中央决定推进医保省级统筹，2026年求医问药有哪些变化

Core Insights - The core viewpoint of the articles is that the acceleration of provincial-level medical insurance coordination in China by 2026 will lead to significant changes in the healthcare market structure, benefiting insured individuals while presenting challenges for healthcare institutions [1][2][4]. Group 1: Provincial-Level Coordination - The "14th Five-Year Plan" aims to achieve provincial-level coordination of basic medical insurance, building on the city-level coordination established during the "13th Five-Year Plan" [2]. - By 2026, the implementation of provincial-level coordination is expected to enhance the risk resistance capability of the medical insurance fund and improve governance levels [2][3]. - Currently, 20 provinces have initiated policies to promote provincial-level coordination, with two main models: unified collection and expenditure, and a provincial adjustment fund model [2][3]. Group 2: Impact on Insured Individuals - Provincial-level coordination will create a larger medical insurance fund pool, enhancing risk resistance and fairness in treatment, as intra-provincial medical services will no longer be considered as cross-regional [4][5]. - The unification of medical insurance policies within provinces is expected to reduce the need for patients to travel for services, thereby decreasing the number of inter-regional medical visits and fund transfers [5][6]. Group 3: Implications for Healthcare Institutions - The shift to provincial-level coordination may intensify the "siphoning effect" towards larger hospitals, as patients are likely to prefer higher-quality medical institutions within their provinces [5][6]. - Healthcare institutions in less developed areas may face increased pressure, necessitating improvements in their capabilities to compete with larger hospitals [5][6]. - The regulatory environment for large hospitals is expected to tighten, particularly with the inclusion of inter-regional medical services into Diagnosis-Related Groups (DRG) payment systems [6].