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关乎13.27亿人,医保“账单”来了!
中国基金报· 2025-07-14 10:51
Core Viewpoint - The National Healthcare Security Administration (NHSA) has released the "2024 National Medical Security Development Statistical Bulletin," indicating a stable growth in basic medical insurance coverage and a focus on improving service quality and fund management [2][4]. Group 1: Basic Medical Insurance Coverage - As of the end of 2024, approximately 1.327 billion people are enrolled in basic medical insurance in China, maintaining a coverage rate of 95% [4][5]. - The number of employees covered by medical insurance has increased to 379 million, reflecting a 2.3% growth compared to the previous year [5]. Group 2: Fund Revenue and Expenditure - The total revenue and expenditure of the national basic medical insurance fund (including maternity insurance) for 2024 are projected to be approximately CNY 3.49 trillion and CNY 2.98 trillion, respectively [4]. - The employee medical insurance fund revenue is estimated at CNY 2.373 trillion, a 3.5% increase year-on-year, while expenditures are expected to reach CNY 1.910 trillion, marking a 7.6% increase [7][11]. Group 3: Medical Treatment and Benefits - The number of treatment beneficiaries under employee medical insurance is projected to reach 5.308 billion in 2024, a 9.9% increase from the previous year [13]. - The average hospitalization cost for employee medical insurance participants is estimated at CNY 11,707, with varying costs across different levels of medical institutions [15][18]. Group 4: Resident Medical Insurance - By the end of 2024, the number of participants in urban and rural resident medical insurance is expected to reach approximately 947 million [20]. - The revenue for resident medical insurance is projected to be CNY 1.118 trillion, with expenditures of CNY 1.066 trillion, resulting in a cumulative balance of CNY 818.3 billion [21]. Group 5: Maternity Insurance - The number of participants in maternity insurance is expected to reach 25.3 million in 2024, with a 30.2% increase in the number of beneficiaries enjoying maternity benefits [32]. - Maternity insurance fund expenditures are projected to be CNY 140.293 billion, reflecting a 19.2% increase from the previous year [32]. Group 6: Medical Assistance - In 2024, medical assistance expenditures are expected to reach CNY 79.232 billion, providing support to approximately 79.16 million people participating in basic medical insurance [34]. - The average assistance for hospitalization and outpatient services is projected to be CNY 1,254 and CNY 92, respectively [34]. Group 7: Drug and Medical Supply Management - The 2024 National Basic Medical Insurance Drug List includes 3,159 drugs, with 91 new additions this year [38]. - The implementation of centralized procurement for drugs and high-value medical consumables continues, with 62 drugs included in the latest round of procurement [43]. Group 8: Cross-Region Medical Services - In 2024, the total number of cross-region medical visits is expected to reach 397 million, with associated costs of CNY 786.774 billion [44]. - Employee medical insurance accounts for 262 million of these visits, while resident medical insurance accounts for 134 million [44].