医保差异化支付是当前我国政府促进居民基层就医的优选策略，但目前政策效果尚不明显。评价医保差异化支付的具体效用，设计切实可行的优化策略以提高基层医疗服务利用，在我国具有显著的理论与实践意义。.当前国内外医保策略杠杆作用研究已较成熟，可为本研究提供参考。但我国医保差异化支付策略促进群众基层就医的效用尚未明晰；医疗服务利用相关影响因素的效用评价仍难以评估感知服务质量等潜在变量的作用，难以实现“多因-多果”关系的影响路径与影响强度估计；鲜有深入的中微观视角的医保策略研究，其中聚焦差异化支付的研究尤为缺乏。.据此，本研究将集成安德森模型、结构方程、意愿支付等方法，聚焦医保差异化支付，明晰其促进群众基层就医的具体效用范围，明确政策发挥作用的重点人群，以最大程度的发挥医保杠杆作用，构建并最终推荐真正具有行为引导效力的优化策略。为提高基层医疗服务利用，完善分级诊疗制度，达成医改预期目标提供科学支撑。

The differentiated health services reimbursement measure is one of the optimization strategies of Chinese government to improve the utilization of primary health services. This measure also is considered to be one of the critical policies of Chinese health care reform. However, the undesirable utilization of primary health services in China is impeding this impact recently. Therefore, the exact effect of this measure on improving primary health service utilization needs to be discovered. And on this basis optimization strategies need to be developed through it..The research on the leverage of health insurance policy is mature, which can bring support to this study. However, currently, the effectiveness of the differentiated health services reimbursement measure on primary health services utilization is still ambiguous. The developed mathematical model can’t evaluate the impact of latent variables on health care utilization and also can’t estimate the interaction among these variables and “Multi-factor and multi-result” relationship. Additionally, there is little in-depth strategy research in the area of improving primary health service utilization in China, and especially a lack of research focus on the intervention effect of differentiated health services reimbursement policy..Therefore, this study will carry outing the comprehensive research, a variety of methods is going to be used to build theoretical and mathematical models suiting to Chinese actual situation, including Gelberg-andersen Behavioral Model, Structural Equation Model, Willingness to Pay Surveys, Cross-sectional Survey, etc. Focus on the differentiated health services reimbursement measure, the current situation and factors associated with primary health service utilization will be discovered. The exact effect of insurance benefit design on improving the primary health service utilization and the major target population of those insurance policies will be detected. Strategies and relative measures, which capable of behavior guidance, will be developed to develop differentiated health services reimbursement measures. In addition, this study would provide theoretical support and strategy advice for policy makers of China’s Health Care Reform.