Financial Performance - In the first half of 2025, the company achieved a revenue of 1.588 billion CNY, a year-on-year decrease of 20.63% [2] - The medical services segment generated 1.38 billion CNY, while the pharmaceutical segment contributed 210 million CNY [2] - Gross margin was 28.2%, with the medical services segment at 26% and the pharmaceutical segment at 40.47% [2] - Pre-tax operating profit was 33.73 million CNY, and net profit attributable to shareholders was 7.43 million CNY [2] - Operating cash flow was 140 million CNY, a decline of 15% [2] Cost Management - The drug cost ratio was 24.10%, down 2.29 percentage points year-on-year [4] - The cost of consumables accounted for 12.81%, a decrease of 0.91 percentage points [4] - Labor costs represented 36.24%, an increase of 0.71 percentage points, but variable labor costs decreased [4] - Overall, variable cost ratios are declining, indicating effective cost control [4] Hospital Operations - In the first half of 2025, outpatient visits and average outpatient costs remained stable, while inpatient visits decreased by approximately 9% and average inpatient costs fell by about 12% [2] - The company aims to control the drug cost ratio to around 35% in the second half of 2025 [5] - As of mid-2025, the proportion of procurement from centralized purchasing in drug costs was about 23% [6] Insurance and Revenue - Insurance revenue accounted for approximately 50.5% of total revenue in the first half of 2025 [7] - The payment cycle for insurance is typically 1-2 months for monthly payments and annual settlements for yearly payments [8] Strategic Developments - The company is focusing on enhancing hospital standards and technical capabilities, with 42 key disciplines and specialties established [16] - The company is actively adapting to policy changes in medical insurance and drug procurement, aiming to improve management and operational efficiency [15][17] - Plans for bed expansion include 800 new beds at Siyang Hospital and additional projects at other facilities [13][12] Future Outlook - The company anticipates a slowdown in revenue growth due to ongoing reforms in medical insurance payment methods, but expects to enhance management and service capabilities [15] - The focus will remain on integrating medical and pharmaceutical services, as well as expanding non-insurance revenue projects [17]

为推进以按病种付费为主的多元复合式医保支付方式改革，近日，国家医保局印发《医疗保障按病种付 费管理暂行办法》（以下简称《办法》）。根据《办法》，我国将为医保按病种付费建立病种分组方案 动态调整机制，原则上每两年调整一次。 我国传统的医保支付方式是按项目付费，药品、耗材、服务项目用多少结算多少，这种结算方式容易滋 生"大处方""大检查"等过度医疗行为。 为了规范医疗行为，自2019年起，国家医保局以按病种付费为抓手，开展支付方式改革试点。所谓按病 种付费，即通过历史数据测算，根据患者的病情分组，对同组患者确定相似的费用标准，由医保部 门"打包"支付给医疗机构。 经过六年时间，目前，病种付费实现了从试点到扩面，从地方探索到国家统一，基本实现病种付费覆盖 全部统筹地区，付费管理机制不断完善，在提升医保基金使用效率，促进医疗服务行为规范，减轻群众 就医负担等方面发挥了积极作用。 规范总额预算管理方面，要求合理编制支出预算，在此基础上确定按病种付费总额，强调总额预算的刚 性。 规范分组方案制定和调整方面，明确分组方案的制定主体、分组框架、数据和意见支撑、调整内容等， 原则上要求分组方案两年调整一次。 规范核心要素和配套 ...

