11月19日 "北京5家医院试点预住院" 话题冲上热搜 北京市医保局近日印发《关于开展"预住院"费用医保支付试点工作通知》，协和医院、宣武医院等5家医院率先启动试点，相关术前检查费用纳入住院医保 统一结算。 "预住院 "是一种什么模式？ 如何办理"预住院"？ 一起来看 01 提前至门诊阶段完成 检查费用纳入住院费用统一结算 医院确定床位后 患者入院当天就能安排手术 就医流程更紧凑、更高效 "预住院"如何实现 患者省钱、医院增效 "预住院"模式 将原本住院后才做的术前检查 "预住院"模式 不仅降低了患者的就医成本 同时也有效缓解了 医院床位紧张的问题 自付费用下降40%以上 在传统模式下 术前检查需在门诊全额垫付 报销比例较低 而"预住院"将 检查费用直接转入住院费用 享受更高报销比例 患者自付部分大幅降低 以北京市为例，门诊报销比例达70%，住院报销比例达85%以上。据北京市医保局数据，"预住院"患者平均自付费用下降超40%，异地患者综合就医成本降 低近30%。 02 想要办理"预住院" 注意这几点 航天中心医院试点首月数据显示，择期手术床位使用率从82%提升至91%，术前平均住院日从3.2日降至1.7日。 ...

□ 本报记者刘磊通讯员钱小蔷 近日，江苏大学附属医院(江滨医院)迎来历史性一幕：德国纽伦堡医院妇科中心主任Cosima Brucker教 授、妇科肿瘤外科主任Dimitrios Bolovis教授携手该院妇科团队，共同实施了镇江首例达芬奇机器人辅 助腹腔镜下子宫内膜癌根治术。这不仅标志着镇江地区妇科肿瘤微创治疗迈入机器人时代，更折射出江 大附院近年来以"引进来+走出去"双轮驱动、深度融入全球医疗体系的国际化办院战略。 在这一高强度、高密度的协作中，镇江首例达芬奇机器人辅助腹腔镜下子宫内膜癌根治术成为标志性成 果。60岁的患者秦英(化名)在中德医疗团队的协同救治下，不仅手术全程出血仅20毫升，术后更是迅速 康复。这不仅是技术的突破，更是国际标准与本地临床实践深度融合的体现。截至交流结束，团队已共 同完成20余例机器人手术，并成功开展9例(新型)盆底器官脱垂重建术——这一技术填补了本地相关领 域的空白。 江苏大学附属医院党委书记陈吉祥表示，国际化是医院高质量发展的核心战略之一。近年来，医院一方 面继续秉承"引进来"战略：设立全市首个外国专家工作室，与纽伦堡医院建立每年2—3次的常态化合作 机制，并计划引入其他国际 ...

Core Points - The article discusses a significant case of medical insurance fraud in Shanxi Province, where a hospital was involved in fraudulent activities to exploit the national medical insurance fund [1][9] - The case highlights various methods used by the defendants to inflate hospital admissions and costs, ultimately leading to substantial financial gains at the expense of the insurance system [5][7] Summary by Categories Fraud Methods - **Method 1: Increasing Fake Inpatients** The hospital recruited patients through incentives, paying referral fees to those who brought in new patients, thereby artificially inflating the number of hospital admissions [2][3] - **Method 2: Phantom Admissions** Some patients did not actually stay in the hospital but left their insurance cards there, allowing the hospital to create false medical records and claim reimbursements [3][4] - **Method 3: Inflating Treatment Costs** The hospital exaggerated the treatment costs for patients, even those with minor ailments, to reach the maximum reimbursement limits set by the insurance [5][6] - **Method 4: Financial Manipulation** The hospital submitted inflated drug costs to the insurance fund, with discrepancies between actual drug purchase prices and reported amounts, leading to significant overclaims [7][8] Legal Consequences - The main defendant, identified as Ai, was sentenced to 13 years and 6 months in prison, along with fines, while other co-defendants received varying sentences [9]

新京报讯11月17日，宿州市立医院发布情况通报，11月16日，该院一份CT影像诊断报告出现错误。发 现相关情况后，医院迅速成立专门工作组开展调查。目前，已对涉事医生和所在科室主任停职调查。 此事暴露出该院存在制度落实不到位，医疗质量管理不规范等问题，对此表示诚恳歉意。 下一步，医院将根据调查结果，对相关责任人依规依纪严肃处理，并举一反三，严格落实各项制度，规 范医疗服务行为，加强医务人员管理，切实提升服务水平，保障群众健康权益。 ...

