关键词: 职工基本医疗保险, 省级统筹, 医保基金, 道德风险

Abstract: Based on the data of China Family Panel Studies (CFPS), this paper adopts a fixed effect model to estimate the impact of provincial pooling of employee medical insurance on medical insurance fund expenditures. The findings show that the provincial-level pooling of employee medical insurance has significantly improved the expenditure level of insured persons’ medical insurance funds, and this conclusion remains robust even after overcoming the self selection problems using the propensity score matching method. The analysis shows that the insured individuals are more likely to choose large hospitals for medical treatment and increase the utilization of inpatient medical services, which is an important channel for the provincial coordinated expansion of employee medical insurance fund expenditures. The heterogeneity analysis reveals that provincial pooling of employee medical insurance has a stronger effect on increasing medical insurance fund expenditures for the low-income, living-in-rural-areas, and elderly insured populations. Therefore, while promoting the provincial-level coordination of employee medical insurance, it is necessary to strengthen the supervision capacity of medical insurance funds, establish a risk assessment and early warning mechanism for medical insurance funds, and ensure the safety of medical insurance fund expenditures.

Key words: employees basic medical insurance, provincial level pooling, medical insurance fund, moral hazard