梁景洋&鄭清霞 (2015)指出我國醫療費用的支出，已經造成全民健康保險的極大負擔，為了改善這個問題，衛福部不斷的提出新的對策，但始終成效不佳。Porter(2006)則提出醫療改革的根本，即建立醫療價值的概念，而非單純的抑制醫療成本上升。
本研究考量以醫療價值為基礎建立給付模式。首先依病況複雜度進行分類，同時考慮個別病患之醫療成效及醫療成本得到醫療價值，期望給付制度可以讓醫療院所致力於提高醫療價值，同時提高所獲得的醫療給付。研究中採用系統動態學模擬比較包裹式給付制度及本研究提出的以價值為基礎之給付制度，以驗證新模式是否能使得創造高醫療價值的醫院獲得較高的醫療給付。
研究中以個案醫院之血液透析醫療服務為研究對象，四種病況複雜度的病患皆為30位，且皆完成一個月13次的血液透析。利用系統動態學進行模擬，結果顯示，在現行的包裹式給付制中，不論醫療價值為何，皆固定給付相同的金額。在以價值為基礎相較現行包裹式給付模式中，專注於提高醫療價值之醫療院所相較其他醫療價值之醫療院所，則每月可多獲得新台幣2,299,692元，針對此120位病患。
總之，本研究所發展之以醫療價值為基礎之給付模式同時考量病患複雜度以及醫療價值，以進行醫療院所之給付，可提高專注於增加醫療價值之醫療院所相對獲得之報酬。若能鼓勵醫療院所提升自身醫療價值，並使病患得到較好之醫療照護，相信對現行醫療照護環境可獲得改善。

Expenses of healthcare in Taiwan has caused heavy burden on national health insurance (Liang and Cheng, 2015). The Ministry of Health and Welfare has continuously worked out solutions to deal with this issue, while the outcomes are still quite poor. This work adopted the healthcare value concept from Porter (2006), instead of focusing on inhibiting healthcare cost, to deal with the healthcare financial issue. The first step in this work is to classify the patients based on the complexity of their conditions. Then, by finding the healthcare value of each case, combining from outcome as well as healthcare cost, different payment systems are proposed. It is expected that the efforts from healthcare institutions can improve the healthcare value, alongside with the insurance coverage paid. Finally, system dynamics simulation is used to compare the package-based payment system and the value-based payment system.
In this work, the medial service, hemodialysis, was taken as the research subject, and each of four complexity levels of illness have 30 patients who completed 13 times of hemodialysis per month. System dynamics is used and the results show that, in the current package-based payment model, regardless what healthcare value it really is, the same amount will be paid. Those institutes which focus on enhancing the healthcare value, using the value-based payment models, can receive an extra 2,299,692 NTD, (for those 120 patients), compared to other package-based payment models.
The results verify that the proposed model can enable hospitals with higher healthcare value to receive higher healthcare payment.

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