医疗保险

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赋能医疗机构高质量发展医保按病种付费新规出台
Zhong Guo Zheng Quan Bao· 2025-08-15 20:11
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]
赋能医疗机构高质量发展 医保按病种付费新规出台
Zhong Guo Zheng Quan Bao· 2025-08-15 20:09
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]
伯克希尔披露新持股信息后,联合健康股价创五年来最大涨幅
Xin Lang Cai Jing· 2025-08-15 14:28
来源:环球市场播报 此前,巴菲特旗下的伯克希尔·哈撒韦公司披露其持有500万股联合健康股票,价值约16亿美元。"大空 头"投资者迈克尔·伯里和阿帕卢萨管理公司的大卫·泰珀也披露了其持有的大量联合健康股票。 截至周四收盘,在伯克希尔提交文件之前,联合健康股价已下跌近50%。这家最大的私人医疗保险公司 已成为美国公众反对医疗成本上涨的反击对象。联合健康集团目前正面临美国司法部对其医疗保险 (Medicare) 计费操作的调查。 今年5月,该公司撤回了年度盈利预期,首席执行官安德鲁·威蒂 (Andrew Witty) 也宣布辞职。上个 月,联合健康集团公布了新的2025年业绩展望,远低于华尔街预期,这进一步打击了其股价。 德意志银行医疗保健分析师乔治·希尔 (George Hill) 在一份客户报告中表示:"伯克希尔此举代表了对 联合健康集团的极大信任,并可能为大多数MCO领域提供短期交易平台。鉴于伯克希尔的投资记录, 这可能成为近期底部的标志,并促使其他投资者相信该领域可以再次安全投资。" 周五,伯克希尔披露其持有这家陷入困境的保险公司的大量股份后,联合健康股价应声飙升。 这家医疗保健股飙升12%,有望创下五年来 ...
大涨!巴菲特“抄底”保险巨头 二季度建仓6只股票
Zheng Quan Shi Bao Wang· 2025-08-15 11:47
Core Viewpoint - Despite nearing retirement, Buffett's ability to identify valuable investments remains strong, as evidenced by significant stock purchases in the second quarter by Berkshire Hathaway, particularly in UnitedHealth Group, which saw a notable pre-market surge [2][3]. Group 1: UnitedHealth Group - UnitedHealth's stock price surged over 12% in pre-market trading after Buffett's investment, following a period where the stock had dropped more than 50% over the past year, resulting in a market cap loss of nearly $270 billion [3][4]. - The company is under investigation by the U.S. Department of Justice for potential billing misconduct related to its Medicare Advantage plans, raising concerns about inflated risk scores for higher reimbursements [4]. - The recent murder of the former CEO of the insurance division, Brian Thompson, has led to public outcry regarding the U.S. healthcare system, compounding the company's challenges [5]. Group 2: Berkshire Hathaway's Investments - In the second quarter, Berkshire Hathaway acquired over 5 million shares of UnitedHealth, with a market value of approximately $1.57 billion at the end of the quarter [5]. - Other stocks purchased by Berkshire include Nucor Steel (over 6.6 million shares, $860 million), Lennar (over 7 million shares, $780 million), D.R. Horton (1.485 million shares, $190 million), Lamar Advertising (about 1.17 million shares, $140 million), and Allegion (780,000 shares, $110 million), totaling a market value of approximately $3.65 billion for these new positions [7]. - In addition to new purchases, Berkshire reduced its stake in Apple by 20 million shares (approximately 6.67%) while still maintaining it as the largest holding [9].
股神巴菲特出手捞底500万股 UNH,你还怕什么崩盘?
