着力解决百姓就医难 “十四五”期间医保基金支出年均增速达9.1%

Core Viewpoint - The National Medical Insurance Administration emphasizes the importance of enhancing the quality of medical insurance services during the "14th Five-Year Plan" period, focusing on improving access and affordability for the public [1][3]. Group 1: Medical Insurance Coverage and Expenditure - The national basic medical insurance coverage rate has remained stable at around 95%, with a cumulative expenditure of 12.13 trillion yuan, averaging an annual growth rate of 9.1% [1]. - By 2024, the number of people covered by basic medical insurance is expected to reach 1.327 billion [1]. - Nearly 200 billion medical insurance reimbursements have been enjoyed by approximately 200 million people from 2021 to 2024 [1]. Group 2: Support for Specific Demographics - Measures have been taken to enhance support for the elderly and children, including the establishment of a long-term care insurance system, with 190 million participants by the end of 2024 [2]. - The cumulative expenditure for maternity insurance has reached 438.3 billion yuan, benefiting over 96 million people [2]. Group 3: Reducing Medical Costs - Policies have reduced the financial burden on rural low-income populations by over 650 billion yuan during the "14th Five-Year Plan" [3]. - The long-term care insurance has benefited over 2 million disabled individuals, reducing care service costs by over 50 billion yuan [3]. - Direct settlement for cross-provincial medical treatment has reduced the need for out-of-pocket expenses by 590 billion yuan [3]. Group 4: Technological Advancements in Medical Insurance - A unified national medical insurance information platform has been established, significantly improving management efficiency [4]. - The number of people using medical insurance codes has exceeded 1.236 billion, facilitating direct payment for medical services [4]. - The number of direct settlements for cross-provincial medical treatment has increased from 5.37 million in 2020 to 23.8 million in 2024, a 44-fold increase [4]. Group 5: Fund Management and Security - By the end of 2024, the cumulative balance of the medical insurance fund is expected to reach 3.86 trillion yuan [5]. - The administration has recovered 104.5 billion yuan through enhanced fund management and monitoring [5]. - Innovative regulatory measures have been implemented to combat fraud, including the use of big data analysis to identify irregularities [6]. Group 6: Support for Innovative Drugs - Expenditure on innovative drugs has increased significantly, with spending in 2024 being 3.9 times that of 2020, reflecting an annual growth rate of 40% [8]. - A total of 402 new drugs have been added to the medical insurance catalog since the beginning of the "14th Five-Year Plan" [8]. - The establishment of a commercial health insurance catalog for innovative drugs has seen over 100 drugs submitted for approval [9]. Group 7: Future Directions - The National Medical Insurance Administration aims to continue managing the medical insurance fund effectively while supporting the development of the pharmaceutical industry [9]. - The focus will be on providing efficient, safe, and accessible medical products and services to the public, contributing to the overall health of the nation [9].