转自：中国经营网 文 孟庆伟 中国式现代化，民生为大。 回顾2025年，在"实施健康优先发展战略"的引领下，健康中国建设与经济发展同频共振，一项项改革举 措落地生根，并转化为人民群众切实的获得感与幸福感：基本公共卫生服务经费人均财政补助标准提至 99元、国家发放每孩每年3600元的育儿补贴、基层医疗卫生机构提供儿科服务的比例达到93%、所有省 份实现地市内医疗机构之间检查检验结果互认项目超200项、50种1类创新药新进医保目录、长期护理保 险制度覆盖约3亿人……一个个数字背后，是饱含温度的民生答卷。 《中共中央关于制定国民经济和社会发展第十五个五年规划的建议》作出"加快建设健康中国"的重大决 策部署。2025年12月10日至11日召开的中央经济工作会议将"坚持民生为大，努力为人民群众多办实 事"确立为2026年经济工作的一项重点任务，其中明确提出"优化药品集中采购，深化医保支付方式改 革""推行长期护理保险制度""努力稳定新出生人口规模"等，这既是对过往改革路径的延续与深化，也 意味着未来将以更系统、更精准的举措，织密筑牢人民健康保障网，书写健康中国新答卷。 织牢基层网底 织牢建强基层网底，就是筑牢民生保障底 ...

转自：成都日报锦观 制度筑基 服务赋能 用医保温度书写"民生答卷" ——成都市医疗保障工作"十四五"发展综述 数说"十四五" ■全市基本医保参保人数约1885万人。 ■新增949种药品进入医保目录。 ■300余家定点医疗机构实现医保码就医全流程应用。 ■建成"市县镇村"四级经办体系，设立200余个医保工作站。 ■长期护理保险参保累计享受待遇21.56万人。 "十四五"期间，全市基本医保参保人数约1885万人，职工医保和城乡居民医保参保规模稳步扩大；全市1.76万家定点医药机构实现了追溯码上 传，医药机构追溯码采集接入率为100%；截至2025年11月，全市长期护理保险参保累计享受待遇21.56万人……翻阅过去五年成都医保的"民生 账单"，一份份翔实的数据折射出全市人民不断提升的医保获得感。 幸福的体现，不仅在一串串上涨的数字之间，更在一句句群众切身的话语之中——"老伴胃癌手术，报销了大半费用""带娃看病刷个医保码， 全程不用找卡片""4岁患病孙女儿有了长护险上门护理，全家有了盼头"…… 从政策体系到服务落地，"十四五"期间，成都医保的惠民温度藏在千万市民的切身感受里。作为事关群众健康福祉的重大民生工程，成都以 ...

国际医学回复：您好，感谢您对公司的关注。中央经济工作会议对2026年医疗健康领域"三医协同"、药 品集采优化及医保支付方式改革的深化部署，体现了国家推动行业高质量发展的坚定决心，这对所有医 疗机构都提出了更高要求，也蕴含着新的发展机遇。面对行业政策的持续深化，公司将坚持发展战略目 标，以稳健经营为基础，强化成本管控和效率提升；以提升医疗质量和服务体验为核心，加强学科建 设，不断优化患者服务体系；以差异化策略构建竞争优势，增强服务附加值；积极适应行业变革，实现 服务规模的有序扩张、运营效率的持续优化、经营业绩的改善提升。谢谢! 以上内容为证券之星据公开信息整理，由AI算法生成（网信算备310104345710301240019号），不构成 投资建议。 证券之星消息，国际医学(000516)12月29日在投资者关系平台上答复投资者关心的问题。 投资者提问：中央经济会议已经开完了，26年针对三医协同，优化药品集中采购，深化医保支付方式改 革，贵公司明年日子可能会更苦，不知道贵司能不能撑的住？ ...

