments and expanded reimbursement 0 to 8 items. Service volume and expenditure were summed. Weighted average prices ,using service volumes, were calculated pre-policy due to price variations. A standardized cost model was applied to analyze patient burdens, calculating the sum of weighted average prices for medical service items involved in each assisted reproductive technology ,including Intrauterine Insemination (IUI), In Vitro Fertilization (IVF), Intracytoplasmic Sperm Injection(ICSI) and Preimplantation Genetic Testing(PGT), with IVF/ICSI further divided by fresh/frozen embryos.
RESULTS: Prices showed mixed trends: most decreased (6.7%-72.9%, e.g., artificial insemination -67.7% to 500 CNY), while a few (reflecting high technical labor value) increased (0.3%-34.0%, e.g., sperm optimization +34.0% to 750 CNY). Service volume, including artificial insemination, oocyte retrieval, embryo transfer and cryopreservation, rose by 1,496 visits (7.5%) overall. Among them, the service volume of artificial insemination increased significantly by 1,093 visits, reaching 56.3%. Total expenditure decreased by 10.2% (-10.3 million CNY), reducing patient out-of-pocket costs by 42.4-55.2 million CNY. Standardized costs declined: IUI (−40.6% to 1,250 CNY), IVF fresh/frozen (−5.5%/−9.4% to 10,104/15,004 CNY), ICSI fresh/frozen (−4.3%/−7.9% to 12,797/17,697 CNY), PGT (−2.2% to 18,294 CNY).
CONCLUSIONS: After the policy implementation, assisted reproduction medical services in Inner Mongolia were standardized, with prices fluctuating, visit volume increasing and patient costs decreasing.
METHODS: Using EHR data (Feb 2023-Jan 2025) from 9 qualified hospitals in Inner Mongolia, pre- (Feb 2023-Jan 2024) and post-policy (Feb 2024-Jan 2025) periods were compared. The reform integrated 38 original AR items into 12 streamlined ones with price adjustments and expanded reimbursement 0 to 8 items. Service volume and expenditure were summed. Weighted average prices ,using service volumes, were calculated pre-policy due to price variations. A standardized cost model was applied to analyze patient burdens, calculating the sum of weighted average prices for medical service items involved in each assisted reproductive technology ,including Intrauterine Insemination (IUI), In Vitro Fertilization (IVF), Intracytoplasmic Sperm Injection(ICSI) and Preimplantation Genetic Testing(PGT), with IVF/ICSI further divided by fresh/frozen embryos.
RESULTS: Prices showed mixed trends: most decreased (6.7%-72.9%, e.g., artificial insemination -67.7% to 500 CNY), while a few (reflecting high technical labor value) increased (0.3%-34.0%, e.g., sperm optimization +34.0% to 750 CNY). Service volume, including artificial insemination, oocyte retrieval, embryo transfer and cryopreservation, rose by 1,496 visits (7.5%) overall. Among them, the service volume of artificial insemination increased significantly by 1,093 visits, reaching 56.3%. Total expenditure decreased by 10.2% (-10.3 million CNY), reducing patient out-of-pocket costs by 42.4-55.2 million CNY. Standardized costs declined: IUI (−40.6% to 1,250 CNY), IVF fresh/frozen (−5.5%/−9.4% to 10,104/15,004 CNY), ICSI fresh/frozen (−4.3%/−7.9% to 12,797/17,697 CNY), PGT (−2.2% to 18,294 CNY).
CONCLUSIONS: After the policy implementation, assisted reproduction medical services in Inner Mongolia were standardized, with prices fluctuating, visit volume increasing and patient costs decreasing.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HPR78
Topic
Health Policy & Regulatory
Topic Subcategory
Reimbursement & Access Policy
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Reproductive & Sexual Health