智慧医保

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【省医保局】陕西“医保影像云索引共享”功能上线
Shan Xi Ri Bao· 2025-08-21 00:23
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]
深圳医保“一码付”上线,就医结算再快一步!
Nan Fang Du Shi Bao· 2025-08-15 15:17
深圳市医保局相关负责同志表示,将全力推进智慧医保建设,持续深化"互联网+医保"服务,积极拓展 医保码全流程应用、"一码付"、刷脸就医等便民服务场景,支持打造更多标杆项目,让参保群众医保改 革获得感成色更足、幸福感更可持续、安全感更有保障。 "一码付"功能是在医保码身份认证和医保结算原有功能基础上,融合第三方支付渠道,进一步改善参保 群众就医体验的重要举措。参保群众扫描医疗机构提供的二维码,进入医保"一码付"页面,点击页面 上"立即开通",即可使用该功能。开通此项服务后无需再携带现金或银行卡,只需通过手机展示医保码 或者在自助终端前刷脸,便可完成从挂号、就诊、医保结算和现金结算的全部就医流程,真正实现 了"无卡就医、无码支付"。 在保障医保基金安全与公众隐私安全方面,"一码付"依托国家医保统一信息平台和技术规范,采用"人 脸识别+实名+实人"安全核验技术,在确保个人信息安全的前提下,实现医保与自费快速结算,可以有 效防范冒名就医、盗刷套刷医保卡等违法违规行为,有力维护医保基金安全。 据了解,近年来深圳市医保局大力推进医保便民服务改革,以医保电子凭证(医保码)、医保电子处 方、电子票据,移动支付、信用支付"三电子 ...
20cm速递 | 关注科创创新药ETF国泰(589720)低位布局机会,智慧医保与外贸韧性或重塑行业格局
Sou Hu Cai Jing· 2025-08-07 05:41
Core Viewpoint - The launch of the National Smart Medical Insurance Competition in 2025 is expected to enhance the efficiency of innovative drug research and development in the pharmaceutical and biotechnology industry, with open medical insurance data aiding companies in accurately targeting clinical needs, shortening R&D cycles, and reducing costs [1] Group 1: Industry Insights - The innovative drug sector is projected to have high growth potential and investment value in the long term, with deeper application of medical insurance data likely to improve both the quantity and quality of innovative drugs [1] - Once approved, innovative drugs can leverage clinical advantages to capture significant market share and pricing power [1] - The reactivation of the fifth set of standards for the Sci-Tech Innovation Board and the dual financing channel of Hong Kong's 18A is expected to stimulate full-cycle financing for pharmaceutical companies [1] Group 2: Regulatory Changes - New regulations on traditional Chinese medicine decoction pieces and adjustments to the Guangdong medical alliance drug policies are anticipated to impact the industry landscape [1] Group 3: Investment Opportunities - The Guotai Innovative Drug ETF (589720) tracks the Sci-Tech Innovative Drug Index (950161), which can experience daily fluctuations of up to 20% [1] - This index selects technology-driven innovative drug R&D companies from the biopharmaceutical and chemical pharmaceutical sectors, focusing on R&D investment, technological barriers, and growth potential to reflect the overall performance of related enterprises in China's pharmaceutical innovation field [1]
“十四五”时期医保基金累计支出超十二万亿元 减轻看病负担 加强基金监管(权威发布·高质量完成“十四五”规划)
Ren Min Ri Bao· 2025-07-24 22:27
Core Insights - The article discusses the significant advancements and reforms in China's medical insurance system during the "14th Five-Year Plan" period, emphasizing the focus on improving public health and reducing medical costs for citizens [1][2]. Group 1: Medical Insurance Coverage - By 2024, the number of people covered by basic medical insurance is expected to reach 1.327 billion, with a stable participation rate of around 95% during the "14th Five-Year Plan" [1][2]. - Nearly 20 billion medical insurance reimbursements are anticipated from 2021 to 2024, with 2024 figures projected to be 1.6 times that of 2020 [2]. Group 2: Support for Specific Demographics - As of June this year, 253 million people are enrolled in maternity insurance, with cumulative expenditures reaching 438.3 billion yuan, benefiting over 96.14 million instances [2]. - The long-term care insurance system is being established, with 190 million participants expected by the end of 2024, and over 95% of village clinics included in the insurance network [2]. Group 3: Healthcare Accessibility and Efficiency - The number of designated medical institutions for insurance has reached 1.1 million, and the direct settlement rate for cross-province hospitalizations is around 90% [3][5]. - The implementation of a unified national medical insurance information platform has improved service efficiency, with over 1.236 billion people using medical insurance codes for direct settlement [4][5]. Group 4: Fund Security and Regulation - The cumulative recovery of medical insurance funds has reached 104.5 billion yuan during the "14th Five-Year Plan," with a total fund balance of 3.86 trillion yuan expected by the end of 2024 [6][7]. - The National Medical Insurance Bureau has intensified supervision and regulation, conducting inspections on 335,000 medical institutions and recovering 16.13 billion yuan in funds in the first half of this year [6][7].
