China’s National Healthcare Security Administration (NHSA) has released its 2024 “Healthcare Security Development Statistical Bulletin.” The report reveals that by the end of 2024, over 1.33 billion people were enrolled in Basic Medical Insurance (BMI) schemes, maintaining a coverage rate of over 95%. Maternity insurance participation reached 252.98 million, an increase of 3.9 million from the previous year.
Financial Overview
The total income for BMI funds, including maternity insurance, reached RMB 3.481 trillion (USD 479.4 billion) in 2024, while expenditures amounted to RMB 2.9676 trillion (USD 408.7 billion). Maternity insurance fund benefits expenditure rose by 33.92% year-on-year to RMB 143.2 billion (USD 19.7 billion). The combined efforts of BMI, major illness insurance, and medical assistance provided healthcare access to 218.3 million low-income rural residents, reducing their medical cost burden by RMB 196.2 billion (USD 27 billion).
Inter-Provincial Settlements
By year-end, there were 644,000 inter-provincial networked designated pharmaceutical institutions, including 230,300 medical institutions and 413,700 retail pharmacies. Outpatient expenses settled across provinces for 143.4 million people, a 27.37% increase year-on-year, involving RMB 158.7 billion (USD 21.9 billion), up 17.43% YOY. Hospitalization expenses were directly settled for 224 million people, up 90.18% YOY, with RMB 36.1 billion (USD 5 billion) in related expenses settled, a 94.36% YOY increase.
Drug Reimbursement and Procurement
The 2024 NRDL added 91 new drugs, totaling 3,159 kinds of western medicine and traditional Chinese patent medicines. During the agreement period, 397 negotiated drugs were reimbursed for 280 million people. The tenth round of national volume-based procurement (VBP) covered 62 varieties, with cochlear implants and peripheral vascular scaffolds included in the fourth consumables VBP round. The total online procurement orders via provincial platforms reached RMB 996.2 billion (USD 136.2 billion), of which RMB 922.5 billion (USD 127 billion) were for NRDL drugs, accounting for 92.6% of all procurement.
Payment and Price Reforms
In 2024, all planning areas implemented DRG and DIP payments, with over 80% of inpatient funds in reformed regions using these methods. 116 coordinated regions launched DRG 2.0, and over 90% established special case negotiation mechanisms. In price reforms, 11 provinces initiated dynamic price adjustments, and 5 provinces conducted special price adjustments. The tenth national VBP round covered 62 drug varieties, with cochlear implants and peripheral vascular scaffolds included in the fourth consumables VBP round.
Fund Supervision
In 2024, RMB 27.5 billion (USD 3.8 billion) in medical insurance funds were recovered, with RMB 3.1 billion (USD 427 million) recovered through intelligent supervision. A total of 754 reported rewards were distributed, amounting to RMB 1.866 million (USD 257,000).-Fineline Info & Tech
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