Dilemmas and strategies for cross-regional medical insurance fund collaborative supervision: based on the revised SFIC model
10.3760/cma.j.cn111325-20241114-00965
- VernacularTitle:基于SFIC修正模型的跨区域医保基金协同监管困境及策略分析
- Author:
Chang LIU
1
;
Xinxin HU
1
Author Information
1. 天津财经大学财税与公共管理学院，天津 300222
- Publication Type:Journal Article
- Keywords:
Medical insurance fund;
Collaborative supervision;
Regional coordination;
Collaborative governance SFIC model
- From:
Chinese Journal of Hospital Administration
2025;41(4):282-288
- CountryChina
- Language:Chinese
-
Abstract:
With the expansion of cross-regional medical services in China, the supervision of medical insurance funds is facing systemic challenges including insufficient inter-regional coordination and ambiguous multi-stakeholder responsibilities, necessitating the establishment of a collaborative regulatory framework tailored to China′s governance context. The authors constructed a revised " 4+ 1" collaborative regulatory model by integrating complex regulatory network spatial theory with the collaborative governance SFIC model, which included incorporating initial conditions, intervention leadership, institutional design, collaborative processes, and outcome feedback. The research systematically deconstructed China′s medical insurance fund regulatory practices, found reveal persistent challenges in the current collaborative regulatory system, including institutional friction among stakeholders, blocked cross-regional rule transmission, and insufficient dynamic feedback mechanisms, which collectively contributed to policy implementation deviations and diminished regional coordination efficacy. The authors proposed specific optimization paths, including innovating three-dimensional driven institutional supply, restructuring rights and responsibilities to assist collaborative leadership, implementing dynamic negotiation driven effective collaboration, and constructing a feedback loop through dual dimensional coupling.
