Academic Journal of Business & Management, 2026, 8(2); doi: 10.25236/AJBM.2026.080218.
Chen Xu1, Jinlong Shao1, Jiapeng Zhang2
1College of Public Administration and Humanities, Dalian Maritime University, Dalian, 116026, China
2College of Artificial Intelligence, Dalian Maritime University, Dalian, 116026, China
With the gradual improvement of the basic medical insurance system, provincial pooling has become an important way to enhance the mutual assistance ability, management efficiency, and promote fairness of funds. However, this process also faces moral hazard issues caused by changes in the interests of local governments, medical insurance departments, medical institutions, and insured persons. This study systematically reviewed the manifestations, causes, and influencing factors of moral hazard through literature review and case analysis, and proposed measures to strengthen supervision and improve incentive mechanisms. The study also found that Chongqing has achieved significant results in controlling moral hazard, and its experience has important reference significance for other regions. Finally, specific policy recommendations were put forward, including steadily promoting provincial-level coordination, strengthening top-level design, paying attention to local finance, strengthening publicity and education, and establishing dynamic adjustment mechanisms, to ensure the safe and efficient operation of the medical insurance fund and the smooth implementation of provincial-level coordination reform.
Basic medical insurance, Provincial pooling, Moral hazard, Regulatory mechanism, Incentive mechanism
Chen Xu, Jinlong Shao, Jiapeng Zhang. Research on the Moral Risks and Countermeasures of Basic Medical Insurance Coordination. Academic Journal of Business & Management (2026), Vol. 8, Issue 2: 137-141. https://doi.org/10.25236/AJBM.2026.080218.
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