"三医"协同稳健推进，医疗医保良性互动。青海以系统改革破解深层次问题，稳步推进医疗服务价格调 整，累计执行价格项目8163项，医疗服务收入占比提升至36.64%，超过全国平均水平。医保支付方式 改革深入推进，建立激励约束机制，引导医疗机构回归公益定位、提升服务内涵。通过建立医保预付金 制度，有效缓解公立医院资金压力。改革促使全省医疗次均费用和平均住院床日较2021年显著下降，实 现了医疗机构管理水平和基金使用绩效的双提升。 便民服务智能精细，群众办事省心便捷。以"高效办成一件事"为目标，青海"智慧医保"建设提速。医保 码激活使用率在全国率先实现全覆盖，"刷脸"结算基本覆盖定点医药机构。政务服务事项线上可办率超 95%，同时依托基层组织和银行网点等，实现医保服务站点乡镇、村社全覆盖，并探索建立流动服务 队，将服务延伸到群众"门口"。异地就医直接结算拓宽至全国所有定点医药机构，"一站式"结算、跨省 协同（如与川、甘、藏等地对接）让群众切实感受到"看病不用带卡、报销不用跑腿"的便利。 待遇保障持续夯实，群众获得感实实在在。全省基本医保参保扩面成效显著，2025年参保任务完成率达 100.69%，连续三年超额完成国家 ...

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（文章来源：人民日报） 自今年8月启动以来，2025全国智慧医保大赛共吸引802支队伍踊跃参与。本次大赛设置创新药物研发/ 上市后真实世界研究/药械综合价值评价领域、医疗健康领域、金融保险和平台经济领域等11个参赛领 域，推动医保数据赋能千行百业。经过线上初赛、线下模拟实操和决赛答辩评审，来自各地的178支队 伍脱颖而出，分获一、二、三等奖。 本报上海12月11日电 （记者姜泓冰）2025全国智慧医保大赛日前在上海落幕。 ...

12月8日，2025全国智慧医保大赛颁奖仪式在上海浦东举行。德生科技（002908）与广州医保联合打造 的"就医无感支付"项目，在全国802个参赛项目中脱颖而出，凭借数字技术赋能和创新服务模式，荣获 全国总决赛一等奖。 "就医无感支付"项目围绕群众就医缴费流程繁琐等现实痛点，创新构建"四端一体"支付平台，融合医 保、银联、医疗机构与银行等多方资源，实现医保结算、支付服务与医疗流程的深度整合。项目实 现"医保秒报销、个人免排队、零操作"的高效就医体验，覆盖多类就诊人群和医疗场景，助力医疗机构 向服务型模式升级，推动形成数据互通、资源共享、高效运行的新型就医支付生态。(CIS) ...

仪式上，章轲、上海市副市长陈宇剑致辞。现场颁发了2025全国智慧医保大赛一、二、三等奖。上 海银行、中国信通院上海工创中心、张江集团、中电信量子信息科技集团等行业生态单位与获奖团队签 订意向合作协议。 本次大赛由国家医保局和上海市政府联合主办，旨在激发新一代信息技术在医保改革中的创新活 力，进一步推进医药行业创新发展，保障人民群众健康。大赛首次整合跨领域、跨地域的大规模高质量 脱敏数据，数据规模和数据多样性均创国内新高。大赛设置创新药物研发、上市后真实世界研究、药械 综合价值评价等11个参赛领域，推动医保数据赋能千行百业。自今年8月启动以来，大赛共吸引全国802 支队伍参与。经专家评审，178个决赛获奖项目脱颖而出。上海市共有37个项目获奖，其中10个项目获 得一等奖，获奖总数和一等奖数量均位列全国第一。 上海市委、市政府高度重视医保工作，支持医保部门探索医保数据有序开发利用，推动赋能千行百 业。上海持续强化智慧医保赋能，积极培育医保公共数据应用新场景，推动便民服务质效提升，出台医 保商保衔接措施，助力医药产业创新发展。上海将为大赛优秀项目提供转化和验证服务，支持大赛成果 在全国开花结果，共享创新发展机遇，助 ...

