看病缴费"多次排队""排长队"，这件困扰老百姓的烦心事有望得到解决。国家医保局办公室日前发布文 件，将大力推进刷脸支付、一码支付、移动支付、信用支付，力争用3年左右时间构建覆盖门急诊、住 院全场景的便捷支付体系。从跨省异地就医直接结算到推动"看病告别胶片"，再到构建医保便捷支付体 系……近年来，医保便民服务升级一直在路上。建设医保便捷支付体系，将赋能医疗机构管理，改善就 诊秩序，释放优质医疗资源，让群众少跑腿，让数据多跑路。 （文章来源：经济日报） ...

齐鲁晚报.齐鲁壹点姜曼 12月25日，临沂市人民政府新闻办公室召开新闻发布会，记者从发布会上了解到，"十四五"时期，全市医保系统始终以"解除全体人民的疾病医疗后顾之 忧"为根本目标，全力保基本、促改革、兜底线、强监管、优服务，不断织密医疗保障网，圆满完成了各项改革发展任务。其中，全市基本医疗保险参保 率稳定在95%以上，各级财政补助居民参保共投入252.51亿元。 多层次医疗保障体系进一步健全。建立基本医保参保长效机制。完善参保激励约束措施，全市70岁以上老年人由县区政府全额代缴居民医保费，医疗救助 对象实行分类资助参保，"十四五"时期全市基本医疗保险参保率稳定在95%以上，各级财政补助居民参保共投入252.51亿元。稳步提高基本医保待遇保障 水平。职工和居民医保住院政策范围内费用报销比例分别稳定在80%和65%左右。健全重大疾病医疗保险和救助制度。"十四五"时期，医疗救助对象累计 就医348.97万人次，减轻医疗费用负担14.51亿元。支持生育友好型社会建设。大幅提高生育医疗费报销待遇，参保居民住院分娩医保支付标准提高到3000 元，参保职工住院分娩政策范围内报销比例提高到100%，辅助生殖类医疗服务项目纳 ...

Core Insights - The Shandong Provincial Medical Insurance Bureau is implementing a series of measures to enhance public medical insurance services, focusing on addressing common concerns of the public regarding medical insurance [1][8] Group 1: Key Initiatives - The bureau has launched 10 initiatives aimed at improving public services, with 2 of these initiatives included in the provincial government's key livelihood projects [1] - A multi-level medical insurance system is being developed to improve the quality and accessibility of medical services for the public [1] Group 2: Targeted Support for Vulnerable Groups - A comprehensive long-term care insurance system is being established, with pilot programs in 16 cities, covering 5.57 million insured individuals, including 2.79 million residents [2] - Unemployed individuals are now eligible for maternity insurance benefits, alleviating financial pressure during unemployment [2] - Adjustments to severe illness insurance policies are being made to ensure sustainable financial support for patients [3] Group 3: Strengthening Grassroots Services - The initiative aims to enhance the accessibility of medical services at the grassroots level, with 25 recommended disease groups and 105 disease types established for primary healthcare institutions [4] - The number of participating units in the drug procurement program has reached 33,000, increasing accessibility to quality medications [5] Group 4: Streamlining Reimbursement Processes - Efforts are being made to facilitate direct settlement for medical expenses incurred during cross-regional medical treatment, including maternity and long-term care insurance [6] - A pilot program for customized commercial insurance claims is being implemented to improve efficiency in reimbursement processes [6] Group 5: Enhancing Service Efficiency - The bureau has updated its service item list to include 27 standardized services, promoting seamless access to medical insurance services across different regions [7] - Public awareness campaigns are being conducted to improve understanding and accessibility of medical insurance policies [7] Future Directions - The bureau will continue to focus on addressing urgent public concerns and enhancing the overall medical insurance system to ensure the health and well-being of the population [8]