美股研究社· 2025-08-15 11:29
美股投资网 . 美国洛杉矶投资公司,TradesMax.com为美股投资者提供美股行情和投资策略的专业网站。一支有着多年华尔街投资银行工作经验的美籍分析师团队,提供 公司研究报告、美股交易技巧、美股软件、美股开户指南、微信客服niugu88,微博美股投资网 来源 | 美股投资网 据美股投资网了解到,巴菲特领导的伯克希尔哈撒韦今日公布了其2025年第二季度的13F报告。 以下文章来源于美股投资网 ,作者StockWe.com 随着伯克希尔13F报告的正式披露,这一消息得到了证实。报告发布后UNH的股价在盘后交易中大涨超过10%,充分显示了市场对巴菲特投资 决策的积极反应。 其中最引人注意的是,伯克希尔在二季度以约16亿美元建仓了503.9万股美国医保公司联合健康(UNH)。建仓成本价是314美元! 至季度末,这一仓位的总价值已达15.7亿美元,仓位排名已跃升为伯克希尔投资组合中的第18大持股,仅次于亚马逊和星座品牌(STZ)。 | UNH | History | HEALTH CARE | 5,039,564 | 1,572,192,781 | 0.61% | | 18 | 1 5,039,564 | New ...
巴菲特持仓报告出炉,为何花16亿美元重新建仓联合健康?
Xin Hua Cai Jing· 2025-08-15 04:44
Core Viewpoint - Berkshire Hathaway has continued its trend of net stock selling for the 11th consecutive quarter, with a reported long position in U.S. stocks amounting to $257.5 billion as of the end of Q2 2025 [2] Group 1: Berkshire Hathaway's Investment Actions - In Q2, Berkshire Hathaway restarted selling Apple shares, continued to reduce its stake in Bank of America, and increased its holdings in Chevron and the food and beverage sector [2] - Six new positions were established, including significant investments in UnitedHealth, Nucor Steel, Lennar, and Lamar Advertising, with a total market value of approximately $3.65 billion at the end of the quarter [2][5] Group 2: UnitedHealth's Performance and Market Reaction - UnitedHealth reported Q2 revenue of $111.6 billion, a year-on-year increase of 13%, but adjusted net profit fell over 23.7% to $3.406 billion, leading to a decline in stock price [6] - Following Berkshire's announcement of re-establishing a position in UnitedHealth, the stock price surged over 8% in after-hours trading [5][6] Group 3: Market Sentiment and Future Outlook - Analysts suggest that Berkshire's renewed investment in UnitedHealth may be due to its stock price reaching a multi-year low, with a current P/E ratio of 11.55, indicating potential for long-term returns [7] - Despite the challenges, if profit margins improve, the stock could return to a fair value of around $360, with conservative estimates placing the target price above $300 [7]
建仓联合健康,减持苹果!伯克希尔时隔14年重返医疗保险板块
Di Yi Cai Jing Zi Xun· 2025-08-15 00:49
Group 1 - Berkshire Hathaway has re-entered the healthcare insurance sector by purchasing 5.04 million shares of UnitedHealth Group, valued at approximately $1.57 billion as of June 30, marking its first investment in this sector since exiting in 2010 [1] - UnitedHealth's stock price rose over 10% in after-hours trading following the news, despite a nearly 50% decline in its stock price year-to-date due to rising medical costs, a U.S. Department of Justice investigation, a cyberattack last year, and the death of former executive Brian Thompson [1] - Berkshire also sold 20 million shares of Apple, reducing its holdings to 280 million shares, while Apple remains the largest single stock in Berkshire's portfolio [1] Group 2 - Berkshire Hathaway has established new positions in residential builder DR Horton and significantly increased its stake in Lennar, along with new investments in Allegion, Lamar Advertising, and Nucor, all of which saw varying degrees of stock price increases in after-hours trading [2] - The company sold approximately $3 billion more in stocks than it bought during the April to June period, marking the 11th consecutive quarter of net selling in U.S. stocks, with cash and equivalents totaling $344.1 billion as of June 30 [2] - It remains unclear who led these transactions, whether it was Warren Buffett, investment managers Todd Combs and Ted Weschler, or successor candidate Greg Abel, but the market generally views Berkshire's purchases as endorsements of the respective companies [2]
