The National Healthcare Security Administration (NHSA), Ministry of Finance (MOF), and State Taxation Administration (STA) jointly released a notification outlining 2022 work goals for urban employee and rural/residential Basic Medical Insurance (BMI) schemes, focusing on improving funding standards and expanding accessibility.
Funding Standards
- Per Capita Financing: Set at RMB 960 (USD 143).
- Resident Subsidy: Increased by RMB 30 (USD 4.47) to RMB 610 (USD 91) per person annually.
- Individual Contribution: Raised by RMB 30 (USD 4.47) to RMB 350 (USD 52.19) per person annually.
Household Registration Relaxation
The government will loosen restrictions on household registration, allowing out-of-province residents with a residence permit to access reimbursed healthcare and receive subsidies equivalent to local residents.
Inpatient and Outpatient Security
- Inpatient Treatment: Stabilize coverage, ensuring medical expense fund payments within the policy scope remain around 70%.
- Outpatient Measures: Expand coverage for hypertension, diabetes, chronic diseases, and critical illness insurance.
- Maternity Care: Improve resident medical insurance maternity expense treatment and ensure coverage for insured maternity medical expenses.
Payment Management
- NRDL Management: Strengthen oversight of the National Reimbursement Drug List (NRDL) and implement “dual-channel” drug management.
- Access Management: Regulate access for ethnic medicines, hospital preparations, and traditional Chinese medicine products.
- Payment Reform: Launch the “DRG/DIP Payment Method Three-Year Reform Plan” to advance outpatient and TCM payment reforms.
- Designated Management: Improve healthcare management for medical institutions and retail pharmacies.
Volume-Based Procurement (VBP) and Pricing
- National and Inter-Provincial VBPs: By end-2022, cumulative drug VBPs to reach 350, and high-value medical consumables to exceed 5.
- Platform Functionality: Enhance pharmaceutical procurement platform capabilities and strengthen performance evaluation.
- Pricing Reform: Promote pilot reforms for medical service pricing and implement a medical price monitoring project.
Fund Supervision
- Strengthen fund supervision and performance management.
- Crack down on insurance fraud.
- Advance unified drug use scope nationwide and improve cross-province service handling and direct settlement.-Fineline Info & Tech