Core Viewpoint - Meinian Health's stock price has shown a positive trend, with a year-to-date increase of 21.04%, indicating strong market performance and investor interest [1][2]. Financial Performance - For the period from January to September 2025, Meinian Health reported a revenue of 6.925 billion yuan, a year-on-year decrease of 3.01%, while the net profit attributable to shareholders reached 51.86 million yuan, reflecting a significant year-on-year increase of 110.53% [2]. - The company has cumulatively distributed 634 million yuan in dividends since its A-share listing, with 127 million yuan distributed over the past three years [3]. Stock Market Activity - As of November 17, Meinian Health's stock price was 5.54 yuan per share, with a market capitalization of 21.685 billion yuan. The stock experienced a trading volume of 327 million yuan and a turnover rate of 1.53% [1]. - The stock has appeared on the "Dragon and Tiger List" twice this year, with the most recent instance on February 19, where it recorded a net buy of -155 million yuan [1]. Shareholder Structure - As of September 30, 2025, Meinian Health had 152,000 shareholders, a decrease of 11.85% from the previous period. The average number of circulating shares per person increased by 13.44% to 25,490 shares [2]. - The top ten circulating shareholders include notable ETFs, with Huabao Zhongzheng Medical ETF holding 88.664 million shares, a decrease of 15.1218 million shares from the previous period [3].

Group 1 - Duopule plans to reduce its shareholding by no more than 1%, amounting to a maximum of 619,000 shares [1] - Lideman intends to acquire 70% of Xiansheng Xiangrui for 1.733 billion yuan, focusing on tuberculosis screening and diagnosis [2] - Huahuan Group is planning a change in control, leading to a temporary suspension of its stock [3] Group 2 - Dongbai Group clarifies it does not engage in duty-free business, maintaining normal operations [4][5] - Changsheng Bearing's actual controller plans to reduce holdings by up to 1.99%, equating to 5.94 million shares [6][7] - Jidian plans to invest 5.698 billion yuan in the Baicheng Phase II coal power project, a key initiative under the national "14th Five-Year Plan" [9][10] Group 3 - Baoneng New Energy reports completion of land-based works for the expansion of the Lufeng Qiaohai Bay Power Plant [11][12] - Changshu Bank proposes to appoint Lu Dingchang as the new president and chief compliance officer [13][14] - Kangqiang Electronics plans to reduce its shareholding by no more than 1%, totaling up to 3.7526 million shares [14] Group 4 - Jilin Chemical Fiber intends to reduce its holdings by up to 2%, equating to 49.1774 million shares [15][16] - CanSino's inhaled tuberculosis vaccine has commenced Phase I clinical trials in Indonesia [17][18] - ST Dongyi's stock has been suspended for review due to significant price fluctuations [19] Group 5 - ST Yatai plans to reduce its holdings by up to 1.98%, totaling 6.4 million shares [20] - Huaren Pharmaceutical intends to reduce its holdings by up to 3%, equating to 35.4663 million shares [21] - Jianglong Shipbuilding's controlling shareholder plans to reduce holdings by up to 2%, amounting to 7.5534 million shares [22] Group 6 - Borui Pharmaceutical's BGM1812 injection has received approval for clinical trials targeting overweight or obesity [23][24] - ST Zhongzhu announces the transfer of 10.38% of its shares, totaling approximately 403 million yuan [25][26] - Shenzhou Digital plans to establish an employee stock ownership plan with a maximum fundraising of 360 million yuan [27][28] Group 7 - Kaichuang Electric plans to establish a joint research center with Tsinghua University, focusing on embodied intelligence [29] - Daming City intends to acquire 19.43% of Baicaibang for 694 million yuan, specializing in communication solutions [29]

