“十四五”期间江苏医保基金总支出超1.1万亿元

Core Insights - By the end of 2025, the number of basic medical insurance participants in Jiangsu province is expected to reach 81.408 million, maintaining a participation rate of over 95% [1] - During the "14th Five-Year Plan" period, the total expenditure of the medical insurance fund in the province will exceed 1.1 trillion yuan, significantly enhancing the well-being of the population [1] Group 1 - The provincial government has implemented various reforms to strengthen the medical insurance system, including the issuance of the "Implementation Opinions on Deepening Medical Security System Reform" and the establishment of the first medical insurance special plan [1] - A comprehensive "one person, one file" insurance database has been created, achieving city-level coordination and establishing a long-term mechanism to prevent poverty caused by illness [1] - The province has made significant progress in key reforms within the medical insurance sector over the past five years, including the advancement of DRG/DIP payment reform and the establishment of a unified sunshine procurement platform [1] Group 2 - In the next five years, Jiangsu will continue to consolidate the achievements of universal insurance coverage, regulate fund management, and improve the multi-tiered medical insurance system [2] - The province aims to enhance the functions of the maternity insurance system and fully establish a long-term care insurance system, promoting the coordinated development of the "three medicals" [2] - There will be a focus on integrating artificial intelligence with the entire medical insurance process to provide higher quality and more efficient services to the public [2]