“医”路有保障，淄博张店区多措并举提升医疗保障水平

Core Insights - The Zhangdian District government is focusing on enhancing medical insurance to improve public health and stimulate high-quality development through strategic initiatives and practical outcomes [1] Group 1: Medical Insurance Enhancements - The district has strengthened the three-tiered insurance system, steadily increasing coverage levels, with hospitalization reimbursement rates for employees remaining above 80% and for residents at 60% in tertiary medical institutions [3] - Outpatient coverage has been significantly improved, with reimbursement rates for residents reaching 65% for outpatient coordination and 60% for chronic and special diseases; the annual payment limit for employees has been raised to 4,500 yuan for active workers and 5,500 yuan for retirees [3] - The reimbursement rate for outpatient chemotherapy for retirees has been increased to 85%, and a one-stop system is set to provide medical assistance to 10,173 individuals by 2025, with funding of 22.27 million yuan allocated [3] Group 2: Mechanism Innovation and Reforms - Payment method reforms are being deepened, with a focus on a multi-faceted payment system primarily based on Diagnosis-Related Groups (DIP), which encourages medical institutions to control costs and improve quality [4] - The centralized procurement of drugs and medical supplies has resulted in an average price reduction of over 50%, significantly easing the financial burden on the public [4] - The district has implemented a digital transformation in medical insurance services, enhancing efficiency and accessibility through platforms like the "Love Shandong" app and "Zibo Medical Insurance" mini-program [4] Group 3: Future Initiatives - The district plans to focus on expanding insurance coverage, enhancing policy promotion to ensure all eligible individuals are enrolled [5] - There will be an emphasis on improving medical service management and implementing the new DIP payment reform while ensuring proper management of outpatient pharmacy services [5] - The district aims to further solidify the achievements of drug procurement at the grassroots level and increase the variety of drugs available [5]