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Strengthening Supervision of Medical Insurance Funds in Cross-Regional Healthcare: A Study of Guangxi, China

Qiong Liu, Xutao Liang
Frontiers in Economics and Management, (2025), Vol.6, No.8, pp.279-288
Published: August 13, 2025
DOI: 10.6981/FEM.202508_6(8).0026
PDF: Download Full Text PDF
Abstract

The supervision of medical insurance funds for cross-regional healthcare remains a weak link in healthcare fund oversight and a major challenge in improving cross-regional medical services. To enhance medical insurance fund supervision, this study examines the current status and evolving trends in the regulation of cross-regional healthcare funds in Guangxi. It analyzes the concentration and structural characteristics of medical insurance fund oversight and proposes strategies to accelerate the development of a robust supervision system for cross-regional healthcare funds.Key recommendations include:1)Strengthening medical expense review and payment reforms in regions with significant patient outflows, such as Wuzhou City.2)Enhancing medical record-keeping and monitoring of healthcare practices in regions with high patient inflows, such as Nanning City.

Keywords: Medical Insurance; Fund Supervision; Cross-Region Health Care.
APA Citation: Qiong Liu, Xutao Liang (2025). Strengthening Supervision of Medical Insurance Funds in Cross-Regional Healthcare: A Study of Guangxi, China. Frontiers in Economics and Management, 6(8), 279-288. https://doi.org/10.6981/FEM.202508_6(8).0026

References

  1. Roberts, M. J., Hsiao, W., Berman, P., & Reich, M. R. (2010). Getting Health Reform Right: A Guide to Improving Performance and Equity (Minghui REN, Trans.). Beijing: Peking University Medical Press.
  2. North, D. C. (1990). Institutions, institutional change and economic performance. Cambridge University Press.
  3. Williamson, O. E. (1985). The economic institutions of capitalism: Firms, markets, relational contracting. Free Press.
  4. Kornai, János, and Karen Eggleston. Welfare, Choice, and Solidarity in Transition: Reforming the Health Sector in Eastern Europe. Cambridge University Press, 2010.
  5. Arrow (1963): Arrow, Kenneth J. “Uncertainty and the Welfare Economics of Medical Care.” The American Economic Review, vol. 53, no. 5, 1963, pp. 941–973.
  6. Noll, Roger G. “Economic Perspectives on the Politics of Regulation.” In Handbook of Industrial Organization, Volume II, edited by Richard Schmalensee and Robert D. Willig, pp. 1253-1287. Elsevier Science Publishers B.V. (North-Holland), 1989.
  7. Ogus, Anthony I. Regulation: Legal Form and Economic Theory. Clarendon Press / Oxford University Press, 1994.
  8. Pauly, Mark V. “The Economics of Moral Hazard: Comment.” The American Economic Review, vol. 58, no. 3, Part 1, 1968, pp. 531–537.
  9. Li, J. Q., & Wu, G. (2022). The "presence" and "disembedding" of ethnic regional governance from the perspective of spatial structure. Journal of Renmin University of China, 36(5), 49–59.
  10. Guo, M. J., & Guo, L.(2014). Research on instant settlement of medical expenses for floating population in non-local hospitals. Chinese Health Economics,33(1), 26–28.
  11. Wang, Y. H., Wang, L. N., Liang, L. H., et al.(2023). Research on supervision path of medical insurance fund for cross-province medical treatment.Health Economics Research,40(4), 61–65+69.
  12. Wang, W.(2021). Direct settlement of cross-region medical treatment in China: Policy value, implementation effects and optimization paths.Academic Research, (6), 89–95.
  13. Huang, B. S., & Bao, X. X.(2022). Dilemmas and countermeasures of Guangxi's cross-region medical supervision under the background of "streamlining administration and delegating power".Social Welfare (Theory Edition), (6), 36–42.
  14. Lei, X. S. (2019). Problems and countermeasures in the supervision of medical insurance funds in China. Chinese Health Economics, 38(8), 31–33.
  15. Li, Q., Zheng, D. X., & Shen, C. G. (2020). Review of hospital medical insurance fund use policies and discussion on typical problems and improvement strategies. Chinese Health Economics, 39(10), 13–18.
  16. Zheng, S. Z., Gong, Y. C., Geng, T., et al. (2022). Identification of excessive medical behaviors and research on medical insurance supervision indicators. China Health Insurance, (12), 23–28.
  17. He, W. S., Li, Y. Q., & Guan, B. (2023). How does medical insurance supervision affect operational performance of public hospitals? -Perspective from regulatory pressure. Public Administration Review, 5(1), 65–94.
  18. Yi, P., Qu, T. T., & Geng, J. M. (2021). Can the reform of medical insurance supervision mode improve hospitals' technical efficiency? -Empirical analysis based on medical insurance reimbursement data. Economic Theory and Business Management, (4), 40–54.
  19. Wang, H. B., Yuan, J., & Sun, X. Q.(2022). Historical approach, evolutionary logic and future prospects of medical insurance supervision in China: An analysis based on historical institutionalism. Chinese Journal of Health Policy,15(6), 1–8.
  20. Ogus, A. (1994). Regulation: Legal Form and Economic Theory. Oxford: Clarendon Press.
  21. Gunningham, N., & Grabosky, P. (1998). Smart Regulation: Designing Environmental Policy. Oxford University Press.
  22. Ayres, I., & Braithwaite, J. (1992). Responsive Regulation: Transcending the Deregulation Debate. Oxford University Press.
  23. Braithwaite, J. (1982). Enforced Self-Regulation: A New Strategy for Corporate Crime Control.Michigan Law Review,80(7), 1466–1507.
  24. Gunningham, N., Grabosky, P., & Sinclair, D. (1998). Smart Regulation: Designing Environmental Policy(Ch.2). Oxford University Press.
  25. Li, Y. W., & Kou, L. P.(2023). From solidification to dynamization: Research on the emergency management "on-site" based on disembedding theory.Journal of China Emergency Management Science, (2), 29–39.
  26. GU, H., & WU, D. (2021). Essential Connotations and Strategic Framework for High-Quality Development of Basic Medical Security System During the 14th Five-Year Plan Period. Management World, 37(9), 12-25.
  27. National Healthcare Security Administration (NHSA). (2020–2023). National Healthcare Security Development Statistical Bulletin. Beijing: NHSA. Retrieved from http://www.nhsa.gov.cn/col/col7/index.html
  28. Guangxi Zhuang Autonomous Region Healthcare Security Bureau.(2019–2021).Guangxi Healthcare Security Development Statistical Bulletin. Nanning: Author. Retrieved from http://ybj.gxzf.gov.cn/xxgk/jcxxgk/tjgb/
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