What determines the success or failure of policy experiments?—A qualitative field study of China's healthcare reform pilots

Drawing on the coding framework, the analysis identifies two overarching forces shaping CMSC pilot implementation: institutional compatibility and policy potential energy. Institutional compatibility reflects the alignment of CMSC policy design, healthcare insurance payment rules, interdepartmental coordination, incentive structures, and resource-benefit allocation. Policy potential energy derives from the redistribution of administrative power, political momentum from higher-level governments, the capacity of policy entrepreneurs, and the contextual foundations of social capital and trust. Mapping these dynamics reveals four pilot trajectories: upscaling, adjustment, suspension, and autonomy.