Core Insights - The National Healthcare Security Administration (NHSA) has been implementing the "Diagnosis-Related Group (DRG)" payment reform since 2019, which has now covered all medical insurance coordination areas in China [1] - The DRG payment model aims to standardize the use of medical insurance funds by grouping similar inpatient cases and establishing a unified payment standard based on historical data, transitioning from a fee-for-service model to a value-based payment model [1][22] - The upcoming release of the DRG 3.0 version in 2026 is expected to further refine payment groupings and enhance the efficiency of medical insurance fund usage, hospital sustainability, and patient satisfaction [1][22] Payment Reform and Its Implications - The traditional fee-for-service model incentivized excessive medical practices, leading to issues like "over-prescription" and "over-testing" [1] - The DRG model shifts the focus from paying for services rendered to paying for patient outcomes, encouraging hospitals to control costs and reduce unnecessary procedures [1] - Some hospitals have imposed arbitrary limits on hospital stays, such as "no more than 15 days," which can negatively impact patient care [1][3] Collaboration Between Insurance and Healthcare Providers - Effective collaboration between medical insurance and healthcare institutions is crucial for the success of the DRG model, ensuring that funds are used efficiently while hospitals receive appropriate compensation [1][22] - In Anyang, a city implementing DRG, a "special cases, negotiated settlement" mechanism allows for separate billing for complex cases, ensuring that hospitals are not financially penalized for treating severe patients [8][10] Financial Outcomes and Efficiency - The Anyang region has seen a turnaround in its medical insurance fund, achieving a surplus after implementing the DRG model, with total fund expenditures reaching 2.66 billion yuan for special cases in 2024 [8][11] - The average hospitalization cost in Anyang decreased from over 11,100 yuan in 2020 to 9,780 yuan in 2024, a reduction of 11.99% [15] - The overall efficiency of the medical insurance fund has improved, maintaining a balance between income and expenditure, with a surplus of 5.78 billion yuan in 2024 [15] Day Surgery and Cost Reduction - The introduction of "day surgery" has allowed patients to complete procedures within 24 hours, significantly reducing hospitalization time and costs [19][21] - Nearly 60% of tertiary public hospitals in China have adopted day surgery, contributing to faster patient turnover and lower medical expenses [19] Future Directions for DRG Reform - The DRG 3.0 version is expected to introduce more detailed classifications for payment groups, addressing variations in disease severity and treatment methods [22] - Future efforts should focus on enhancing the service capabilities of primary care hospitals and facilitating patient referrals from community settings to hospitals for better resource allocation [22]

Core Viewpoint - The performance trends of leading insurance companies are becoming clearer as the year-end approaches, with ZhongAn Online reporting record premium income and significant profit growth, indicating potential for continued success in 2025 [1][2]. Group 1: Premium Income and Profitability - ZhongAn Online recorded premium income of RMB 32.904 billion for the first 11 months of the year, representing a year-on-year increase of 5.63%, marking the highest historical performance close to the projected full-year premium of RMB 33.418 billion for 2024 [1]. - The company reported a net profit of RMB 668 million for the first half of the year, surpassing the total net profit of RMB 608 million for the entire previous year, suggesting a strong potential for exceeding both premium and profit targets in 2025 [2]. Group 2: Segment Performance - The contribution rates of various segments to premium income for the first half of the year were as follows: Health (37.7%), Digital Life (37.3%), Consumer Finance (16.2%), and Automotive (8.8%), with significant growth observed in the Health and Automotive segments [3][4]. - The health insurance segment saw a 3.1% increase in premium scale, with ZhongAn focusing on a diverse product matrix including critical illness and high-end medical insurance, leading to an enhanced market share [5]. Group 3: Business Operations and Management - ZhongAn has transitioned its automotive insurance business from a joint operation with Ping An to independent management, achieving a breakthrough in compulsory traffic accident insurance in Shanghai and Zhejiang [5]. - The company has recently confirmed the continuation of its leadership under Chairman Yin Hai for the next three years, which is expected to provide stability and continuity in strategic direction [5]. Group 4: Financial Trends and Challenges - Despite the positive trends, ZhongAn has faced significant fluctuations in performance over the past five years, with profit growth rates showing extreme variability, including a 1103.54% increase in the first half of 2025 [5]. - Revenue growth has shown a declining trend, with a slight contraction of 0.4% in the first half of 2025, indicating ongoing challenges in sustaining performance [5].