Core Viewpoint - The company is planning to expand and upgrade its existing hospitals, focusing on enhancing operational capacity and quality through new construction and advanced medical equipment acquisition [1] Expansion and Upgrades - The company intends to implement the second phase of Nanjing Mingji Hospital's construction and acquire advanced medical equipment, as well as the third and fourth phases of Suzhou Mingji Hospital's construction [1] - The company aims to enhance its operational capabilities and quality through these expansions [1] Investment and Acquisition Opportunities - The company plans to identify suitable acquisition targets in China (e.g., Guigang City, Guangxi) and Southeast Asia (Vietnam and Malaysia), particularly targeting comprehensive hospitals with 200 to 500 beds, 100 to 200 medical professionals, and at least two key departments, especially in surgery and oncology [1] Smart Hospital Upgrades - The company plans to enhance its technical infrastructure by establishing local and cloud data storage servers, deploying 5G technology, and improving internal medical data transmission speed [1] - Investments will be made in technology research and development, focusing on advanced data security, privacy protection technologies, and artificial intelligence [1] - The establishment of a medical database and clinical decision support system is planned to facilitate quick information retrieval, optimize case discussions, and support clinical teaching and research [1] Financial Performance - In 2024, the company achieved a revenue of 2.659 billion yuan, a year-on-year decrease of 1.07%, and a net profit of 109 million yuan, down 34.95% [2] - For the first half of 2025, the company reported a revenue of 1.312 billion yuan, a decline of 1.34%, and a net profit of 48.704 million yuan, down 23.18% [3] - The operating cash flow for 2024 was 258 million yuan, a decrease of 27.92%, while for the first half of 2025, it was 80.129 million yuan, down 52.05% [2][3] Asset and Liability Changes - As of June 30, 2025, the company's fixed assets increased by 6.45%, while inventory decreased by 20.82% [16] - Long-term borrowings increased by 35.64%, and short-term borrowings rose by 10.83% [19]

Core Viewpoint - The Jiangsu province is implementing a series of reforms to enhance public hospitals' focus on public welfare, reduce patient burdens, and improve healthcare experiences through coordinated efforts in medical services, financing, and technology [1][2][3]. Group 1: Financial Investment and Support - Since the beginning of the "14th Five-Year Plan," Jiangsu has invested 230 billion yuan in public hospital services, with an annual increase of 9.6% in operational subsidies [1] - In 2023, the provincial government allocated an additional 12.5 billion yuan to ensure high-quality development of public hospitals [1] - In Yangzhou, 4.5 billion yuan has been allocated in 2023 for public hospital infrastructure, equipment, and talent development, with a projected 32.9% increase in fiscal subsidies for 2024 [1] Group 2: Human Resources and Compensation - Jiangsu has increased public hospital staffing by 49,000 positions, focusing on critical specialties such as pediatrics and infectious diseases [2] - The proportion of personnel expenses to business expenses in Nanjing's hospitals reached 38.3%, a 5.4 percentage point increase since 2021, with fixed salaries now accounting for 49.2% of total expenses, up 7.2 percentage points [2] - The reforms aim to stabilize key departments by improving compensation for specialists in high-demand areas [2] Group 3: Healthcare Accessibility and Technology - Jiangsu is enhancing healthcare accessibility through initiatives like "no companion wards" and "pre-admission" models, which reduce patient burdens and waiting times [2] - The province is deploying a health business collaboration platform to integrate resources across public medical institutions, aiming for full coverage by next year [3] - The development of AI tools, such as "AI personal health assistants" and "AI general practitioners," is underway to provide personalized healthcare services and support [3] Group 4: Community and Grassroots Healthcare - Jiangsu has implemented the "Health Talent Strengthening Project" for seven consecutive years, increasing the number of grassroots health workers to over 350,000 [4] - The establishment of 565 community hospitals and 200 rural health centers aims to provide specialized services at the grassroots level [4] - A consultation and referral service center in Yancheng connects 19 high-level hospitals with local public medical institutions, facilitating accessible healthcare for residents [5]

