By Fineline Cube 
The first blue book on the reform of China’s medical insurance payment methods, titled “Report on the Reform and Development of China’s Medical Insurance Payment Methods (2023-2024),” was officially released last week. Developed by China Health Insurance magazine and published by Social Sciences Academic Press, the report highlights significant progress in the reform of medical insurance payment methods. It indicates that Diagnosis Related Groups (DRG) and Diagnosis-Intervention Packet (DIP) payment models have essentially achieved nationwide coverage.
Current Status of Reform
Among China’s 393 coordinated regions, 191 have implemented DRG payment models, while 200 regions have adopted the DIP system. Tianjin and Shanghai have implemented both models. This has ensured nationwide coverage across all coordinated regions and full inclusion of eligible medical institutions, achieving 95% disease coverage and 80% medical insurance fund coverage.
Challenges and Future Directions
Despite these achievements, the reform faces three major challenges: balancing cost containment with payment system management, improving overall reform quality, and enhancing multi-stakeholder collaboration to strengthen reform synergies. Future measures will focus on improving quality and efficiency through the coordinated development of diverse payment systems, accelerating the establishment of supporting regulatory mechanisms, strengthening inter-departmental coordination, and advancing data-driven and intelligent management capabilities to deepen the medical insurance payment reform.-Fineline Info & Tech