Group 1 - The National Smart Medical Insurance Competition reflects the government's supportive attitude towards the development of innovative drugs, with open medical insurance data empowering drug research and development [1] - Medical insurance data covers a large population and has rich dimensions, providing substantial real-world data support for innovative drug development, helping teams accurately target clinical needs and determine research directions, thereby improving research efficiency [1] - The competition promotes cross-industry resource integration among pharmaceutical companies, technology firms, and research institutions, with big data analysis and artificial intelligence technologies from tech companies combining with drug research to create new research models and accelerate the transition of innovative drugs from the lab to clinical application [1] Group 2 - Long-term, the deepening application of medical insurance data in innovative drug development is expected to enhance both the quantity and quality of innovative drugs, indicating high growth potential and investment value in this sector [1] - The Science and Technology Innovation and Entrepreneurship ETF (588360) tracks the Science and Technology Innovation 50 Index (931643), which can fluctuate by up to 20% in a single day, reflecting the overall performance of listed companies in high-tech industries such as new-generation information technology, biomedicine, and high-end equipment manufacturing [1] - Investors without stock accounts can consider the Guotai Zhongzheng Science and Technology Innovation and Entrepreneurship 50 ETF Initiated Link C (013307) and Link A (013306) [1]

国家医保局正以前所未有的力度支持医药创新。 7月中下旬，国家医保局连续召开五场座谈会，专门聚焦"医保支持创新药械"。第一财经记者受邀参加 了第五场座谈会即投资专场。 投资专场的与会名单，堪称中国医药资本的"全明星阵容"——全国社保基金理事会、中投公司、中信集 团、工银瑞信、招商创科、富国基金、海通证券等头部机构齐聚。 在这场座谈会上，国家医保局医药管理、大数据中心、办公室等司局的负责人向与会的投资机构详细解 读了《支持创新药高质量发展的若干措施》（下称"若干措施"）内容，表明了国家医保局以前所未有的 力度支持创新药的态度，并向在座的投资机构发出邀约，共同促进我国创新药的高质量发展。 第一财经在座谈会现场了解到，医保部门的数据开放和医保商保协同体系的构建，穿透了市场对于创新 药研发与市场的不确定性，多家"国字头"的投资机构表示，要发挥耐心资本的优势，通过设立医疗产业 基金或是投融资平台等举措加入到创新药的"黄金赛道"中来。 拒绝伪创新、内卷式创新 前述国家医保局举行的系列座谈会正是为了落实若干措施，推动创新药高质量发展，更好满足人民群众 多元化就医用药需求。 其中，首场座谈会主题是对"创新药械开展医保综合价值评 ...

Group 1 - The 2025 National Smart Medical Insurance Competition has been launched, focusing on utilizing public data to support innovative drug research and development [2][3] - The competition will provide desensitized medical insurance data from Shanghai and selected cities in Jiangsu, Zhejiang, and Anhui provinces, aimed at addressing public health challenges through digital means [2][3] - The competition adopts an open model without specific tracks, covering over ten fields including innovative pharmaceuticals and healthcare [2][3] Group 2 - The initiative to support the use of medical insurance data for innovative drug development is part of a broader policy aimed at enhancing the quality of innovative drugs in China [3] - The National Medical Insurance Administration emphasizes the importance of data security and compliance while providing necessary medical insurance data services for drug research [3][4] - The competition aims to explore cross-industry data integration, combining medical insurance data with other public data to create new application scenarios [4][5] Group 3 - The competition is expected to enhance the development of new productive forces by leveraging big data analysis, artificial intelligence, and machine learning [4][5] - The Shanghai government is providing additional desensitized public data to enrich the data pool available for participants, ensuring data security and compliance [4][5] - The initiative is seen as a way to promote the integration of the Yangtze River Delta region through collaborative data utilization [4][5]

此次大赛的一大亮点是会向决赛团队开放上海市脱敏后的医保和部分非医保领域公共数据，长三角江 苏、浙江、安徽三省各1个地市的医保脱敏数据等，可用于创新药物研发等十多个领域。 备受业内关注的医保数据支持创新药研发有了新进展。 第一财经从国家医保局了解到，国家医保局和上海市联合主办的2025全国智慧医保大赛于8月1日启动。 此次大赛的一大亮点是会向决赛团队开放上海市脱敏后的医保和部分非医保领域公共数据，长三角地区 江苏、浙江、安徽三省各1个地市的医保脱敏数据等，可用于创新药物研发等十多个领域，通过数字化 手段释放医保数据要素潜能，破解民生难题。 4日，国家医保局正式发布名为"诚邀八方英才，智助医药创新"的2025全国智慧医保大赛公告。公告 称，为充分挖掘政府公共数据要素的价值，探索利用政府公共数据的新模式、新路径，组办方将为决赛 团队提供多类脱敏数据支持，该数据不出域、不涉及个人隐私信息，实施最严格的数据安全保护，仅供 决赛团队使用组办方提供的可信数据空间和安全设施设备进行封闭式操作。 在此前举行的新闻发布会上，国家医疗保障局副局长黄华波表示，本次大赛首次采用"不设赛道，只分 领域"的开放模式，设置了创新医药、医疗健 ...

Core Insights - The integration of national medical insurance data with commercial health insurance is expected to enhance the design of more precise and inclusive insurance products for patients with pre-existing conditions [5][6][14] - The launch of the first national "Medical Insurance + Commercial Insurance" clearing and settlement center in Beijing signifies the removal of barriers between national medical insurance data and commercial health insurance, allowing for one-stop settlement for patients seeking medical care across provinces [2][3] Group 1: Beijing Model and Its Features - The "Beijing Model" allows for synchronous settlement that covers patients seeking medical care across provinces, with no need for hospitals to modify their information systems, facilitating easier implementation [3][12] - The model leverages authorized access to medical insurance data, enhancing the attractiveness for insurance companies and potentially resolving issues related to quick claims and direct payments for patients [3][12][14] Group 2: Current Developments and Challenges - Several provinces have initiated provincial-level coordination for employee and resident medical insurance, but many commercial insurance products remain limited to local government guidance, leaving cross-province patients underserved [4][11] - The "Beijing Model" is distinct from other regions, as it integrates a higher level of medical insurance data openness, which is crucial for the development of commercial insurance products that cater to patients with pre-existing conditions [3][4] Group 3: Innovations in Claims Processing - The clearing center supports innovations such as "fast claims," where patients can authorize their insurance company to automatically retrieve encrypted medical insurance settlement data, significantly reducing the waiting period for claims [10][11] - The introduction of "commercial insurance codes" allows for real-time payment during hospital visits, enhancing the patient experience and increasing the accessibility of insurance products [8][10] Group 4: Hospital Perspectives - Hospitals may not directly benefit from the one-stop settlement model, but it is expected to improve patient experience by providing timely claims similar to basic medical insurance [12][13] - Concerns exist regarding the potential impact on hospital operations, as they may face requests for documentation or explanations related to commercial insurance claims, which could disrupt normal business activities [12][14]