The establishment of close-knit medical consortia represents a significant endeavor in China's pursuit of a high-quality, efficient, and integrated healthcare service system. A scientifically sound healthcare insurance payment mechanism is pivotal to ensuring the effective operation of these close-knit medical consortia. This paper provides an overview of the current status of healthcare insurance payment mechanisms for integrated healthcare service systems both domestically and internationally. It comprehensively analyzes the existing issues in the payment methods of close-knit medical consortia at present. Furthermore, the paper proposes adjustment and optimization strategies for the reform of healthcare insurance payment mechanisms in close-knit medical consortia, including the global budget calculation methods, the multiple composite healthcare insurance payment methods on the basis of global budget, the balance retention and reasonable over-expenditure sharing mechanism, and the corresponding supervision and assessment methods, which can be used as a reference for practice.