Core Insights - The article emphasizes the importance of healthcare insurance in safeguarding the public's health and financial well-being, highlighting the efforts made during the "14th Five-Year Plan" to enhance and expand insurance coverage for all citizens [1] Group 1: Universal Coverage - The national basic medical insurance coverage rate has stabilized at around 95% during the "14th Five-Year Plan," with nearly 20 billion people benefiting from insurance reimbursements from 2021 to 2024 [2] - Innovations such as allowing newborns to enroll in insurance using birth certificates and relaxing household registration restrictions have marked a new phase in universal coverage [3] Group 2: Maternity Insurance Expansion - By June 2025, approximately 253 million people are expected to participate in maternity insurance, with cumulative expenditures reaching 438.3 billion yuan, benefiting 96.14 million people [3] - Nearly 60% of regions have begun directly issuing maternity benefits to insured female employees, with plans to enhance services in maternal and pediatric care [3] Group 3: Major Illness Insurance and Medical Assistance - During the "14th Five-Year Plan," medical assistance policies have benefited 673 million rural low-income individuals, reducing their financial burden by over 650 billion yuan [3] - Full funding for insurance for special hardship groups and orphans ensures that vulnerable populations receive necessary medical coverage [3] Group 4: Expanding Benefit Coverage - The introduction of the "medical insurance wallet" allows insured individuals to transfer personal account funds to family members for medical expenses, breaking provincial limitations [4] - The establishment of a comprehensive outpatient mutual aid mechanism and the inclusion of assisted reproductive services in insurance coverage are part of broader efforts to enhance benefit offerings [4] Group 5: Healthcare Service Upgrades - The number of designated medical institutions has reached 1.1 million, with 435 types of drugs included in centralized procurement, further alleviating the financial burden on citizens [5] - The total number of drugs in the insurance catalog has reached 3,159, reflecting ongoing adjustments to improve healthcare service accessibility [5] Group 6: Digital Transformation in Healthcare - The implementation of a unified national medical insurance information platform has significantly improved service efficiency, allowing for cross-province processing of high-frequency matters [7] - Advanced technologies such as big data and artificial intelligence are enhancing the accessibility of medical insurance services [7] Group 7: Fund Management and Oversight - The healthcare fund regulatory system has been fully established, recovering over 100 billion yuan in misused funds [8] - Comprehensive inspections have covered all regions and types of fund usage, addressing historical issues of fund misappropriation [8] Group 8: Economic Impact of Healthcare Insurance - Cumulative healthcare fund expenditures have reached 12.13 trillion yuan during the "14th Five-Year Plan," providing financial support for both public health and the pharmaceutical industry [9] - The ongoing management of healthcare funds aims to bolster the development of related industries while safeguarding public health [9]

Core Insights - The article emphasizes the continuous improvement of China's basic medical insurance system, aiming to alleviate the medical financial burden on citizens and ensure access to healthcare services [1] Group 1: Coverage and Participation - During the "14th Five-Year Plan" period, the national basic medical insurance participation rate remains stable at around 95%, with nearly 20 billion people benefiting from insurance reimbursements from 2021 to 2024 [2] - The expansion of maternity insurance coverage is highlighted, with 253 million people participating and a total fund expenditure of 438.3 billion yuan, benefiting 96.14 million people [2] Group 2: Benefit Enhancements - The introduction of the "medical insurance wallet" allows insured individuals to transfer personal account funds to family members for medical expenses, breaking provincial limitations [4] - The number of designated medical institutions has reached 1.1 million, and the total number of drugs in the insurance catalog has reached 3,159, further reducing the medical burden on citizens [5] Group 3: Service Upgrades - The establishment of a unified national medical insurance information platform has significantly improved service efficiency, allowing for cross-province handling of high-frequency matters [6] - The implementation of data and AI technologies has enhanced the accessibility of medical insurance services and reduced fraudulent activities [7] Group 4: Financial Management - The cumulative expenditure of the medical insurance fund has reached 12.13 trillion yuan, providing financial support for both healthcare and the pharmaceutical industry [9] - The regulatory framework for medical insurance funds has been fully established, with over 100 billion yuan recovered from fraudulent activities [8]