Financial Data and Key Metrics Changes - Year-to-date adjusted EBITDA increased by 30%, with a revised full-year guidance of $530 million to $555 million due to industry-wide cost pressures [4][17] - Revenue for the third quarter grew by 8.8% to $1.58 billion, or 11.7% excluding a one-time revenue adjustment [15][17] - Adjusted EBITDA for the third quarter rose by 46% to $143 million, with margins expanding by 240 basis points to 9.1% [7][15] Business Line Data and Key Metrics Changes - Admissions growth was 5.8% in the third quarter, with year-to-date admissions up 6.7% [6][14] - Adjusted admissions increased by 2.9%, consistent with the 2025 guidance range of 2-3% [7][14] - Inpatient surgery growth was 9.7% in the third quarter, while outpatient surgeries declined by 1.8% [14] Market Data and Key Metrics Changes - The company's markets are growing two to three times faster than the national average, supported by rising care complexity [6][23] - Strong demand across markets is expected to continue, providing a foundation for strategic growth [6][23] Company Strategy and Development Direction - The company is focused on optimizing costs and strengthening margins through its impact program, which includes contract renegotiations and staffing adjustments [10][11] - Strategic investments will continue to support long-term growth, with plans to open several urgent care and imaging centers in 2026 [21][22] - The company aims to enhance operational efficiencies in labor, supply chain, and revenue cycle management [11][12] Management's Comments on Operating Environment and Future Outlook - Management acknowledged persistent industry-wide cost pressures, particularly in professional fees and payer denials, impacting earnings more than anticipated [4][9] - Despite these challenges, management remains confident in the company's ability to deliver sustainable growth and long-term shareholder value [5][23] - The company is taking decisive actions to mitigate the impact of industry headwinds and strengthen performance [9][10] Other Important Information - The company recorded a $43 million revenue reduction due to a change in accounting estimate related to the transition to the Kodiak RCA net revenue platform [18] - An increase of $54 million in professional and general liability reserves was attributed to adverse claims development in the New Mexico market [19] Q&A Session Summary Question: What are the headwinds and tailwinds for 2026? - Management indicated that it is too early to provide definitive guidance for 2026 but noted strong durable demand and ongoing outpatient development [26][28] Question: Are there discussions about implementing a share repurchase program? - Management stated it would be premature to discuss a share repurchase program but emphasized a commitment to optimizing shareholder value [30] Question: What drove the increase in professional fees? - The increase in professional fees was attributed to pressures in anesthesia and radiology, with expectations for moderation in the future [58][60] Question: How widespread is the payer denial issue? - Payer denials have increased across managed care, Medicare, Medicaid, and health exchanges, prompting the company to ramp up appeals and litigation efforts [44][46] Question: How is the company addressing the elevated denial activity? - The company is focusing on improving contract terms and increasing the number of appeals filed, with a significant rise in demand letters sent to payers [46][48] Question: What is the status of contract negotiations for 2026? - Management reported that approximately three-quarters of contracts for 2026 have been negotiated, with a focus on improving yield under contracts [81]

Core Viewpoint - The article discusses a significant case of medical insurance fraud in Datong, Shanxi Province, where a hospital was involved in fraudulent activities to illegally obtain funds from the national medical insurance system, highlighting the serious implications for public trust and the integrity of the healthcare system [1][15]. Summary by Sections Fraud Methods - **Method 1: Increasing Fake Inpatients** The hospital recruited patients, offering referral fees to those who brought in new patients, thereby inflating the number of hospital admissions [2][3]. - **Method 2: Phantom Admissions** Some patients did not actually stay in the hospital but left their insurance cards with the hospital, which then fabricated medical records and treatment documents to claim reimbursements [3][4]. - **Method 3: Inflating Treatment Costs** The hospital manipulated treatment records to elevate costs to the maximum reimbursement limit, even for minor ailments, by adding unnecessary treatments and medications [7][9]. - **Method 4: Financial Fraud** The hospital engaged in financial misreporting by inflating the costs of medications and treatments, submitting false data to the insurance system to claim higher reimbursements than actual expenses [11][13][17]. Legal Consequences - The main perpetrator, Ai Mouzhong, was sentenced to 13 years and 6 months in prison, with fines imposed on him and other co-defendants, reflecting the severity of the fraud and its impact on the healthcare system [18].