Objective: The paper discusses the feasibility of exploring vertical administration of provincial healthcare security departments under the current management system, and structurally solve the uncoordinated and mismatched phenomena in the development of healthcare security. Methods: Based on the principle of "practicality and feasibility", the paper fully draws on the experience of other provincial-level vertical administration departments with high similarity in reform, and indirectly demonstrates its feasibility through "precise grafting" of reform experience. Results: Provincial vertical administration is likely to become a supporting system for the provincial coordinated management of medical insurance funds, jointly forming the reform driving force for the future development of healthcare security. Conclusion: The vertical administration system reform, as the "second institutional reform" in the field of healthcare security, is a practical path that continues the "first institutional reform" and systematically reshapes and structurally optimizes the field of healthcare security. We can start from the management system to deeply promote the specialized and refined reform in the field of healthcare security, explore a healthcare security service management system suitable for China's national conditions, gradually move from medical security to health security, and lay a solid foundation for Chinese path to modernization.