Objective: Under the background of increasingly convenient trans-provincial medical treatment, the paper analyzes the factors influencing the choice of trans-provincial (except Beijing City, Tianjin City and Hebei Province) medical treatment place and total medical cost in Baoding City in 2023, and puts forward suggestions according to the basic situation of trans-provincial medical treatment in Baoding City and the challenges of medical insurance fund supervision. Methods: Firstly, the paper used Excel to analyze the settlement data of Baoding City in 2023 for medical treatment in a different place and establish a database. Secondly, SPSS23.0 software was used to analyze the data by descriptive statistical analysis, unordered multicategorical logistics regression analysis and multiple linear regression. Results: Most of the insured people in Baoding City in 2023 who sought medical treatment in other places flowed to Shandong Province (50.2%), and the average values of total incurred costs and total fund expenditures were 17728.81 yuan and 10053.80 yuan, respectively. Unordered multicategorical logistics regression analysis showed that hospitalization bed days, hospital grade, fund payment ratio, age and personnel category were the significant influencing factors for the occurrence of off-site medical care behavior (P<0.05). The results of multiple linear regression showed that age, personnel category, hospitalization bed days, total fund expenditure and fund payment ratio were significant influencing factors of total costs of off-site hospitalization (P<0.05). Conclusion: Baoding City, as a place of insurance with a large number of medical treatment in other places, should improve the basic medical resources, reasonably guide and improve the behavior of medical treatment in other places, improve the supervision mechanism of the fund in other places, and maintain the safe operation of the fund.