Core Insights - The report highlights the progress and effectiveness of China's medical insurance payment reform, emphasizing the establishment of a multi-faceted payment system primarily based on disease-specific payments [1][2] - The reform has led to a reduction in patients' out-of-pocket expenses and improved the efficiency of medical insurance fund usage, benefiting both medical institutions and patients [1][2] Group 1: Reform Progress - As of now, 191 out of 393 regions have implemented Disease-Related Group (DRG) payment, and 200 regions have adopted Disease Indicator Point (DIP) payment, achieving a coverage rate of 95% for disease types and 80% for insurance funds [2] - The payment reform has resulted in a balanced operation of medical insurance funds, improved internal revenue structures for medical institutions, and reduced economic burdens for patients [2] Group 2: Future Outlook and Challenges - The report outlines ongoing challenges in the reform process, including imbalances in insurance funding, benefit guarantees, and medical costs, as well as increased regulatory difficulties [2] - Continuous improvement and exploration in theory, policy, technology, and methods are necessary to enhance the quality of disease-specific payment implementation and promote coordinated development in the medical, insurance, and patient sectors [2]
蓝皮书:医保支付方式改革基本覆盖所有统筹地区
Xin Jing Bao·2025-04-18 10:13