医药总费用增速高位回落，超13亿人医保账本释放这些关键信号

Core Insights - The core message of the news highlights the comprehensive reforms in China's medical insurance system, which have led to a more regulated medical service behavior and a reduction in overall medical expenses [1] Group 1: Medical Insurance Coverage and Financials - By the end of 2024, approximately 1.327 billion people are expected to be covered by basic medical insurance, maintaining a coverage rate of over 95% [2] - The total revenue of the national basic medical insurance fund (including maternity insurance) is projected to be around 3.49 trillion yuan, with total expenditures of 2.98 trillion yuan in 2024 [2] - The income from employee medical insurance (including maternity insurance) is estimated at 2.37 trillion yuan, reflecting a growth of 3.5% compared to the previous year, while expenditures are expected to reach 1.91 trillion yuan, an increase of 7.6% [2] Group 2: Medical Expenses and Utilization - The total medical expenses for employee insurance participants are projected to be approximately 2.06 trillion yuan in 2024, with a growth rate of 3.6% [6] - For resident insurance participants, medical expenses are expected to be around 2.03 trillion yuan, with a growth rate of 3.7% [6] - The number of treatment instances for employee insurance participants is projected to reach 5.308 billion, a 9.9% increase from the previous year, while resident insurance participants are expected to have 3.035 billion treatment instances, a 14.9% increase [2] Group 3: Impact of Policy Reforms - The integration of maternity insurance with employee basic medical insurance since 2019 has streamlined the calculation of medical expenses [3] - The cumulative expenditure of the medical insurance fund since the establishment of the National Medical Insurance Bureau has reached 16.48 trillion yuan, with an average annual growth rate of 11% [3] - The establishment of a new mechanism for the entry and negotiation of innovative drugs into the medical insurance system has significantly shortened the time from drug launch to inclusion in insurance [3] Group 4: Trends in Medical Costs - The growth rate of total medical expenses has decreased from over 20% to 3% due to the release of pent-up demand for medical services following the pandemic [5] - The structure of declining medical expenses indicates a notable decrease in drug prices, while the prices for certain medical services have shown mixed trends, with some prices increasing [6] - The overall trend in medical expenses is influenced by ongoing reforms in payment methods and service pricing, leading to a more regulated medical service environment [6]