On January 9, the National Medical Security Work Conference was held in Beijing. The meeting fully implemented the deployment of the first economic work conference, summarized the medical insurance work in 2023, analyzed the situation of medical insurance work, and studied and deployed the work in 2024.
The meeting pointed out that in 2023, the national medical insurance system will resolutely implement the spirit of the important instructions and instructions of the general secretary, fully implement the decision-making and deployment, and transform the educational achievements of the theme of learning and implementing the socialist ideology with Chinese characteristics in the new era into the practical effect of medical insurance reform and development to benefit the people, and promote new progress in medical insurance work.
The first is to improve the quality of insurance participation and build a solid foundation. While more than 16 million people have been repeatedly enrolled, the participation rate of low-income rural people and people lifted out of poverty has remained stable at 99More than 9%, the triple system guarantees the benefit of the masses outpatient and inpatient medical treatment more than 1500 million person-times, reducing the burden by more than 170 billion yuan.
The second is to improve the outpatient security treatment. The general outpatient medical insurance has been basically established for employees, covering more than 400,000 medical institutions, with more than 2.5 billion people and more than 200 billion yuan of reimbursement during the year. The outpatient drug guarantee mechanism for the "two diseases" of residents' medical insurance continues to be optimized.
The third is to continue to promote the centralized procurement of drug consumption. During the year, two batches of 80 kinds of drugs were procured by the state, with an average price reduction of 57%. Carry out centralized procurement of intraocular lenses and sports medicine consumables, with an average price reduction of 70%. Carry out special treatment of oral implant medical service charges and consumables, and the overall cost of a single dental implant has increased from an average of 150,000 yuan dropped to about 6,000-7,000 yuan, and a total of 1.5 million seeds were planted.
Fourth, optimize the medical insurance catalog. There are 126 new drugs in the new version of the catalog, bringing the total number to 3,088, and more than 2100 million person-times, superimposed on price reductions and medical insurance reimbursements, reducing the burden on patients by more than 200 billion yuan.
Fifth, improve the convenience of seeking medical treatment in other places. There are 550,000 cross-provincial and remote medical treatment networked medical institutions, benefiting the masses to seek medical treatment1300 million person-times, reducing the advance payment of the masses 1536700 million yuan.
Sixth, guard the "life-saving money" of the masses. In 2023, 750,000 medical institutions will be inspected and verified, and 36 will be processed30,000 families, recovering medical insurance**171500 million yuan.
Seventh, expand the application of medical insurance informatization. The cumulative activation of the medical insurance code exceeds 10800 million people, covering more than 800,000 designated medical institutions, more than 7 percent of the country's medical insurance government services have been handled online, and 8 high-frequency matters such as residents' insurance registration have been handled "across provinces".
Eighth, strengthen the ability of drug management. Uniformly standardize the data of drugs linked to the network, carry out normalized supervision, and orderly correct the abnormal problems of 116 kinds of drug consumables.
Nine is to deepen the reform and management of medical services. In 2023, 28 provinces will carry out price adjustments, accelerate the review of new medical service projects, and add more than 1,900 items throughout the year.
The meeting made it clear that in 2024, the medical insurance work should be guided by the socialist thought with Chinese characteristics in the new era, adhere to the general tone of seeking progress while maintaining stability, and unswervingly follow the development path of medical security with Chinese characteristics.
The first is to consolidate and expand the achievements of universal insurance. Study and improve the long-term incentive and restraint mechanism for participating in insurance, use the system to ensure that the masses who continue to pay premiums benefit, and ensure that the whole people participate in insurance.
The second is to improve the quality of medical security for the masses. Consolidate and expand the achievements of medical insurance in poverty alleviation, improve the multi-level medical security system, and more accurately reduce the burden of medical expenses on patients with serious illnesses.
The third is to optimize medical insurance services. Improve the level of standardization of medical insurance, and implement the list of government service items handled by medical insurance. Promote the digital transformation of medical insurance, and promote more medical insurance public service matters to be handled online.
Fourth, strengthen the high-pressure situation of supervision. Achieve comprehensive coverage of on-site supervision and precise crackdown on off-site supervision, and give full play to the role of a searchlight to govern corruption in the pharmaceutical field. Jointly gather multiple departments to carry out special governance in key areas, and effectively give full play to the role of "promoting reform through investigation".
Fifth, deepen the reform and management of medical services. Focus on projects with prominent contradictions, and carry out special management of large-scale equipment inspections.
Sixth, promote the "expansion and quality improvement" of centralized procurement. Carry out the centralized procurement of new batches of state-organized drug consumables, do a good job in the continuation of the agreement on the selected varieties in centralized procurement, and achieve a total of at least 500 drugs at the national and provincial levels.
Seventh, give full play to the efficiency of drug management. Promote the special governance of online drugs, explore new mechanisms for the formation of drugs, and increase the disclosure of credit evaluation and disclosure of procurement services.
Eighth, optimize the reform of payment methods. Give full play to the role of medical insurance in supporting the high-quality development of public hospitals, the inheritance and innovation of traditional Chinese medicine, and the construction of a close-knit county-level medical community.
Ninth, we will promote maternity insurance and long-term care insurance in an orderly manner. Study and improve maternity insurance policies and measures. In accordance with the decision-making and deployment of the first decision, promote the establishment of a long-term care insurance system.
The meeting was held in the form of **, representatives of relevant departments of state organs, relevant responsible comrades of the discipline inspection and supervision group of the National Health Commission, and responsible comrades of various units of the National Medical Security Administration attended the meeting at the main venue. The main responsible comrades of the medical security departments of all provinces, autonomous regions, municipalities directly under the Central Government, cities specifically designated in the state plan, and the Xinjiang Production and Construction Corps attended the meeting at the local branch venues.
Editor-in-charge: Shi Jian |Review: Li Zhen |Supervisor: Wan Junwei.