住院率控制

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去年居民医保结余猛增400亿,住院率不再公开
第一财经· 2025-07-17 03:11
Core Viewpoint - The 2024 National Medical Security Development Statistical Bulletin indicates a significant improvement in the financial health of the medical insurance system, with a notable increase in the residents' medical insurance surplus and a decrease in the growth rate of total medical insurance expenditures compared to 2023 [3][4][5]. Group 1: Financial Health of Medical Insurance - The residents' medical insurance surplus reached 51.942 billion RMB in 2024, an increase of over 40.736 billion RMB compared to the previous year [4][7]. - The total medical insurance fund expenditure growth rate decreased to 5.5% in 2024, down from 14.7% in 2023, indicating a slower spending pace [21][22]. - The total income of the medical insurance fund in 2024 was 349.1337 billion RMB, reflecting a growth of 4.2% compared to 2023 [13][14]. Group 2: Changes in Insurance Participation - The total number of insured individuals in 2024 was 1.327 billion, with a participation rate maintained at 95%, despite a slight decrease in absolute numbers [13]. - The number of participants in employee medical insurance increased by 8.537 million (2.3%), while the number of residents' medical insurance participants decreased by approximately 15.8 million (1.6%) [13]. Group 3: Hospitalization and Medical Costs - The hospitalization rate continued to rise in 2024, but the growth rate was lower than in 2023, with the hospitalization rate for employee insurance rising from 17.6% in 2022 to 21.86% in 2023 [16][18]. - The average hospitalization costs for employee and resident medical insurance decreased to 11,707 RMB and 7,408.08 RMB, respectively, in 2024 [29]. Group 4: Cross-Regional Medical Treatment - The total number of cross-regional medical treatments reached 397 million in 2024, a 63.2% increase from the previous year, with total expenses amounting to 786.774 billion RMB, up 10.6% [6][24]. - The proportion of cross-regional medical treatment expenses in total medical insurance expenditures increased from 2.67% in 2021 to 6.56% in 2024 [26][27]. Group 5: Regulatory Changes and Challenges - Stricter regulations on fraudulent medical insurance claims have been implemented, recovering 27.5 billion RMB in 2023, contributing to the improved financial stability of the medical insurance fund [11]. - Local medical insurance bureaus are now prohibited from drafting deficit budgets, which is expected to enhance the financial management of medical insurance funds [12].
2024年居保结余猛增400亿,医保金状况好转了吗?
Hu Xiu· 2025-07-17 01:00
Core Insights - The National Healthcare Security Administration released the "2024 National Medical Security Development Statistical Bulletin," indicating a positive trend in healthcare funding and expenditure management [1][2][3]. Group 1: Financial Health of Medical Insurance - The current balance of resident medical insurance reached 51.942 billion RMB, an increase of over 40.736 billion RMB compared to the previous year [2][7]. - The total income of the medical insurance fund for 2024 is 349.1337 billion RMB, a growth of 14.1237 billion RMB, with a growth rate of 4.2%, marking the lowest increase in four years [19]. - The total expenditure of the medical insurance fund for 2024 is 297.6403 billion RMB, an increase of 15.5073 billion RMB, with a growth rate of 5.5%, significantly lower than the 14.7% increase in 2023 [20][36]. Group 2: Changes in Insurance Participation - The total number of insured individuals in 2024 is 1.327 billion, with a participation rate maintained at 95%, despite a decrease in absolute numbers [18]. - The number of participants in employee medical insurance increased by 8.537 million, a growth of 2.3%, while the number of residents insured decreased by approximately 15.8 million, a decline of 1.6% [18]. Group 3: Hospitalization and Medical Costs - The hospitalization rate for 2024 is not disclosed, but it is reported to have increased without exceeding the growth rate of 2023 [4][24]. - The average hospitalization costs for employee and resident medical insurance decreased to 11,707 RMB and 7,408.08 RMB, respectively, compared to the previous year [52]. - The total medical expenses for employee medical insurance in 2024 are 205.8746 billion RMB, a growth of 3.6%, while for resident medical insurance, it is 203.1216 billion RMB, a growth of 3.7%, both significantly lower than the previous year's growth rates of over 19% [38]. Group 4: Cross-Province Medical Treatment - The total number of cross-province medical visits in 2024 reached 397 million, an increase of 63.2%, with total expenses amounting to 786.774 billion RMB, a growth of 10.6% [5][43]. - The proportion of cross-province medical expenses in total medical insurance expenditures has been increasing, reaching 6.56% in 2024 [46]. - The National Healthcare Security Administration is implementing policies to manage the financial pressure caused by the increase in cross-province medical treatment, including adjusting reimbursement rates [49][50].