新京报贝壳财经讯12月13日，国家医保局党组书记、局长章轲在今日举行的全国医疗保障工作会议上表 示，"十四五"期间，全国各级医保部门通过协议处理、行政处罚等方式，共追回医保资金约1200亿元， 查处太和县4家医院、无锡虹桥医院和哈尔滨4家药店骗保等大案；通过大数据模型和智能监管子系统挽 回基金损失95亿元；创新开展药品追溯码采集和监管应用，累计归集追溯码超1000亿条。 ...

医保结算速度不断提升，聚焦创新药保障与科技深度融合 文 |《财经》记者 辛颖 随着2025年冬天的第一场瑞雪落地，12月13日，全国医疗保障工作会议在北京召开。 编辑| 王小 第一，加强多层次目录管理。推动2025年版多家医保药品目录落地，动态调整医保目录药品。要深入落实《支持 创新药高质量发展若干措施》，指导各地加强部门协作，积极落地商保创新药品目录，提高创新药多元支付能 力。持续建设完善"医保药品云平台"功能。 第二，支持商业健康保险发展，健全多层次医疗保障体系。充分发挥商业健康保险在精算测算、产品设计、投资 运营、核保监管等方面的优势，支持商业健康保险与基本医保衔接互补、差异化发展。积极落地商保创新药目 录，鼓励商业健康保险将更多基本医保目录外的合理医疗费用纳入保障范围。鼓励商业健康保险机构扩大对创新 药的投资规模，促进创新药研发。在个人充分授权和确保数据安全基础上，为有需要的商业健康保险产品提供"医 保+商保"一站式清分结算服务，提高核赔效率，让数据多跑路，让群众少跑腿。 第三，优化医保支付结算机制。2026年，要全面推进医保基金即时结算，到年底，实现即时结算资金占当地月结 算资金的80%以上，开通即 ...

Market Overview - On December 10, the market showed a rebound after hitting a low, with the Shanghai Composite Index down 0.23%, the Shenzhen Component Index up 0.29%, and the ChiNext Index down 0.02%[3] - The total trading volume in the Shanghai and Shenzhen markets was less than 1.78 trillion yuan, showing a week-on-week decrease[1] Sector Performance - The leading sectors included precious metals, real estate services, education, commercial retail, real estate development, aviation, and automotive, while sectors like power equipment, banking, photovoltaic equipment, consumer electronics, and wind power equipment saw declines[1] - A total of 2,379 stocks rose, while 2,685 stocks fell, indicating a market with more decliners than gainers[1] Monetary Policy and Market Sentiment - Year-end capital competition is suppressing risk appetite, leading to tighter liquidity in both bond and stock markets[1] - Uncertainty in overseas monetary policy is causing market disturbances, with a cautious trading sentiment prevailing in the A-share market[1] Bond Market Insights - Positive signals emerged in the bond market starting Tuesday, with prices rebounding and yields slightly declining[1] - A potential interest rate cut by the Federal Reserve could boost the domestic bond market, positively impacting stock market liquidity[1] Fund Flows - On December 10, net inflows were recorded at 2.308 billion yuan for the Shanghai Stock Exchange and 4.226 billion yuan for the Shenzhen Stock Exchange[4] - The top three sectors for net inflows were communication equipment, real estate development, and automotive parts, while the top three sectors for outflows were components, photovoltaic equipment, and consumer electronics[4] Economic Indicators - In November, the Consumer Price Index (CPI) rose by 0.7% year-on-year but fell by 0.1% month-on-month, with food prices increasing by 0.2% and non-food prices rising by 0.8%[5] - The average CPI for January to November remained flat compared to the same period last year[5] Government Bond Issuance - The Ministry of Finance successfully issued 7 billion yuan of government bonds in Hong Kong on December 10, with a subscription rate of 5.22 times[6][7] - The issuance included 20 billion yuan for 2-year bonds at an interest rate of 1.43%, 30 billion yuan for 3-year bonds at 1.45%, and 20 billion yuan for 5-year bonds at 1.65%[7] Industry Developments - The China Securities Regulatory Commission proposed to appropriately relax capital space and leverage constraints for quality institutions, potentially reviving the brokerage sector[2] - The 6G network research is progressing, with active sectors including aerospace, communication equipment, and new materials, which investors should monitor[2] Long-term Investment Trends - There has been an acceleration of medium to long-term funds entering the A-share market, enhancing market resilience and promoting value investment transformation[13] - Foreign institutional interest in Chinese assets remains strong, with over 9,000 A-share company investigations conducted this year, leading to a cumulative increase of over 340 billion yuan in northbound capital holdings by the end of Q3[14]

