In Taiwan, the health care system is closed-form and non-gate-keeping. This study explains patients' choices and practitioners' referrals according to a two-stage model. The results show that a patient's hospital or clinic choice depended on not only the co-payment, but also the benefit consideration. This was because hospitals and clinics in the closed-form system might provide services with different treatment efficiencies. According to the incentives of patients' choices, increasing the co-payment only changed the financial incentives; however it did not affect the treatment or benefit consideration. Under the closed-form and non-gate-keeping system in Taiwan, practitioner referrals would be encouraged through the reform of the insurance payment system and the vertical integration between hospitals and clinics. This could provide hospitals and clinics with financial incentives and discourage patients' self-refer.