Core Insights - The National Medical Insurance Administration (NMIA) has announced several measures and data at the National Medical Security Work Conference, highlighting improvements in medical insurance coverage and support for healthcare institutions. Group 1: Medical Insurance Coverage - The total amount of personal accounts for employee medical insurance has exceeded 100 billion yuan, with over 7.8 billion instances of account sharing in the past five years [2] - A comprehensive outpatient medication guarantee mechanism for hypertension and diabetes has been established, benefiting over 340 million people through major illness insurance [2] - Medical assistance has reached 1.189 billion people, with over 90% reimbursement for rural disadvantaged groups [2] Group 2: Support for Healthcare Institutions - By 2025, the NMIA will implement a comprehensive payment reform based on disease categories, with a 2.0 version of the payment scheme to be introduced [3] - All medical insurance areas will conduct real-time settlements, reducing the payment timeline to within 20 working days after submission, with some areas achieving next-day settlements [3] - The NMIA plans to release a 3.0 version of the payment scheme by 2026, promoting the use of new drugs and technologies in clinical settings [3] Group 3: Maternity and Long-term Care Insurance - The NMIA aims to achieve "no out-of-pocket" expenses for childbirth within policy coverage by 2026, expanding maternity insurance to cover flexible employment and migrant workers [4] - The long-term care insurance system is being developed to cover approximately 300 million insured individuals, benefiting over 3.3 million disabled individuals [4] - Nearly 95% of insurance areas will directly distribute maternity benefits to insured individuals [4] Group 4: Anti-fraud Measures - Over the past five years, approximately 120 billion yuan has been recovered from fraudulent medical insurance claims, with comprehensive coverage of inspections across all provinces [5] - The NMIA has utilized big data models and intelligent regulatory systems to recover 9.5 billion yuan in fund losses [5] - In 2026, the NMIA will enhance inspection efforts, focusing on areas with high out-of-pocket rates and ensuring strict penalties for fraudulent activities [6]

去年12月国家医保局同国家卫健委印发《关于完善医药集中带量采购和执行工作机制的通知》。今年7 月国家医保局发布第11批药品集采规则，明确稳临床、保质量、防围标、反内卷原则。该行认为随着多 项政策出台，药品集采有望步入新阶段，长期将推动医药企业稳定生产，推动临床用药在价格可及与质 量可靠之间达成可持续平衡。 深化医保支付方式改革，"双目录"机制形成清晰分工 智通财经APP获悉，中金发布研报称，中央经济工作会议提出"优化药品集中采购，深化医保支付方式 改革。实施康复护理扩容提升工程，推行长期护理保险制度"等相关内容。该行认为上述政策有望推动 医药行业内需稳中有升，目前中国药企正进入高质量发展时代，国产创新药已渐从跟随走向FIC/BIC创 新;展望明年器械出海与商保破局也有望带来新的投资机会。 中金主要观点如下： 优化药品集中采购，践行"反内卷"原则 今年9月国家医保局印发《国家长期护理保险服务项目目录(试行)》的通知。该行认为建立国家统一长 护险目录有助于规范长护服务行为，提升服务质量，稳定保障长护险享受人员权益，更好保障长护险基 金平稳运行。 风险 新产品研发不及预期，政策推进进度不及预期。 根据医保局官网，基 ...

