In the wake of China’s monumental achievement in establishing the world’s most extensive social health insurance system, encompassing 1.4 billion individuals, a unique challenge known as the “siphoning effect” has emerged. This effect involves insured individuals seeking medical care predominantly in major urban centers, straining resources and hindering local healthcare service development. A policy innovation of cross-regional direct settlement of medical outpatient expenses has been implemented nationwide to address this. However, increased population mobility and urbanization have introduced new complexities, prompting insured individuals to seek healthcare beyond their home regions. This study explores the determinants of patient satisfaction in the context of cross-regional medical treatment, adopting a comprehensive approach across six independent dimensions. Findings indicate a 70% satisfaction rate, emphasizing room for improvement, particularly in communication and service efficiency. The study reaffirms the significance of medical competence and professionalism as primary determinants of patient satisfaction, highlighting their robustness in diverse healthcare contexts. Sociodemographic factors also play a crucial role, emphasizing the need for tailored services. Also, accessible information within hospital settings proves vital in enhancing patient satisfaction. This research calls for prioritizing investments in enhancing medical competence and professionalism among healthcare staff. It underscores the importance of adapting services to cater to specific patient groups’ characteristics and the need for standardization in medical insurance policies. A patient-centered approach is crucial to ensure comprehensive and easily understandable information, ultimately enhancing overall patient satisfaction in cross-regional medical treatment within China’s evolving healthcare system. These insights contribute to a broader understanding of healthcare management and services.