Provider and patient perceptions of traditional Chinese medicine service pricing reform: evidence from Northeast...

In 2025, China issued the Guidelines for the Establishment of Pricing Items for TCM Medical Services, aimed at shifting TCM services toward value-based pricing. This study examined provider, patient, and administrator perceptions of TCM pricing reform in Northeast China.

A survey was conducted in Jilin and Liaoning provinces, yielding 399 valid questionnaires, including 250 from healthcare professionals, 125 from patients, and 24 from healthcare security and medical administration staffs. Healthcare professional data were analyzed using multivariate regression, patient data described demand-side perceptions and stated pricing preferences, administrator data provided contextual evidence.

Among healthcare professionals, professional title (β = -0.129, p = 0.017) and medical insurance payment restrictions (β = -0.236, p = 0.000) were negatively associated with pricing and payment satisfaction, while hospital management support was positively associated with satisfaction (β = 0.396, p = 0.000). Implementation-barrier models had low explanatory power and were interpreted as exploratory. Patients showed limited direct awareness of pricing item or billing changes, but reported tension between affordability and service value: 54.0% favored moderately lower prices, 39.5% supported moderate price increases with better service quality, and 37.9% supported tiered pricing. Logistic analyses identified no clear respondent level predictors. Administrators highlighted cost-accounting complexity and weak coordination between pricing reform and insurance payment.

TCM service pricing reform is a health system coordination issue involving provider incentives, patient affordability, insurance payment, and equitable access. The findings support value-based cost accounting, tiered pricing and access mechanisms, improved patients value communication, and closer pricing-insurance coordination.