Core Viewpoint - The article discusses the implementation of a new payment reform in China's healthcare system, focusing on a disease-based payment model to enhance efficiency and control costs in medical services [1][2]. Summary by Sections Payment Reform Overview - The National Healthcare Security Administration (NHSA) has introduced the "Interim Measures for the Management of Disease-Based Payment" to promote a multi-faceted payment reform primarily based on disease categories [1]. - The new measures will establish a dynamic adjustment mechanism for disease grouping schemes, with adjustments occurring approximately every two years [1][2]. Disease-Based Payment Mechanism - Disease-based payment involves grouping diseases or calculating values to implement a "bundled payment" system for medical institutions [2]. - The NHSA has been actively promoting disease-based payment for inpatient medical expenses, focusing on two pilot projects: Diagnosis-Related Groups (DRG) and Disease-Based Value Payment (DIP) [2]. - Adjustments to the DRG grouping scheme will maintain stability in major diagnostic categories while focusing on core and detailed subgroup adjustments [2]. Key Policies and Measures - The new measures clarify policies, key technologies, core elements, and supporting measures related to disease-based payment, emphasizing rigid total budget management [2]. - The NHSA will incorporate disease-based payment requirements into agreement management, enhance monitoring and evaluation of reform effectiveness, and strengthen fund supervision [2]. Special Case Mechanism - A "special case negotiation" mechanism has been established to support medical institutions in treating complex and severe patients, allowing for reasonable use of new drugs and technologies [3]. - Cases eligible for special negotiation include those with long hospital stays, high resource consumption, and complex conditions that do not fit standard payment models [3]. Impact on Medical Institutions - The shift from fee-for-service to disease-based payment encourages medical institutions to control costs while still generating revenue [5]. - Institutions can apply for special case negotiations for patients requiring extensive resources or new treatments, ensuring adequate care [5]. Impact on Patients - The reform does not alter the patient discharge settlement experience, and patients may see a reduction in out-of-pocket expenses due to fewer unnecessary medical services [6]. - The NHSA has not imposed restrictions on hospital stays, and any coercive practices by medical institutions regarding discharge will be strictly addressed [6].

Core Viewpoint - The National Healthcare Security Administration (NHSA) has officially issued the "Interim Measures for the Management of Disease-Specific Payment in Medical Insurance," aiming to reform the payment system primarily based on disease categories, establishing a dynamic adjustment mechanism for disease grouping schemes every two years [1] Summary by Relevant Sections Payment Reform - The new payment method involves grouping diseases or calculating scores to implement "bundled payments" to medical institutions, requiring dynamic adjustments to adapt to clinical changes due to rapid advancements in medical technology [1] - The NHSA has been promoting disease-specific payment for inpatient medical expenses, conducting pilot programs for Diagnosis-Related Groups (DRG) and Disease-Specific Payment (DIP) [1][5] Key Policies and Mechanisms - The "Interim Measures" clarify policies, key technologies, core elements, and supporting measures related to disease-specific payments, emphasizing rigid total budget management and the need for reasonable expenditure budgeting [1] - The measures also incorporate requirements for disease-specific payments into agreement management, enhance monitoring and evaluation of reform effectiveness, and strengthen fund supervision [1] Special Case Payment Mechanism - A dedicated section in the measures supports medical institutions in treating complex and severe patients, allowing for a "special case single negotiation" mechanism for cases that are not suitable for standard disease payment [2][5] - Cases eligible for special negotiation include those with long hospital stays, high resource consumption, and the use of new drugs or technologies [2] Impact on Patients and Institutions - The shift from itemized payments to disease-specific payments aims to reduce unnecessary medical services, potentially lowering the out-of-pocket expenses for patients [6] - The NHSA has stated that there are no restrictions on hospital stays, and any coercive practices by medical institutions to discharge patients prematurely will be strictly addressed [6]

Group 1 - The A-share market has seen a significant increase in trading volume, with the medical device sector gaining attention from investors after four years [1] - The medical device index ETF (159898) received over 70 million yuan in net inflows last week, bringing its total size to 336 million yuan, a new record since its listing [1] - Over the past 20 trading days, the ETF has seen net inflows in 17 of those days, totaling over 134 million yuan [1] Group 2 - Recent positive signals from medical device policies have contributed to the sustained increase in market investment in this sector [3] - The 11th batch of drug procurement has started, moving away from a simple lowest price reference, which is expected to benefit domestic manufacturers as prices may see marginal recovery [3] - The National Medical Insurance Administration has held multiple meetings to support innovative drugs and devices, indicating a comprehensive policy framework that will enhance industry innovation and benefit domestic companies with independent innovation capabilities [4] Group 3 - The National Medical Insurance Administration is promoting reforms in payment methods, focusing on disease-based payments to establish a unified and efficient medical insurance payment mechanism [4] - Analysts from Xiangcai Securities believe that despite ongoing cost control pressures in the pharmaceutical industry, the establishment of a multi-tiered payment system will stabilize the industry [4] - Industrial recovery is anticipated in the second half of the year as the impact of high-cost procurement gradually diminishes, with some products expected to see improved pricing and volume [4]