Core Insights - The article emphasizes the continuous improvement of China's basic medical insurance system, aiming to alleviate the medical financial burden on citizens and ensure access to healthcare services [1] Group 1: National Insurance Coverage - During the "14th Five-Year Plan" period, the national basic medical insurance coverage rate has stabilized at around 95%, with nearly 20 billion instances of insurance reimbursement from 2021 to 2024 [2] - The introduction of measures such as allowing newborns to enroll in insurance using birth certificates and expanding the coverage of maternity insurance aims to enhance accessibility [2] - By June 2025, approximately 253 million people are expected to participate in maternity insurance, with cumulative expenditures reaching 438.3 billion yuan, benefiting over 96.14 million individuals [2] Group 2: Medical Assistance and Support - The medical assistance policies during the "14th Five-Year Plan" have benefited 673 million rural low-income individuals, reducing their financial burden by over 650 billion yuan [2] - Full funding for insurance coverage for vulnerable groups, including orphans and those on minimum living allowances, is being implemented to ensure comprehensive medical coverage [2] Group 3: Expansion of Benefits - The introduction of the "medical insurance wallet" allows insured individuals to transfer personal account funds to family members for medical expenses, breaking provincial limitations [4] - The establishment of a comprehensive outpatient mutual aid mechanism and the inclusion of assisted reproductive services in insurance reimbursement are part of the ongoing expansion of medical benefits [4] Group 4: Service Upgrades - The national medical insurance information platform has achieved millisecond-level response times, with 644,000 cross-provincial designated medical institutions [6] - The integration of big data and artificial intelligence technologies is enhancing the accessibility and convenience of medical insurance services for citizens [6] Group 5: Fund Management and Oversight - The medical insurance fund regulatory system has been fully established, recovering over 100 billion yuan in misused funds [8] - Continuous efforts are being made to combat fraud and illegal activities within the medical insurance system, including the implementation of tracking codes [8] Group 6: Economic Impact - Cumulatively, the medical insurance fund has disbursed 12.13 trillion yuan, providing financial support for both healthcare and the pharmaceutical industry [9] - The management of the medical insurance fund is aimed at safeguarding public health while simultaneously supporting the development of related industries [9]

Group 1 - The core viewpoint of the news is the stable operation of the basic medical insurance fund in Hainan province, with a total income of 8.263 billion yuan and total expenditure of 6.451 billion yuan from January to May this year, resulting in a cumulative balance of 45.929 billion yuan [1] - As of June 13, the total number of insured individuals in the province reached 9.5237 million, with a comprehensive insurance rate stabilizing around 95% [1] - The province has eliminated the household registration restrictions for insurance participation and improved the incentive and constraint mechanisms for continuous insurance, focusing on specific groups such as college students and new employment forms [1] Group 2 - The province has increased the ordinary outpatient benefits for employee medical insurance, raising the annual maximum payment limit to 25,000 yuan for employed individuals and 30,000 yuan for retirees [1] - The "Hui Qiong Bao" 2025 version of the one-stop claim service has been launched, allowing simultaneous settlement of medical insurance, commercial insurance, and out-of-pocket expenses, eliminating the need for upfront payments by insured individuals [2] - The cross-provincial direct settlement for medical treatment has been actively promoted, with 366 hospitals and 744 outpatient facilities already connected for direct settlement [2]

Core Viewpoint - The Henan Provincial Medical Security Bureau has launched an innovative "One Code Payment" service, enhancing the efficiency of medical insurance reimbursement and payment processes for patients [1] Group 1 - The new service allows insured individuals to complete medical expense payments by scanning a single code, streamlining the reimbursement process [1] - This initiative addresses the inconvenience faced by patients who previously had to switch between various online platforms and perform multiple operations to access their medical insurance [1] - The implementation of this service is expected to alleviate long waiting times during peak medical service hours, thereby improving the overall healthcare experience for patients [1]