As we all know, "health is the greatest asset". However, when the disease comes, medical insurance becomes a "protective umbrella" to protect our physical and mental health.
In recent years, the medical insurance policy, which carries the expectations of more than 1.3 billion insured people, has been evolving. Recently, the National Health Insurance Administration (NHSA) has delivered a series of encouraging medical insurance messages at a regular press conference, releasing a positive signal for the future development of the mainland's medical insurance system.
01
There is no so-called "surrender wave" in residents' medical insurance
The latest data as of the end of March 2024 shows that the number of domestic medical insurance participants is basically unchanged compared to 2023, contrary to the "surrender wave" reported by some media.
The number of participants in basic medical insurance for employees reached 371 million, and the number of participants in basic medical insurance for residents reached 963 million. The number of employees participating in medical insurance increased by 9 million, and the overall participation rate increased to 27.8%, indicating an improvement in the insurance participation structure.
At the same time, in 2023, about 80 million low-income people will receive financial support from the national health insurance agency, which reduces their financial burden.
The proportion of low-income residents in rural areas participating in medical insurance has remained stable at more than 99%, which has effectively protected the rights and interests of vulnerable groups in society and ensured that the effectiveness of "basic medical security" has been continuously strengthened.
02
The overall medical insurance fund remained stable, and the overall fund achieved a reasonable balance
According to public data from the National Medical Security Administration, in 2023, the cumulative balance of the medical insurance fund will reach 3.4 trillion yuan, including the cumulative balance of the employee medical insurance pooling fund of 2.6 trillion yuan, and the cumulative balance of the resident medical insurance pooling fund will exceed 760 billion yuan. This data is a strong indication that the fund's income exceeds its expenditure, and clearly sends a message: "The health insurance fund is very stable".
Such a generous medical insurance fund has undoubtedly laid a solid foundation for the continuous reform and improvement of the mainland's medical insurance system, and provided a strong financial guarantee for the medical needs of the majority of insured people.
03
In 2023, fund expenditures will increase restoratively
The annual increase in the expenditure of the medical insurance fund for employees and residents was 16.9% and 12.4%, indicating that the medical insurance coverage capacity has been enhanced, as well as the medical benefits of the insured groups have been better guaranteed, and the ability to make fund payments to designated medical institutions has been enhanced.
Medical insurance provides more adequate medical protection for the insured population, and the number of inpatient and outpatient settlements increased by 27% year-on-year to a total of 8.247 billion.
In addition, the scope of medical insurance has been further expanded, with 126 new drugs added to the medical insurance list, and 13 million inter-provincial medical insurance direct settlements have been realized, which has greatly facilitated the public's use of medical security services.
However, due to factors such as the aging of the population and the declining ratio of active to retired personnel, the rigid growth of medical expenditure will continue. From more than 980 billion yuan in 2006, the total health expenditure has increased to 8.5 trillion yuan in 2022, and the per capita health expenditure has also risen to 6,044 yuan.
These changes are caused not only by changes in demographic composition, but also by economic and social development and rising prices. Therefore, medical insurance institutions need to continue to promote the reform of the payment system, reasonably control the increase in medical expenses and hospitalization rates, and ensure the smooth operation of medical insurance funds.
04
In 2023, the direct settlement rate of inter-provincial hospitalization will exceed 80%
In 2023, the direct settlement of cross-provincial and non-local medical treatment has achieved remarkable results.
First of all, 550,400 medical institutions across the country have become designated hospitals through inter-provincial networking, a year-on-year increase of 68.37%.
Secondly, this year, the number of inter-provincial direct settlements for hospitalization nationwide exceeded 11,254,800, an increase of 5.57 million over the same period last year, an increase of nearly 100%.
In addition, the number of inter-provincial outpatient direct billing reached 118 million throughout the year, an increase of 85.42 million compared with last year, a growth rate of 263%.
Finally, the cross-provincial direct settlement of five outpatient chronic diseases, including diabetes and hypertension, was implemented, saving 3.352 billion yuan in advance payment.
This year, the NHSA also plans to increase the number of designated hospitals with inter-provincial network interconnection, and plans to include 3 to 5 outpatient chronic diseases in the scope of direct billing, so that more patients can enjoy the service of direct billing in other places.
Write at the end
The above are the 4 good news revealed by the press conference of the National Health Insurance Administration. Medical insurance, the "umbrella" that guards our health, is continuously optimized, and the service capacity is constantly improving, which more effectively protects the interests of the majority of insured people and gives us more peace of mind and hope!