上海“十五五”规划建议：建立健全医保支付、商保赔付等衔接的多元支付机制

Core Viewpoint - The Shanghai Municipal Government has released recommendations for the 15th Five-Year Plan, emphasizing the need to improve the social security system and develop a multi-tiered pension insurance framework [1] Group 1: Social Security System - The plan aims to accelerate the development of a multi-tiered and multi-pillar pension insurance system, enhancing the mechanisms for determining and adjusting benefits [1] - It highlights the need to expand the coverage of enterprise annuities and promote the development of personal pensions and commercial health insurance [1] - The recommendations include optimizing drug procurement and medical insurance fund usage policies, establishing a multi-faceted payment mechanism that integrates medical insurance payments and commercial insurance reimbursements [1] Group 2: Employment and Insurance Coverage - The plan calls for expanding the coverage of unemployment and work injury insurance, and advancing pilot programs for occupational injury protection [1] - It emphasizes increasing the insurance participation rate among flexible employment workers, migrant workers, and new employment form personnel [1] - The recommendations stress the importance of solidifying the sustainable development foundation of social insurance funds and enhancing safety supervision systems [1] Group 3: Elderly Care Services - The plan aims to improve the quality of elderly care services and promote the development of elder care technology [1] - It encourages the innovation of integrated care models that combine medical and nursing services, rehabilitation care, and palliative care [1] - The recommendations include perfecting the long-term care insurance system, promoting mutual aid elderly care services, and strengthening the construction of the elderly care workforce [1]