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Health industry transformation is changing the socioeconomic conditions under which medical insurance systems operate. This study examines the relationship between established financing mechanisms and evolving health service models, including digital health integration, value-based care, and the expansion of preventive and personalized interventions. A systems analysis of institutional design, fiscal sustainability, and stakeholder alignment identifies structural tensions between existing insurance arrangements and emerging health system priorities. On this basis, the study proposes a diversified financing framework that combines innovations in risk pooling, dynamic contribution mechanisms, and cross-sectoral funding instruments to strengthen equity, adaptability, and long-term sustainability. The analysis emphasizes that effective diversification requires changes in governance, accountability, and intertemporal resource allocation, as well as additional funding sources, to support health system transformation.
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钟斌 et al. (2026) studied this question.
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