Vol. 54 No. 3 (2026): Published on September 30, 2026.
DOI https://doi.org/10.18799/26584956/2026/3/2165
Balancing administrative and market mechanisms in medical services market regulation
The article examines the conflict between the administrative and market contours of regulation in the medical services market within a mixed healthcare model. Relevance. Central contradiction inherent in the mixed healthcare model: the need to preserve the accessibility of medical care under tariff and regulatory constraints while simultaneously creating incentives to improve the quality, sustainability, and service orientation of medical organizations. Aim. To develop a model for assessing the balance between the administrative and market contours of the medical services market and the mechanisms for resolving incentive conflicts. The model makes it possible to evaluate the consistency between the compulsory health insurance tariff contour and compensatory market mechanisms through an analysis of the dynamics of compulsory health insurance tariffs, the participation of private medical organizations in the compulsory health insurance system, the volume of voluntary medical insurance, and paid medical services. Methods. Systemic approaches, as well as a comparative analysis of statistical and regulatory data. The institutional approach makes it possible to consider the medical services market as a space of interaction among formal rules, financial constraints, and behavioral incentives of market participants. The systemic approach is used to analyze the relationship between the administrative and market contours as elements of a unified regulatory model. In addition, a preliminary empirical assessment of the relationships between key indicators was carried out using Pearson’s pairwise correlation coefficients. Results. The authors have developed the analytical model explaining how the constraints of the compulsory health insurance tariff contour are compensated by insurance-based, institutional, and commercial mechanisms. The authors obtained as well the preliminary empirical estimates, confirming the heterogeneous nature of coordination among the administrative, insurance, and commercial segments. The study identifies mechanisms for resolving the conflict of incentives between the administrative tariff contour and the market motivation of market participants. The proposed model makes it possible to explain not only the mixed healthcare model itself, but also its functioning through adaptive responses and coordination tools. Conclusions. Regulatory effectiveness is achieved not through the simple combination of administrative and market instruments, but through their coordination, including tariff differentiation according to case complexity, institutional access of private providers to the compulsory health insurance system, clear differentiation between compulsory and voluntary health insurance, and digital transparency of patient pathways and financial flows.
For citation: Deren I.I., Kusanova A.Yu. Balancing administrative and market mechanisms in medical services market regulation. Journal of Wellbeing Technologies, 2026, vol. 54, no. 3, pp. 98–114. https://doi.org/10.18799/26584956/2026/3/2165
Keywords:
medical services market, healthcare regulation, compulsory medical insurance, voluntary medical insurance, compulsory medical insurance tariffs, private medical organizations, mixed healthcare model, incentive conflicts, regulation effectiveness, regulation mechanisms
References:
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