高质量完成“十四五”规划｜减轻百姓看病负担 加强基金监管力度——国新办发布会聚焦我国“十四五”时期医保改革

Core Viewpoint - The article emphasizes the ongoing reforms in China's medical insurance system during the "14th Five-Year Plan" period, focusing on reducing the financial burden on citizens and enhancing the regulatory framework for medical insurance funds [1]. Group 1: Medical Insurance Coverage - The national basic medical insurance coverage rate remains stable at around 95%, with an expected 1.327 billion people insured by 2024 [2]. - Nearly 200 billion medical visits have been reimbursed through insurance from 2021 to 2024, benefiting 3.5 billion low-income individuals through medical assistance programs [2]. Group 2: Support for Vulnerable Groups - Measures have been implemented to enhance support for children and the elderly, including the establishment of a long-term care insurance system, with 190 million participants expected by the end of 2024 [3]. - The maternity insurance program has seen participation from 253 million individuals, with over 96 million enjoying benefits [3]. Group 3: Financial Impact of Medical Insurance - Cumulative medical insurance fund expenditures reached 12.13 trillion yuan, with an annual growth rate of 9.1% [4]. - Spending on innovative drugs has significantly increased, with 2024 expenditures projected to be 3.9 times that of 2020, reflecting a 40% annual growth rate [4]. Group 4: Reducing Medical Costs - Policies have reduced the financial burden on low-income rural populations by over 650 billion yuan during the "14th Five-Year Plan" [5]. - A total of 402 new drugs have been added to the insurance coverage list, and price regulation efforts have standardized over 27,000 drug specifications [5]. Group 5: Enhancements in Medical Services - Cross-province medical services have been improved, allowing for direct settlement of outpatient chronic disease treatments for 10 types of conditions [7]. - The establishment of a "15-minute medical service circle" aims to enhance accessibility, with over 1.236 billion people using medical insurance codes for direct settlement [7]. Group 6: Fund Security and Regulation - The cumulative balance of the medical insurance fund reached 3.86 trillion yuan by the end of 2024, with ongoing monitoring to ensure stable operations [8]. - Innovative regulatory measures, including big data analysis, have led to the recovery of 10.45 billion yuan in misused funds [8][9].