Core Viewpoint - The National Healthcare Security Administration (NHSA) has issued a temporary measure to manage disease-based payment systems, aiming to enhance the standardization of medical insurance payments across all regions in China [1][2]. Group 1: Payment Reform - The traditional payment method in China was fee-for-service, which often led to excessive medical practices such as over-prescribing and unnecessary tests [2]. - Since 2019, the NHSA has been promoting a "disease-based payment" reform, where payments are bundled based on historical data and patient conditions, shifting the focus from quantity of services to cost control [2][4]. - As of the end of 2024, over 90% of hospital discharges will be covered under the disease-based payment system [5]. Group 2: Impact on Medical Institutions - The reform has led to more standardized medical practices, reduced time and costs, and shorter average hospital stays [4]. - Medical institutions can apply for special cases for patients with long hospital stays or high resource consumption, allowing for project-based payments if necessary [4][5]. - Nearly 60% of tertiary public hospitals have adopted "day surgery," allowing patients to complete procedures within 24 hours, thus improving bed turnover and reducing costs [7]. Group 3: Patient Experience - The disease-based payment system reduces the financial burden on patients and encourages hospitals to control costs and standardize treatment [7]. - Patients who previously required hospitalization for simple procedures can now receive treatment as day surgeries, which are reimbursed at the same rate as inpatient care [7][9]. - In Shandong, patients can undergo simple surgeries and be discharged within 24 hours, significantly reducing hospital stay duration and costs by approximately 30% [11].

Core Viewpoint - The National Healthcare Security Administration (NHSA) has implemented a pilot program for disease-based payment management to enhance the standardization of medical insurance payments, transitioning from a fee-for-service model to a bundled payment approach [1][3]. Group 1: Payment Reform - The traditional fee-for-service model in China has led to excessive medical practices, prompting the NHSA to promote a disease-based payment system since 2019, which groups patients by similar conditions and sets a standard payment based on historical data [1][3]. - As of the end of 2024, over 90% of hospital discharges will be covered under the disease-based payment system, which aims to reduce unnecessary hospital stays and costs [6]. Group 2: Impact on Medical Institutions - The reform has led to more standardized medical practices, reduced time and costs, and shorter average hospital stays [3]. - Medical institutions can apply for special cases for patients with long hospital stays or high resource consumption, allowing for project-based payments or adjusted payment standards after NHSA review [5]. Group 3: Patient Experience - The payment reform does not impose restrictions on hospital stay durations, and NHSA has not set limits like "no more than 15 days per hospitalization," ensuring patients receive adequate treatment [6]. - Patients benefit from reduced personal financial burdens due to fewer unnecessary medical services, as the reimbursement is based on a percentage of the costs incurred [8]. Group 4: Day Surgery Promotion - The disease-based payment system encourages hospitals to adopt day surgery practices, with nearly 60% of tertiary public hospitals now offering such services, which can complete treatment within 24 hours [9]. - In Shandong Province, day surgery reforms allow patients to undergo simple procedures and be discharged within 24 hours, significantly reducing hospital stay durations and costs by approximately 30% [11][13].