Core Viewpoint - The Central Economic Work Conference held in Beijing on December 10-11 outlined key tasks for economic work in the coming year, including optimizing drug centralized procurement and deepening medical insurance payment reform [1]. Group 1: Drug Centralized Procurement - Since the launch of the "4+7" centralized procurement pilot by the National Healthcare Security Administration (NHSA) in November 2018, eleven batches of drug procurement have been conducted, successfully procuring 490 types of drugs [1]. - The goals of drug centralized procurement include reducing the economic burden on insured individuals, improving the efficiency of medical insurance fund usage, and encouraging companies to transition towards innovation [1]. - The eleventh batch of centralized procurement, which produced results on October 27, 2025, included 55 types of drugs covering common medications in various fields such as anti-infection, anti-allergy, anti-tumor, and blood sugar regulation [1]. Group 2: Optimization of Procurement Rules - The eleventh batch of procurement achieved its expected goals of "stabilizing clinical use, ensuring quality, countering excessive competition, and preventing collusion" by aligning selected products with medical institution needs, raising qualification thresholds for bidding companies, and guiding rational pricing [1]. - There is ongoing attention on how to further counter excessive competition in future drug procurements, with suggestions for establishing a minimum bidding price to provide more certainty for companies [2]. - Experts suggest that procurement rules could be further strengthened around the four dimensions of "stabilizing clinical use, ensuring quality, countering excessive competition, and preventing collusion," including potentially setting a "bottom price" for bids [2].

Group 1 - The core focus of the Central Economic Work Conference held on December 10-11 in Beijing is to enhance efforts in anti-involution, including optimizing drug centralized procurement and deepening medical insurance payment reform [1] - Since the launch of the "4+7" centralized procurement pilot by the National Healthcare Security Administration in November 2018, eleven batches of drug procurement have been conducted, successfully procuring 490 types of drugs [1] - The goals of drug procurement include reducing the economic burden on insured individuals by cutting out intermediaries and improving the efficiency of medical insurance fund usage, while also pushing companies towards innovation [1] Group 2 - The eleventh batch of national drug centralized procurement, which concluded on October 27, 2025, included 55 types of drugs across various common therapeutic areas, achieving the expected goals of "stabilizing clinical use, ensuring quality, countering involution, and preventing collusion" [2] - The procurement process has been optimized to better match selected products with medical institution needs, raise the qualification thresholds for bidding companies, encourage rational pricing, and standardize bidding behavior [2] - There is ongoing high interest in how to further counter involution in future drug procurements, with suggestions for establishing a minimum bidding price to provide more certainty for companies [3] Group 3 - Experts suggest that the procurement rules can be further strengthened around the four dimensions of "stabilizing clinical use, ensuring quality, countering involution, and preventing collusion," including potentially setting a minimum price for selected drugs [3] - There is a proposal to explore separating medical insurance payment standards from drug prices, allowing for a situation where non-selected drugs could be priced above the insurance payment standard, ensuring the availability of off-patent original drugs while requiring lower prices for non-selected options [3]

据新华社，中央经济工作会议12月10日至11日在北京举行。会议确定，明年经济工作抓好以下重点任 务。坚持民生为大，努力为人民群众多办实事。实施稳岗扩容提质行动，稳定高校毕业生、农民工等重 点群体就业，鼓励支持灵活就业人员、新就业形态人员参加职工保险。推进教育资源布局结构调整，增 加普通高中学位供给和优质高校本科招生。优化药品集中采购，深化医保支付方式改革。实施康复护理 扩容提升工程，推行长期护理保险制度，加强对困难群体的关爱帮扶。倡导积极婚育观，努力稳定新出 生人口规模。扎实做好安全生产、防灾减灾救灾、食品药品安全等工作。 责任编辑：曹睿潼 责任编辑：曹睿潼 据新华社，中央经济工作会议12月10日至11日在北京举行。会议确定，明年经济工作抓好以下重点任 务。坚持民生为大，努力为人民群众多办实事。实施稳岗扩容提质行动，稳定高校毕业生、农民工等重 点群体就业，鼓励支持灵活就业人员、新就业形态人员参加职工保险。推进教育资源布局结构调整，增 加普通高中学位供给和优质高校本科招生。优化药品集中采购，深化医保支付方式改革。实施康复护理 扩容提升工程，推行长期护理保险制度，加强对困难群体的关爱帮扶。倡导积极婚育观，努力稳定 ...