Macro Economy - The Chairman of the China Securities Regulatory Commission, Wu Qing, stated that during the "14th Five-Year Plan" period, the securities industry will undertake four major missions, including serving the real economy and supporting the construction of a financial power [2] - As of the end of November 2025, China's foreign exchange reserves reached $33,464 billion, an increase of $3 billion from the end of October, marking a continuous four-month stay above the $3.3 trillion mark [2] - The People's Bank of China reported that as of the end of November, gold reserves were 74.12 million ounces, an increase of 30,000 ounces from the previous month [3] Industry Trends - The National Healthcare Security Administration and the Ministry of Human Resources and Social Security issued the 2025 drug directory, which includes 114 new drugs, 50 of which are Class 1 innovative drugs [5] - The real estate market is transitioning from a focus on construction to filling properties with people and industries, with current housing prices under pressure due to insufficient usage value [4] - The storage chip market has seen a significant surge in spot prices, with DDR4x chip prices increasing over four times this year, while manufacturers face low inventory levels [6] Company Dynamics - Wuliangye plans to adjust the price of its 52-degree eighth-generation product to 900 yuan per bottle, with potential costs for distributors dropping to around 800 yuan after discounts and rebates [7] - Apple is experiencing significant executive turnover, with key positions related to AI and design seeing resignations, raising concerns about leadership stability [7] - China Life Insurance announced that its vice president is under investigation for serious violations of discipline and law [10]

证券研究报告 医保基金数据跟踪：10月居民医保收入下降， 支出增加 医药行业 强于大市（维持） 证券分析师 叶寅 投资咨询资格编号:S1060514100001 邮箱：YEYIN757@PINGAN.COM.CN 倪亦道 投资咨询资格编号:S1060518070001 邮箱：NIYIDAO242@PINGAN.COM.CN 王钰畅 投资咨询资格编号:S1060524090001 邮箱：WANGYUCHANG804@PINGAN.COM.CN 2025年12月3日 请务必阅读正文后免责条款 核心观点 2025年1-10月统筹医保基金收入维持正增长，且收入大于支出。2025年1-10月收入为23520.10亿元，同比增长1.97%，2025年1-10月支出 为19036.24亿元，同比下降0.68%。除5月外，统筹医保基金收入均大于支出，累计统筹医保基金2025年1-10月呈增长趋势。2025年1-10 月，统筹医保基金结余共计4483.86亿元，同比增长14.99%。结余率方面，2025年1-10月结余率为19.06%，同比2024年1-10月提升2.15pp， 2025年单10月结余率为27.84%，2025 ...

原标题：贯彻落实党的二十届四中全会精神权威访谈|健全多层次医疗保障体系 筑牢民生保障底线—— 访国家医保局局长章轲 新华社北京12月3日电（新华社记者 彭韵佳）医保，关系每个参保人的切身利益。党的二十届四中全会 审议通过的《中共中央关于制定国民经济和社会发展第十五个五年规划的建议》（以下简称《建 议》），提出"健全多层次医疗保障体系""推进基本医疗保险省级统筹"等系列部署。 如何健全多层次医疗保障体系？如何让医保改革成果更好惠及群众健康？新华社记者专访了国家医保局 局长章轲。 破解看病难、看病贵问题取得突破性进展 国家医保局持续推进"1+3+N"多层次医疗保障体系建设，基本医保、大病保险、医疗救助三重基本医疗 保障制度进一步巩固提升。职工医保、居民医保政策范围内住院费用报销比例分别达到80%和70%左 右，普遍开展普通门诊统筹和门诊慢性病、特殊疾病保障，减轻参保人员门诊医疗费用负担。大病保险 进一步减负，城乡居民大病保险保障水平在基本医保基础上提高10到15个百分点。健全统一规范的医疗 救助制度。 以"减负、提质、便民"为导向，多举措强化保障实效。"十四五"期间，医保基金累计支出超13万亿元， 惠及近200亿 ...

Group 1: Economic Development Strategy - The "15th Five-Year Plan" aims to achieve significant progress in modernizing Guangxi alongside the nation, focusing on high-quality development [1] - The plan emphasizes the importance of political responsibility and innovation to ensure effective implementation [1][2] - The strategy includes enhancing economic reforms to drive high-quality development and address new challenges [2][3] Group 2: Industrial and Technological Advancement - Guangxi plans to leverage its unique geographical and resource advantages to develop advanced manufacturing and become a key industrial base [3] - The region will focus on integrating artificial intelligence and modernizing ten key industries to boost economic growth [3] - The contribution of high-tech manufacturing to tax revenue has been increasing, indicating a positive trend in economic vitality [3] Group 3: Taxation and Financial Management - The tax system will focus on compliance and risk management to ensure stable revenue generation while fostering new tax sources [4] - Policies will be tailored to support industries like artificial intelligence and green development, enhancing the precision of tax incentives [4] - The tax authority aims to improve the business environment and support local enterprises in enhancing international competitiveness [4] Group 4: Cultural and Tourism Development - The plan aims to stimulate cultural innovation and create a strong cultural tourism sector, enhancing Guangxi's global appeal [5] - The region's forestry industry is projected to exceed 1.069 trillion yuan in output value by 2024, showcasing its growth potential [5] Group 5: Health and Social Welfare - The strategy includes improving the social security system and promoting health initiatives to enhance the quality of life for residents [7] - The healthcare system will focus on reforming medical services and integrating technology to improve accessibility and efficiency [8] - Emergency management will prioritize safety and stability, enhancing the region's resilience to risks and disasters [8]