Core Insights - The article emphasizes the importance of establishing a multi-tiered medical insurance system to enhance public health security in the context of China's 14th Five-Year Plan [2][3] Group 1: Medical Insurance System - The provincial medical insurance bureau aims to implement the central government's decisions and focus on key reforms in medical insurance payment and drug pricing to improve service levels [2][3] - The bureau will enhance budget and operational management of the medical insurance fund to ensure its sustainable operation and strengthen regulatory frameworks to combat fraud [3][4] - The integration of artificial intelligence in the medical insurance sector is planned to optimize services and improve efficiency for the public [3][4] Group 2: Healthcare Development - The medical insurance system will support the collaborative development of healthcare, medical insurance, and pharmaceuticals, including the implementation of a new drug list and direct settlement with pharmaceutical companies [4] - The bureau aims to create a more equitable and adequate medical insurance benefit mechanism and extend services to grassroots levels [4][5] Group 3: Education Sector Improvements - The article highlights significant investments in educational infrastructure, with over 15 billion yuan allocated to improve conditions in compulsory education schools, resulting in the addition of 1620 new student places [5][6] - The province has implemented various student aid programs, distributing approximately 96.835 billion yuan to support over 74 million students across different educational levels [6][7]

Core Insights - The launch of "Yibaoer (Liaoxiaobao)" marks a new phase in the digital and intelligent transformation of public medical insurance services in Liaoning Province [1][2] Group 1: Service Features - "Yibaoer (Liaoxiaobao)" provides 24/7 standardized services for policy consultation, business processing guidance, and insurance information inquiries, effectively filling the service gaps during off-hours [1] - The AI digital assistant can accurately understand and respond to various medical insurance inquiries, including payment and reimbursement issues, by aggregating the latest policies and guidelines [1] - Personalized service information is pushed to users based on big data analysis, catering to specific demographics such as students and elderly users with tailored features [1] Group 2: Application and Integration - The AI service is integrated into platforms like Alipay, allowing users to access it through various search functions and enjoy instant responses [2] - The establishment of a unified medical insurance information platform in Liaoning has facilitated information connectivity, laying the groundwork for "one-stop service" [2] - High-frequency services such as appointment scheduling, online medication purchases, and inter-provincial medical treatment registration have been streamlined for user convenience [2]

Group 1 - The core viewpoint of the news is the launch of the "Medical Insurance Imaging Cloud Index Sharing" function in Shaanxi, which allows patients' imaging reports to be accessed across different regions in China, marking a significant advancement in smart medical insurance construction in the province [1][2] - The new function aims to reduce redundant medical examinations caused by data barriers, thereby alleviating the economic burden on patients and optimizing medical resource utilization [1] - As of now, over 1.1 million digital medical imaging data have been uploaded to the national medical insurance information platform, covering various examination types such as CT, X-ray, and MRI [1] Group 2 - The successful implementation of this initiative is attributed to Shaanxi's solid promotion of the national medical insurance imaging cloud construction, with Xianyang being the first pilot city [2] - Since the pilot program began in May, Xianyang has collected over 160,000 ultrasound and radiology imaging cases, with an average of over 700 shared recognitions per day, and is expected to save approximately 80 million yuan in medical insurance funds annually [2] - The next step involves summarizing and promoting the experiences from the Xianyang pilot to facilitate the connection of all cities in Shaanxi to the national medical insurance information platform [2]

Core Points - The launch of the "One Code Payment" service in Guangdong Province significantly enhances the medical experience for insured individuals by allowing them to complete medical reimbursements and out-of-pocket payments with a single scan or facial recognition, eliminating the need for multiple platforms and scans [1][2] - The "One Code Payment" integrates third-party payment channels with existing medical insurance code functionalities, streamlining the entire medical process from registration to payment [1] - The service employs advanced security measures, including facial recognition and real-name verification, to protect personal information and prevent fraudulent activities related to medical insurance [1] Industry Developments - Shenzhen's Medical Insurance Bureau has been actively promoting reforms in medical insurance services, transitioning from a "card era" to a "code era" and "face era" through the implementation of electronic medical insurance credentials and mobile payment options [2] - Over 18.98 million medical insurance codes have been activated in Shenzhen, with more than 99% of designated medical institutions supporting full-process applications of the medical insurance code [2] - The Medical Insurance Bureau aims to further develop smart medical insurance services and expand the application of "One Code Payment" and facial recognition in medical services, enhancing the overall experience for insured individuals [2]

Group 1 - The core viewpoint of the news is the progress and achievements of China's medical insurance reform during the "14th Five-Year Plan" period, emphasizing a people-centered approach and innovation in the healthcare system [1][2] - The basic medical insurance coverage rate remains stable at around 95%, with the number of insured individuals expected to reach 1.327 billion by 2024 [1] - The cumulative balance of the medical insurance fund is projected to be 3.86 trillion yuan by the end of 2024, with a total expenditure of 12.13 trillion yuan during the "14th Five-Year Plan" period, reflecting an annual growth rate of 9.1% [2] Group 2 - The medical insurance system has implemented various measures to enhance fund security, including a comprehensive regulatory framework and the recovery of 104.5 billion yuan in misused funds [2] - As of June 2025, 2.53 million people are enrolled in maternity insurance, with total expenditures reaching 438.3 billion yuan, benefiting over 96 million individuals [2] - The use of smart healthcare services has increased, with over 1.236 billion people using medical insurance codes for direct settlement, and the online service availability rate rising from 55% in 2020 to 92% in 2024 [3]