The National Healthcare Security Administration (NHSA) has released its comprehensive annual statistical report for the national medical and healthcare development in 2023. The report highlights that the Basic Medical Insurance (BMI) fund recorded an income of RMB 3.35 trillion, with expenditures amounting to RMB 2.82 trillion over the year.
In terms of medical insurance payments, the NHSA facilitated 2.53 billion person visits under the employee-focused scheme in 2022, marking a 20.25% year-on-year increase. This included 2.18 billion visits to regular outpatient and emergency departments, 270 million outpatient visits for chronic or special diseases, and 80 million hospitalizations. Pharmacy drug purchases reached 2.3 billion person/times, with 240 million person/times receiving reimbursements for negotiated drugs, resulting in over RMB 230 billion in savings for patients.
The maternity insurance security function saw a significant rise, with 28.34 million person/times benefiting from various maternity insurance benefits, a 60.2% year-on-year increase. The maternity insurance fund’s expenditure was recorded at RMB 117.723 billion.
Regarding the implementation of DRG/DIP, by the end of 2023, 190 DRG cities and 192 DIP cities were operating effectively, with Tianjin and Shanghai notable for running both DRG and DIP in parallel. A total of 384 coordinated areas have implemented live DRG/DIP payments.
In drug and consumables procurement, the 8th and 9th rounds of volume-based procurement (VBP) were conducted, covering 80 drugs with an average price reduction of 57%. The 4th round of VBP for artificial lenses and sports medicine consumables saw an average price cut of 70%. To date, nine rounds of drug VBP have been completed, covering 374 drugs, and four rounds of high-value medical consumables, including coronary stents, artificial joints, orthopedic spinal consumables, and artificial lenses and sports medicine consumables.
Medical price governance initiatives in 2023 included the launch of online drug price governance, with 275 instances of enterprises being urged to correct abnormal high prices. Talks were held with 23 pharmaceutical companies involving 30 drug varieties, leading to an average price reduction exceeding 40%. The pilot reform of medical service prices progressed orderly, with five pilot cities guided to conduct the first round of price adjustments and 28 provinces carrying out price adjustments. Each province added over 1900 new medical service price items throughout the year.
In fund security, the NHSA conducted 34 flying inspections and inspected 66 designated medical institutions and 32 medical insurance agencies across 23 provinces, identifying suspected irregular use of funding amounting to RMB 920 million. Through agreement processing, RMB 18.65 billion was recovered from inspected pharmaceutical institutions. A total of 451,000 designated pharmaceutical institutions were involved in the refusal or recovery of funds, out of 802,000 institutions inspected.
The long-term care pilot program saw 183.3087 million people participating in long-term care insurance across 49 pilot cities, with 1.3429 million people enjoying benefits. In 2023, the fund revenue was RMB 24.363 billion, and the fund expenditure was RMB 11.856 billion. There were 8,080 designated service institutions for long-term care insurance, staffed by 302,800 nursing service personnel.- Flcube.com
