From local innovation to national policy: Cross-boundary policy entrepreneurship in China's health regulatory reform

Many contemporary social problems are innately complex, increasingly requiring joint efforts across sectoral boundaries to find a resolution. Cross-boundary policy entrepreneurship, a distinctive form of policy dynamism, represents a nascent approach to policy innovation in the face of emerging disruptive technologies. By analysing a major health regulatory reform in China that was catalysed by local innovation, this study explains how a coalition of entrepreneurial actors across the local government, the corporate sector, and public hospitals was formed, and how it secured policy adoption at both local and national levels. In-depth interviews were extensively used in data collection, and a processual approach was adopted in qualitative analysis. This two-episode case study characterises four types of policy entrepreneurs and explains their respective motivations and entrepreneurial strategies used in the reform. This study's findings illustrate how local innovations are scaled-up into national policies in a multilevel governance structure through collective manoeuvres.

Points for practitioners

• Many contemporary social problems require joint innovative efforts across sectoral boundaries.
• Policy entrepreneur, process broker, program champion, and technology innovator play distinctive roles in cross-boundary policy innovations.
• Issue framing, strategic planning, coalition building, venue-shopping, persuasion, and leading by example are common entrepreneurial strategies in scaling up local innovations to national policies.
• Caveats must be drawn from both legal and ethical grounds to scrutinise cross-boundary policy entrepreneurship.