The National Healthcare Security Administration (NHSA) has published its annual “Healthcare Security Development Statistical Bulletin” for 2023, revealing significant developments in China’s Basic Medical Insurance (BMI) landscape. By the end of 2023, participation in various BMI schemes reached 1.33 billion, maintaining a coverage rate of over 95%. Specifically, 370.94 million employees and 962.9 million urban and rural residents were enrolled, while maternity insurance participation rose by 3 million to 249.07 million.
In terms of financials, the BMI fund, including maternity insurance, recorded total income of RMB 3,335.52 billion (USD 460.7 billion) against expenditures of RMB 2,814.03 billion (USD 388.73 billion). Notably, maternity insurance benefits increased by 12.38% year-on-year, amounting to RMB 106.91 billion (USD 14.77 billion). The combined impact of BMI, major illness insurance, and medical assistance supported 186.5 million low-income rural residents, alleviating medical expenses by RMB 188.35 billion (USD 26.01 billion).
On the inter-provincial front, there were 550,040 designated medical institutions by year-end, facilitating outpatient expense settlements for 118 million people—up 2.6 times year-on-year—totaling RMB 18.548 billion, a 2.96-fold increase. Hospitalization expenses were settled for 11.25 million individuals, reflecting a 98% increase year-on-year, with total fund settlements reaching RMB 135.166 billion, up 77%.
The new National Reimbursement Drug List (NRDL) added 126 drugs, bringing the total to 3,088, including 1,698 western medicines and 1,390 traditional Chinese medicines. Throughout the year, 346 negotiated drugs were reimbursed, benefiting 240 million individuals.
Payment reforms gained traction, with over 90% of planning areas implementing Diagnosis-Related Group (DRG) and Disease Intervention Payment (DIP) systems, which accounted for over 70% of inpatient medical insurance funds in reformed areas. In 101 pilot cities, the personal financial burden on insured individuals decreased by approximately RMB 21.5 billion compared to 2021.
Additionally, price adjustments were made in 28 provinces, addressing over 40% of inflated prices across 30 drug varieties. The eighth and ninth rounds of national volume-based procurement (VBP) encompassed 80 varieties, while online procurement orders through provincial platforms reached RMB 1,279.3 billion, an increase of RMB 217.8 billion from 2022. Notably, online drug procurement orders within the NRDL accounted for 90% of total orders, reflecting a 3.5 percentage point increase since 2020.- Flcube.com
