China News Network, July 10 According to the news on the website of the National Medical Insurance Administration on the 10th, the "2022 National Medical Security Development Statistical Communiqué" (hereinafter referred to as the "Communiqué") was released, the data shows that since the establishment of the National Medical Insurance Administration in 2018, the medical insurance drug list access negotiations have been carried out for five consecutive years, and a total of 341 drugs have been added to the catalog through negotiation, with an average price reduction of more than 50%. In 2022, 180 million people will be reimbursed for 275 negotiated drugs during the agreement period. Through negotiation of price reductions and medical insurance reimbursements, the cumulative burden of patients was reduced by more than 210 billion yuan during the year.
According to the Communiqué, in terms of medical insurance, by the end of 2022, the number of participants in the national basic medical insurance (hereinafter referred to as basic medical insurance) was 134592 million, and the participation rate was stable at more than 95%. In 2022, the total income of the national basic medical insurance (including maternity insurance) fund will be 3.092217 billion yuan, an increase of 7.6% over the previous year; The total expenditure of the national basic medical insurance (including maternity insurance) fund was 2.459724 billion yuan, an increase of 2.3% over the previous year; The current balance of the national basic medical insurance (including maternity insurance) fund is 632.493 billion yuan, with a cumulative balance of 4.263989 billion yuan, of which the personal account of basic medical insurance for employees (hereinafter referred to as employee medical insurance) has a cumulative balance of 1.371265 billion yuan.
In terms of maternity insurance, in 2022, 246.21 million people will participate in maternity insurance nationwide, an increase of 8.7 million over the previous year, an increase of 3.7%. 17.69 million people enjoyed various maternity insurance benefits, an increase of 4.48 million over the previous year, an increase of 34.0% over the previous year, and the expenditure of the maternity insurance fund in 2022 was 95.135 billion yuan.
In terms of medical assistance, in 2022, the national medical assistance expenditure will be 62.6 billion yuan, the medical aid fund will subsidize 81.86 million people to participate in basic medical insurance, and implement 118.29 million outpatient and inpatient assistance, and the national average inpatient assistance and outpatient assistance will be 1226 yuan and 84 yuan respectively. In 2022, the central government will arrange medical aid subsidies of 31.1 billion yuan, an increase of 4% over the previous year. (Note: The number of participants subsidized by medical assistance does not include the number of participants subsidized by other departments.) In 2022, the participation rate of low-income rural people included in the monitoring scope nationwide will be stable at more than 99%. Various comprehensive medical insurance assistance policies have benefited 145 million low-income rural people seeking medical treatment, reducing the burden of medical expenses on rural low-income people by 148.7 billion yuan.
In terms of the catalogue of medical insurance drugs, the National Basic Medical Insurance, Work-related Injury Insurance and Maternity Insurance Drug Catalogue (2022) contains a total of 2,967 Western medicines and proprietary Chinese medicines, including 1,586 Western medicines and 1,381 proprietary Chinese medicines. In 2022, 111 drugs were newly included in the adjustment. In addition, it contains 892 kinds of Chinese medicine pieces. Since the establishment of the National Health Insurance Administration in 2018, it has carried out negotiations on the access of the medical insurance drug catalogue for five consecutive years, and a total of 341 drugs have been added to the list through negotiation, with an average price reduction of more than 50%. In 2022, 180 million people will be reimbursed for 275 negotiated drugs during the agreement period. Through negotiation of price reductions and medical insurance reimbursements, the cumulative burden of patients was reduced by more than 210 billion yuan during the year.
According to the Communiqué, in terms of medical insurance payment reform, by the end of 2022, 30 national pilot cities paying by disease diagnosis related group (DRG) and 71 regional point method total budgets and original national pilot cities paying by disease score (DIP) were running smoothly. All localities have taken active action to achieve the goal of covering 40% of the coordinated areas in the three-year action plan for DRG/DIP payment reform. 206 coordinated regions across the country have realized actual DRG/DIP payment.
In terms of drug procurement, in 2022, the total amount of online procurement orders through the provincial centralized pharmaceutical procurement platform will be 1,085.6 billion yuan, an increase of 51.6 billion yuan over 2021. Among them, Western medicines (chemical drugs and biological products) amounted to RMB881 billion and proprietary Chinese medicines amounted to RMB204.6 billion, an increase of RMB49.5 billion and RMB2.1 billion respectively over 2021. The drugs in the medical insurance catalogue amounted to 928.6 billion yuan, accounting for 85.5% of the total amount of online procurement orders. In 2022, the seventh batch of centralized procurement of state-organized drugs will be carried out, involving 61 varieties and an average price reduction of 48%. Guide the four provinces of Shanghai, Jiangsu, Henan and Guangdong to take the lead in carrying out the successive procurement of inter-provincial alliances after the expiration of the agreement. Carry out the national organization of orthopedic spine high-value medical consumables collection, and include 5 kinds of spine orthopedic consumables, with an average reduction of 84%.
In terms of long-distance medical treatment, in 2022, there will be 110.5 million general outpatient emergency treatment, outpatient chronic disease and hospitalization in different places nationwide, of which 72.99 million are treated in different places under employee medical insurance and 37.51 million are treated in different places under resident medical insurance. The national general outpatient emergency, outpatient chronic disease and hospitalization long-distance medical expenses were 521.7 billion yuan, of which 193.1 billion yuan were spent on employee medical insurance and 328.5 billion yuan were spent on residents' medical insurance. 8,758,700 people were hospitalized across provinces. The scope of direct settlement of medical treatment across provinces has been further expanded, with 62,700 and 88,700 designated medical institutions connected to inpatient and outpatient expenses respectively, and the number of designated retail pharmacies connected across provinces reaching 226,200, realizing that at least one designated medical institution in each county can provide cross-provincial direct settlement services for medical expenses, including outpatient expenses. In 2022, 5,687,900 inpatient expenses will be directly settled across provinces, reducing the advance payment of 76.233 billion yuan for the insured people, and 32,435,600 outpatient expenses will be directly settled across provinces, reducing the advance payment for the insured people by 4.685 billion yuan.
In terms of medical insurance fund supervision and agreement management, in 2022, the national medical insurance system inspected a total of 767,000 designated medical institutions and dealt with 398,000 institutions that violated laws and regulations, including 3,189 medical insurance service agreements, 12,029 administrative penalties, and 657 transferred to judicial organs; 39,253 insured persons were handled, of which 5,489 were suspended from medical insurance card settlement and 2,025 were transferred to judicial organs. In 2022, a total of 18.84 billion yuan of medical insurance funds were recovered. In 2022, the National Health Insurance Administration organized 24 flight inspections, inspected 48 designated medical institutions and 23 medical insurance handling institutions in 23 provinces, and found 980 million yuan of suspected illegal funds. Among the inspected medical institutions, RMB13.87 billion was recovered through agreements, of which RMB11.60 billion were refused to be paid and recovered, RMB1.89 billion was liquidated damages, and 142,000 designated medical institutions were involved in refusal or recovery.
In terms of long-term care insurance, in 2022, a total of 169.902 million people participated in long-term care insurance in 49 pilot cities, and 1.208 million people enjoyed treatment. In 2022, the fund income will be 24.08 billion yuan, and the fund expenditure will be 10.44 billion yuan. There are 7,679 designated service institutions for long-term care insurance, with 331,000 nursing service personnel.
Source: China News Network
Release: Integrity and Rule of Law Media Center
Audit: Disciplinary Culture
Edit: Sunshine