Objective: Based on the “six unifications” principle of basic medical insurance provincial pooling, this study evaluates the current status of provincial pooling progress and its driving factors with a view to providing policy recommendations for promoting provincial pooling. Methods: Firstly, a “development evaluation index system for basic medical insurance provincial pooling” was constructed from the perspectives of fairness, sustainability, stability and unification and the overall index in each province as well as index in each dimension was calculated; then regional level differences were measured by Theil index and spatial agglomeration and heterogeneity patterns were analyzed by spatial auto-correlation; finally, the driving factors were analyzed using geographically weighted regression model. Results: There are significant differences in the progress of provincial pooling and development levels among provinces with a decreasing trend of overall index from east to west in geographical space showing a random distribution pattern. Economic level, policy factors, medical resources and educational investment have significant impacts on promoting provincial pooling. Conclusion: Improving financing mechanisms, strengthening coordination, enhancing institutional linkage, optimizing resource allocation and enhancing talent cultivation can effectively promote the process of basic medical insurance provincial pooling, achieve fairness, sustainability, stability, and unification in the medical insurance system, and better safeguarding people's health rights.