Core Viewpoint - The National Healthcare Security Administration (NHSA) has issued the "Interim Measures for Disease-Specific Payment Management," aiming to guide local governments in advancing the reform of disease-specific payment systems, particularly focusing on Diagnosis-Related Groups (DRG) and Disease-Specific Payment (DIP) methods [1][2]. Summary by Relevant Sections Reform Background - The DRG payment system was first implemented in China in 2008, with a nationwide rollout of a comprehensive DRG system starting in 2018. The DIP pilot began in 2020, marking a significant shift towards a unified national payment system [2]. - The NHSA has been actively promoting payment reform to enhance the efficiency of medical fund usage and control costs within healthcare institutions [2]. Key Features of the New Measures - The new measures emphasize three main areas: 1. Total budget management, requiring reasonable budget preparation and emphasizing the rigidity of total budget limits. 2. Standardization of grouping schemes, including clear guidelines on the formulation and adjustment of grouping schemes, which should be revised every two years. 3. Clarification of core elements and supporting measures, ensuring that key factors like weight, rate, and payment standards are well-defined [3][4]. Implementation and Adjustments - The NHSA is responsible for the formulation and adjustment of grouping schemes, while local authorities can tailor DRG subdivisions to local conditions. The grouping framework includes major diagnostic categories, core groups, and detailed subdivisions [3][4]. - Adjustments to the DRG grouping scheme will focus on maintaining stability in major diagnostic categories while allowing for changes in core and detailed groups, with a two-year adjustment cycle [4]. Transparency and Support Mechanisms - The new measures aim to enhance transparency in total budget management and provide clearer technical standards for grouping and adjustments, addressing concerns from healthcare institutions [5]. - The NHSA has also introduced supporting mechanisms, including prepayment of medical funds to qualifying institutions, which has exceeded 1.7 trillion yuan as of July 2024, and reduced settlement cycles for medical institutions [6]. Training and Capacity Building - The NHSA emphasizes the need for local healthcare departments to improve policies and supporting mechanisms, monitor reform effectiveness, and provide training for staff involved in the implementation of disease-specific payment systems [7].

Core Viewpoint - The National Healthcare Security Administration (NHSA) has released the "Interim Measures for Medical Insurance Payment by Disease" aimed at reforming the medical insurance payment system to establish a unified, efficient, and standardized mechanism that supports the high-quality development of medical institutions [1] Summary by Relevant Sections Payment System Reform - The new measures focus on payment by disease, emphasizing the need for a comprehensive reform of the medical insurance payment methods [1] - The goal is to create a nationwide unified payment mechanism that is effective and collaborative [1] Budget Management - The measures stipulate strict total budget management, requiring reasonable expenditure budgeting to determine the total payment amount by disease [1] - It emphasizes the rigidity of the total budget [1] Grouping Scheme - The measures clarify the responsibilities for formulating and adjusting grouping schemes, including the framework, data support, and adjustment content [1] - Grouping schemes are to be adjusted every two years [1] Core Elements and Supporting Measures - The measures define key elements such as weight, rate, and payment standards, requiring collaboration between the NHSA and medical institutions to reach consensus [1] - It also standardizes supporting measures related to medical insurance payments, including special negotiations, advance payments, opinion collection, and data publication to enhance the scientific level of medical insurance payments [1]

Core Viewpoint - The National Healthcare Security Administration (NHSA) has released the "Interim Measures for Disease-Specific Payment Management," aiming to reform the medical insurance payment system to establish a unified, efficient, and standardized mechanism that supports the high-quality development of medical institutions [1] Summary by Relevant Sections Payment System Reform - The new measures focus on disease-specific payment as a key aspect of the medical insurance payment reform [1] - The goal is to create a nationwide unified payment mechanism that is effective and collaborative [1] Budget Management - The measures emphasize the importance of total budget management, requiring reasonable expenditure budget preparation and establishing a rigid total for disease-specific payments [1] Grouping Scheme - The measures specify the formulation and adjustment of grouping schemes, detailing the responsible parties, framework, supporting data, and adjustment content, with a principle of biennial adjustments [1] Core Elements and Supporting Measures - The measures clarify the definitions of key elements such as weight, rate, and payment standards, mandating that the NHSA collaborates with medical institutions to reach consensus [1] - It also standardizes supporting measures related to medical insurance payments, including special case negotiations, advance payments, opinion collection, negotiation, and data publication to enhance the scientific level of medical insurance payments [1]