推进基本医保省级统筹有了“时间表”

Core Viewpoint - Hunan Province is implementing a comprehensive reform of its basic medical insurance system to enhance public health coverage and ensure equitable access to medical services for its residents [1] Group 1: Policy Implementation - The new plan establishes a unified policy for employee medical insurance contributions, including a standardized contribution base and rate across the province [2] - It aims to standardize reimbursement thresholds and payment ratios for inpatient and outpatient services, while also optimizing outpatient coverage [2] - The plan includes a unified approach to maternity insurance and cross-regional medical treatment policies, with a reduction in reimbursement ratios for non-emergency cross-provincial treatments [2] Group 2: Fund Management - The reform will enhance the risk management of medical insurance funds by eliminating the city-level risk reserve system and establishing a provincial adjustment fund [3] - The provincial adjustment fund will initially be capped at 5% of the current budget revenue, with plans for gradual expansion as management improves [3] - A risk assessment and early warning mechanism for fund operations will be established to ensure long-term sustainability [4] Group 3: Payment Mechanisms - The plan will standardize the management of medical insurance drug lists, medical services, and consumables, including the personal payment ratios for certain drugs and services [5] - It will implement a multi-faceted payment system primarily based on disease categories, incorporating costs for cross-regional medical treatment into the payment reform [5] - The timeline for implementation includes full realization of city-level coordination by the end of 2026, with provincial coordination for employee insurance starting in 2027 and for resident insurance by the end of 2028 [5]