Objective: This paper aims to analyze the catastrophic health expenditure on patients with hypertension in the minority-inhabited areas in western China. Methods: The incidence and intensity of catastrophic payment for health care were estimated from two rounds of household survey in 2011 and 2014, respectively. Concentration index were also estimated over the same period. Results: The incidence, average distance and concentration index of catastrophic health expenditure were reduced, but relative distance was not changed. Conclusion: The intensity and impact of catastrophic health expenditure was reduced due to two-way referral system. Adjustment of health insurance compensation is needed to control the trend of pro-rich distribution of catastrophic health expenditure.