Core Viewpoint - The latest report from the National Medical Insurance Administration highlights a stable medical insurance system in China, with a focus on governance reform aimed at enhancing service quality, innovation, and regulatory oversight [1][3]. Group 1: Medical Insurance Coverage and Financials - By the end of 2024, approximately 1.327 billion people were covered by basic medical insurance, maintaining a coverage rate of over 95% [3]. - The total income of the national basic medical insurance fund (including maternity insurance) was about 3.49 trillion yuan, while total expenditures reached 2.98 trillion yuan in 2024 [3]. - The income from employee medical insurance (including maternity insurance) was approximately 2.37 trillion yuan, reflecting a 3.5% increase from the previous year, while expenditures were about 1.91 trillion yuan, up 7.6% [3]. Group 2: Medical Expenses and Utilization - In 2024, the total medical expenses for employee insurance participants were around 2.06 trillion yuan, marking a 3.6% increase year-on-year, while for residents, it was approximately 2.03 trillion yuan, with a 3.7% increase [7]. - The number of treatment instances for employee insurance participants reached 5.308 billion, a 9.9% increase from the previous year, while for residents, it was 3.035 billion, up 14.9% [3][7]. Group 3: Trends in Medical Costs - The growth rate of total medical expenses significantly decreased from over 20% in 2023 to single digits in 2024, attributed to a reduction in demand following the pandemic [6][7]. - The structure of medical expenses showed a notable decline in drug prices, while the prices for certain medical services, particularly those reflecting physician labor value, increased [8]. Group 4: Policy and Innovation Support - The establishment of a new mechanism for drug access and negotiation has significantly shortened the time for innovative drugs to be included in the insurance system, with over 540 billion yuan in sales from newly negotiated drugs between 2018 and 2024 [4]. - Recent measures support the use of medical insurance data for innovative drug research and development, aiming to enhance the efficiency of drug innovation [4].

Core Insights - The core message of the news highlights the comprehensive reforms in China's medical insurance system, which have led to a more regulated medical service behavior and a reduction in overall medical expenses [1] Group 1: Medical Insurance Coverage and Financials - By the end of 2024, approximately 1.327 billion people are expected to be covered by basic medical insurance, maintaining a coverage rate of over 95% [2] - The total revenue of the national basic medical insurance fund (including maternity insurance) is projected to be around 3.49 trillion yuan, with total expenditures of 2.98 trillion yuan in 2024 [2] - The income from employee medical insurance (including maternity insurance) is estimated at 2.37 trillion yuan, reflecting a growth of 3.5% compared to the previous year, while expenditures are expected to reach 1.91 trillion yuan, an increase of 7.6% [2] Group 2: Medical Expenses and Utilization - The total medical expenses for employee insurance participants are projected to be approximately 2.06 trillion yuan in 2024, with a growth rate of 3.6% [6] - For resident insurance participants, medical expenses are expected to be around 2.03 trillion yuan, with a growth rate of 3.7% [6] - The number of treatment instances for employee insurance participants is projected to reach 5.308 billion, a 9.9% increase from the previous year, while resident insurance participants are expected to have 3.035 billion treatment instances, a 14.9% increase [2] Group 3: Impact of Policy Reforms - The integration of maternity insurance with employee basic medical insurance since 2019 has streamlined the calculation of medical expenses [3] - The cumulative expenditure of the medical insurance fund since the establishment of the National Medical Insurance Bureau has reached 16.48 trillion yuan, with an average annual growth rate of 11% [3] - The establishment of a new mechanism for the entry and negotiation of innovative drugs into the medical insurance system has significantly shortened the time from drug launch to inclusion in insurance [3] Group 4: Trends in Medical Costs - The growth rate of total medical expenses has decreased from over 20% to 3% due to the release of pent-up demand for medical services following the pandemic [5] - The structure of declining medical expenses indicates a notable decrease in drug prices, while the prices for certain medical services have shown mixed trends, with some prices increasing [6] - The overall trend in medical expenses is influenced by ongoing reforms in payment methods and service pricing, leading to a more regulated medical service environment [6]