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晶采观察·解码“十四五”丨便民又贴心!数字化赋能医保服务
Yang Guang Wang· 2025-07-28 01:55
Group 1 - The core viewpoint of the articles highlights the significant advancements in healthcare services through digitalization during the "14th Five-Year Plan" period, emphasizing the convenience and efficiency brought to the public [1][2][3] - As of June 2025, over 1.236 billion people in China are expected to have activated and be using the medical insurance code, facilitating direct settlement for medical services across various scenarios [1] - The introduction of the "drug price comparison" mini-program aims to help citizens find reasonably priced medications easily, enhancing consumer choice and transparency in drug pricing [2] Group 2 - The number of people utilizing cross-provincial medical insurance direct settlement has surged from 5.37 million in 2020 to 238 million in 2024, marking a 44-fold increase, with over 90% of hospitalization costs settled directly [2] - Digitalization in healthcare services is not only about efficiency but also about enhancing the warmth of service, as seen in the implementation of bilingual voice broadcasting in healthcare facilities in Pingxiang, Jiangxi, catering to the elderly [3] - The balance between efficiency and warmth in healthcare services is a key aspect of the digital transformation, aiming to ensure that every insured individual feels valued and recognized in the digital age [3]
“十四五”期间 跨省异地就医直接结算服务超5亿人次
Yang Shi Wang· 2025-07-24 03:37
Group 1 - The core viewpoint of the news is the introduction of reforms in the medical insurance system during the "14th Five-Year Plan" period, focusing on optimizing services to better meet the needs of the public [1][2][3] - The National Medical Insurance Bureau emphasizes the importance of using modern technologies such as big data, cloud computing, and artificial intelligence to create a unified and efficient medical insurance information platform [1] - The initiative includes the establishment of a five-level medical insurance service network, aiming to create a "15-minute medical insurance service circle" for citizens [1][2] Group 2 - The "standardized service" approach has led to the development of 23 coding standards and 37 technical specifications, streamlining the process for maternity benefits to be completed within 10 working days [2] - The "cross-regional service" has expanded direct settlement from hospitalization to outpatient services for chronic diseases, benefiting over 500 million people and reducing out-of-pocket expenses by over 550 billion yuan [2] - The "efficient service" includes a nationwide medical insurance platform with a response time in milliseconds, handling over 14.5 million daily settlements and enabling cross-province processing for high-frequency services [2]