【摘要】 近年来，我国加强了对基本医疗保险基金的监管，严厉打击基金违规使用行为。然而，由于医疗服务中的信息不对称，建立高效和常态化的基金监管体系仍面临挑战。为此，本文首先构建了医疗机构和医保部门之间的重复博弈模型，并采用时间断点回归分析法，检验国家医保局首次通报欺诈骗保典型案例对医疗服务利用的影响。研究稳健地发现：通报当天，百度“骗保”资讯指数显著提升5倍，表明网络关注度大幅增加；通报后，对于未受稽查的医疗机构，其住院费用和医保支出分别显著下降约24%和21%，住院人次减少约9%，门诊—住院转化率下降3个百分点，体现了基金监管的震慑效应。机制检验表明，通报骗保案例释放了监管力度加强的信号，提高了医疗机构的预期惩罚成本和稽核概率。估算表明，首次案例通报在短期内为医保基金节约了161亿元。本文为中国特色的监督监管体系建设和常态化医保基金监管提供了有益的政策启示。更多还原

【Abstract】 China has intensified supervision of its public health insurance fund, cracking down on fraudulent usage in recent years.However, due to information asymmetry in healthcare services, establishing an efficient and routine fund supervision system remains chal-lenging. To explore this issue, this study develops a repeated game model between healthcare institutions and public insurers and employsa Regression Discontinuity in Time(RDi T) design to examine the impact of the National Healthcare Security Administration’s(NHSA) firstpublic disclosure of healthcare fraud cases on healthcare service utilization. Findings show that on the announcement date, the Baidusearch index for "healthcare fraud" increased approximately fivefold, indicating heightened public attention. After disclosure, unaudited in-stitutions exhibited significant reductions in hospitalization costs and reimbursement by approximately 24% and 21%, respectively, inpa-tient admissions by 9%, and the outpatient-to-inpatient conversion rate by 3 percentage points, demonstrating a deterrence effect of fundsupervision. Mechanism analysis confirms that publicizing fraud cases signals intensified supervision, raising institutions’ perceived penal-ties and audit probabilities. Estimates indicate that the first disclosure saved RMB16.1 billion for the health insurance fund in the shortterm. This study provides valuable policy insights for building a supervision system with Chinese characteristics and establishing routinehealth insurance fund regulation.更多还原