Core Viewpoint - The recent efforts by the Qingdao Municipal Commission for Discipline Inspection and Supervision focus on addressing issues related to fraud and improper use of medical insurance funds, emphasizing the importance of strengthening management and oversight in the healthcare sector [1] Group 1: Regulatory Actions - The Qingdao Municipal Commission has established a framework of "task, problem, rectification, and effectiveness" to enhance supervision and accountability among relevant departments [1] - In Hunan Province, the establishment of a task force involving multiple departments aims to promptly address violations by medical institutions and individuals engaged in fraudulent activities [2] - The Heilongjiang Provincial Commission has issued 10 disciplinary recommendations to address systemic issues and enhance governance in the healthcare sector [2] Group 2: Educational Initiatives - The use of typical cases in the healthcare sector serves as a warning and educational tool for party members and officials, promoting awareness and prevention of misconduct [3] - In Nanyang, regular reports and educational meetings are held to inform and deter officials from engaging in corrupt practices, thereby reinforcing the importance of integrity in healthcare management [3] - The analysis of case handling processes aims to extract practical experiences and provide guidance for lower-level disciplinary bodies, enhancing overall effectiveness in managing medical insurance fund issues [3]

Core Viewpoint - Guangxi is actively establishing a multi-department consultation mechanism to promote the coordinated development and governance of medical services, medical insurance, and pharmaceuticals, aiming to improve the healthcare experience for the public [1][2] Group 1: Healthcare Policy Improvements - Guangxi has implemented several policies since 2024, including special medical services management in public hospitals and "pre-admission" treatment management, aimed at enhancing the healthcare experience for citizens [1] - The "pre-admission" treatment management effectively reduces waiting times for patients needing hospitalization, thereby alleviating the burden of medical care [1] - The "no accompanying caregiver" ward pilot allows nurses and medical caregivers to take care of patients during hospitalization, reducing the pressure and costs on family members [1] Group 2: Accessibility and Support for Vulnerable Groups - Measures such as priority windows for elderly patients in registration, payment, and medication collection have been established to improve the healthcare environment for older individuals [1] - The "Pediatric Medical Service Year" action plan (2025-2027) aims to enhance the accessibility of pediatric medical services [1] Group 3: Financial Relief and Medical Aid - Guangxi has launched a special action to improve medical services, with 7069 convenience service measures implemented across 458 secondary and higher medical institutions, benefiting 125 million people and reducing patient costs by approximately 168 million yuan [2] - The region has advanced medical insurance reforms, with a 100% medical expense assistance ratio for extremely poor individuals, and a total of 34.79 billion yuan spent on medical aid by September 2025, benefiting over 301 million insured individuals [2] Group 4: Drug Cost Management - Guangxi has optimized the medical insurance payment scope, including 147 nationally negotiated drugs, with 44 covering 34 rare diseases, and increased the number of outpatient special chronic disease categories to 38, with 1658 corresponding drugs [2] - 211 new medical service items have been included in medical insurance, optimizing 863 payment categories, with a total of 5.82 billion yuan spent on 291,100 cases [2] Group 5: Drug Safety and Regulation - Guangxi has deepened drug regulatory reforms, ensuring strict adherence to drug safety responsibilities, with 2902 batches of drugs tested this year and a compliance rate of 99.21%, maintaining a "zero occurrence" of drug safety incidents [2]

Domestic Macro - The National Development and Reform Commission (NDRC) and other departments released the "Action Plan for Deepening Smart City Development and Promoting Comprehensive Digital Transformation," aiming to establish over 50 fully digital transformation cities by the end of 2027 [5][15]. - The Chairman of the China Securities Regulatory Commission (CSRC) Wu Qing emphasized key tasks for enhancing the inclusiveness and adaptability of the capital market during the "14th Five-Year Plan" period [5][15]. - The Ministry of Finance established a new Debt Management Department to oversee government debt management systems and risk prevention [5][15]. Industry Policy - The Minister of Finance, Lan Fo'an, highlighted the need to support consumption, expand investment, and stabilize foreign trade [6][15]. - The NDRC and other departments launched a smart city development action plan [6][15]. - The 138th Canton Fair concluded with on-site intended export transactions exceeding 25 billion USD, indicating strong international interest [6][15]. Local Policy - Shenzhen optimized policies for converting existing non-residential buildings into affordable rental housing [7][15]. - The Xiamen Special Economic Zone's personal bankruptcy protection regulations officially took effect [7][15]. - Guangdong Province allocated an additional 3.5 billion CNY to promote consumption [7][15]. Overseas Dynamics - President Xi Jinping attended the APEC informal leaders' meeting and proposed three suggestions for regional cooperation [8][15]. - China and South Korea renewed their bilateral currency swap agreement [8][15]. - The U.S. announced plans to invest approximately 500 billion USD into alternative investment markets [8][15].