全省医疗保障工作会议在宁召开

Core Insights - The Jiangsu provincial medical insurance system aims to implement reforms and achieve a balanced fund operation by the end of the "14th Five-Year Plan" period, with a target of 81.41 million insured individuals and a total expenditure exceeding 1.1 trillion yuan [1][2]. Group 1: Policy and Framework - The provincial government has issued implementation opinions to deepen medical insurance system reforms and established the first special medical insurance plan [2]. - A long-term insurance mechanism has been introduced, including a comprehensive database for individual insurance records and measures to prevent poverty due to illness [2]. - The establishment of a joint regulatory mechanism for medical insurance funds aims to enhance fund security and oversight [2]. Group 2: Fund Management and Safety - The government plans to gradually increase financial subsidies for residents' medical insurance and implement regular inspections and special governance in key areas [2]. - The introduction of DRG/DIP payment reform and the establishment of a unified procurement platform are key breakthroughs in reforming the medical insurance system [2]. Group 3: Information Technology and Public Services - The integration of smart technology in medical insurance services includes the promotion of various payment methods and the establishment of a comprehensive public service system across multiple administrative levels [2]. - A dedicated hotline and streamlined processes for various life events have been implemented to enhance public service convenience [2]. Group 4: Future Directions - By 2026, the medical insurance system will focus on high-quality development, ensuring the sustainability of universal coverage and optimizing service delivery [3]. - The plan includes enhancing the long-term care insurance system and improving the management of medical insurance funds [3]. - The integration of artificial intelligence in the medical insurance process is expected to optimize services and enhance data monitoring [3].