青岛1994家机构实现医保“刷脸支付”
Qi Lu Wan Bao· 2025-07-22 00:29
Group 1 - The core viewpoint is that Qingdao's medical insurance bureau has implemented a "face payment" system across the city, enhancing convenience for patients in both urban and rural areas [1][2] - As of now, 2,400 "face payment" terminals have been installed, covering 1,484 medical institutions and 510 pharmacies, including 80 dual-channel pharmacies [1] - From January to June 2025, the total medical insurance settlement reached 44.0466 million transactions, with 7.5813 million transactions completed via "face payment" [1] Group 2 - The Qingdao medical insurance bureau has organized training sessions for medical institutions to improve the usage rate of the "face payment" terminals and enhance user experience [2] - The training focused on the usage of the "face payment" system, addressing common issues related to network, equipment, and operation, thereby improving the application skills of medical institutions [2] - Future plans include increasing the promotion of mobile payment functions and continuing to enhance the digital and cardless level of medical insurance services [2]
异地共享互认!济南市首批医保影像云索引数据直连国家医保信息平台
Qi Lu Wan Bao Wang· 2025-07-04 00:32
Core Insights - The first batch of medical insurance imaging cloud index data from Jinan City has been uploaded to the National Medical Insurance Information Platform, promoting cross-regional medical imaging sharing and recognition [1][3]. Group 1: Data Sharing Implementation - The Shandong Provincial Medical Insurance Information Platform launched the "Medical Insurance Imaging Cloud Index Sharing Module" on May 13, 2025, with Jinan City as a pilot city [3]. - As of June 23, 2025, over 50,800 imaging index data entries from 48 designated medical institutions in Jinan, including CT, DR, and MRI, have been successfully uploaded [3]. Group 2: Collaborative Efforts - The Shandong Provincial Medical Insurance Bureau emphasizes the importance of collaboration between provincial and municipal levels to enhance the efficiency of imaging data sharing [6]. - A dedicated transmission channel for medical imaging data has been established to ensure secure and rapid data transfer to the National Medical Insurance Information Platform [6]. Group 3: Future Developments - Plans are in place to accelerate the construction of medical insurance imaging cloud data sharing centers across all 16 cities in Shandong Province by the end of 2025 [7]. - The integration of artificial intelligence and advanced technologies is expected to enhance diagnostic accuracy and improve healthcare services through the use of imaging data [7].
新疆兵团“医保钱包”上线 实现跨省共济
Zhong Guo Xin Wen Wang· 2025-05-08 15:06
Core Points - The Xinjiang Production and Construction Corps has launched the "Medical Insurance Wallet" to address the challenges of cross-province use of personal medical insurance accounts, providing a more convenient and efficient way for insured individuals to manage their medical funds [1][3] - The "Medical Insurance Wallet" is linked to personal medical insurance codes and allows for fund transfers among close relatives, facilitating medical expenses and personal contributions to health insurance [1][3] Group 1 - The launch of the "Medical Insurance Wallet" represents a significant breakthrough in integrating medical insurance with financial services, aimed at solving the cross-province usage issue of personal medical accounts [3] - The Agricultural Bank of China’s Xinjiang Corps branch has activated 1.13 million medical insurance electronic certificates, collaborating on various aspects such as fund payment and mobile payment solutions [3] - The "Medical Insurance Wallet" allows for flexible payments in hospitals and designated pharmacies, alleviating the burden on relatives without personal account funds during medical settlements [3]