Objective: By analyzing the current situation of the medical insurance outpatient mutual aid system reform, and the inclusion and supervision of designated retail pharmacies in Baoding City, this paper explores how to strengthen the supervision of designated pharmacies for outpatient security while fully protecting the rights and interests of insured employees, ensuring the safe and stable operation of the medical insurance fund. Methods: The paper searches the outpatient mutual aid policies for employees of Baoding City and other cities in Hebei Province from January 1, 2022 to December 31, 2024, and compares the level of employee outpatient security benefits horizontally. Also, it analyzes the regulatory practice of Baoding City in incorporating designated retail pharmacies into outpatient security from 2022 to 2024, and summarizes the experience and problems. Results: After the reform of the employee outpatient mutual aid, the benefit level of employees' outpatient pooling in Baoding City is at medium to high level in Hebei Province. The number of outpatient patients has grown rapidly, and the insured people has begun to enjoy dividends of the reform. Baoding City includes the designated retail pharmacies to outpatient pooling in batches, which better serves the public and reduces regulatory pressure. However, it had some negative impacts on drug price management and medical insurance payments in pharmacies. The creative use of remote video surveillance systems has played a role in strengthening supervision, but we should continue to strengthen regulation by combining other regulatory measures. Conclusions: We should continue to strengthen and improve the drug price management of designated retail pharmacies, optimize medical insurance payment policies, improve the regulatory measures for outpatient security pharmacies, and ensure the safety of medical insurance funds while fully meeting the needs of the public for outpatient medication.