伯克希尔二季度减持苹果、美国银行
Zheng Quan Shi Bao Wang· 2025-08-15 00:00
Group 1 - Berkshire reduced its holdings in Apple by 20 million shares in the second quarter, yet Apple remains its largest position [1] - Berkshire also sold over 26 million shares of Bank of America [1] - The company completely exited its position in T-Mobile during the second quarter [1] Group 2 - Berkshire initiated a new position in health insurance giant UnitedHealth, purchasing approximately 5.04 million shares with a market value of nearly $1.6 billion [1] - Additionally, Berkshire entered positions in the largest steel producer Nucor, valued at over $800 million, and homebuilder Lennar, valued at nearly $800 million [1] Group 3 - Among the top ten holdings, Chevron was the only stock that Berkshire increased, adding 3.45 million shares [1]
121种药通过初审 国家医保局将首次制定商保创新药目录
Yang Shi Xin Wen· 2025-08-13 06:09
2025年国家医保药品目录调整工作日前启动。今年目录调整中增设了商保创新药目录,这也是国家医保局将首次制定商业健康保险创新药品目录。 首版商保创新药目录 通过初审名单公布 昨天,国家医保局公示了通过2025年国家基本医疗保险、生育保险和工伤保险药品目录及商保创新药目录调整初步形式审查的药品及相关信息。 国家医保局共收到商保创新药目录申报信息141份,涉及药品通用名141个,经初步审核,121个药品通用名通过形式审查。其中,5款细胞疗法高值创新药进 入商保创新药目录。 形式审查是目录调整程序中的第一步,代表该药品具备了参与目录调整后续工作流程的资格,不代表其已经纳入了目录。 满足多元用药需求 助商业健康保险发展 基本医保和商业健康保险都是我国多层次医疗保障体系的重要组成部分。2024年,基本医保参保13.26亿人,参保率巩固在95%。当年基金总支出达到2.97万 亿元,为广大人民群众看病就医提供了坚实保障。 但基本医保总体筹资水平不高,人均筹资仅1070元,其中约2/3还是来自各级财政补助,因此必须牢牢把握"保基本"定位。 随着医药技术创新发展和医疗服务水平提升,确有一小部分临床效果显著、创新程度高的药品因超出 ...
奋勇争先,决战决胜“十四五”|健康中国建设全面推进
Ren Min Ri Bao· 2025-08-11 00:46
Group 1: Healthcare System Development - The establishment of a national medical insurance cloud index in Hubei Province allows for seamless access to patient imaging data across different healthcare facilities, enhancing convenience for patients [1] - The "14th Five-Year Plan" emphasizes the comprehensive promotion of health in China, aiming to improve the quality of healthcare services and ensure better access for the public [1][2] - The construction of a tiered diagnosis and treatment system is underway, with 2,188 counties advancing the establishment of closely-knit county medical communities, facilitating mutual recognition of results between primary and higher-level medical institutions [2] Group 2: Medical Insurance and Financial Support - In Guangzhou, over 7,000 mothers spent less than 100 yuan on childbirth after insurance reimbursement, highlighting the financial relief provided by the medical insurance system [3] - The coverage of medical insurance has expanded significantly, with the reimbursement rates for inpatient expenses reaching 80% for employee insurance and 70% for urban and rural residents [3] - The 2024 National Medical Insurance Directory includes 3,159 types of drugs, significantly increasing access to essential medications for various diseases [3] Group 3: Public Health System Enhancement - The integration of disease control and prevention personnel into hospitals is being expanded, with 254 cities participating in the pilot program to enhance public health monitoring [4] - The per capita financial subsidy for basic public health services has reached 99 yuan, reflecting increased public financial support for health initiatives [4] - The health literacy rate among residents has improved from 17.06% in 2018 to 31.87% in 2024, indicating a growing societal emphasis on health [4]