China has recently implemented major healthcare reforms aimed at improving the efficiency of healthcare delivery

including the establishment of county medical consortia and the reform of medical insurance payment systems. This study examines the impacts of the county medical consortium reform and the Diagnosis‑Intervention Packet (DIP) payment reform on hospital operational performance. Using panel data on public medical institutions in W County of Henan Province from 2015 to 2024

we exploit the staggered implementation of the consortium reform and the introduction of the DIP payment system as a quasi‑natural experiment. Difference‑in‑differences (DID) and triple‑differences (DDD) models are employed to identify the policy effects. The results show that the county medical consortium reform significantly increases outpatient service volume at leading hospitals

suggesting that healthcare integration enhances hospitals' patient‑attracting capacity. At the same time

the reform is associated with a higher medical insurance advance rate

indicating increased short‑term financial pressure related to insurance settlements. The interaction effect between the consortium reform and the DIP payment reform is not statistically significant in the short run. Robustness checks and heterogeneity analyses confirm the stability of the findings. Overall

this study provides new empirical evidence on the interaction between healthcare system integration and medical insurance payment reform and offers policy implications for coordinating healthcare reforms in China.