With the development of basic medical insurance and health care reform，raising the fund-pooling level is becoming urgent in China.Provincial risk adjustment mechanism is an important modified form for this issue.In practice，there are still many problems in it，which need to be further studied and perfected.Therefore，this paper took the provincial risk adjustment mechanism as the research object，summarized the relevant experience of the domestic provinces and cities，drew lessons from the international experience，and tried to put forward some recommendations.