The National Healthcare Security Administration (NHSA) has released its annual “Healthcare Security Development Statistical Bulletin” for 2022, revealing an overall break-even performance. By the end of 2022, the number of participants in the national Basic Medical Insurance (BMI) schemes reached 1.345 billion, a decrease of 17.27 million over the previous year, or 1.3% year-on-year (YOY). The rate of coverage remained stable at more than 95% of the population.<\/p>\n\n\n\n
BMI Scheme Participation<\/strong> Fund Income and Expenditures<\/strong> Inter-Provincial Direct Settlements<\/strong> Reimbursement and Procurement Reforms<\/strong> DRG\/DIP Implementation<\/strong>
A total of 362.42 million people participated in the employee BMI scheme (UEBMI), up 2.3% YOY. Meanwhile, 983.28 million people were covered by urban or rural resident BMI (URBMI) schemes, down 2.5% YOY.<\/p>\n\n\n\n
In terms of fund income and expenditures, the BMI funds (including maternity insurance) saw income of RMB 3.07 trillion (USD 440 billion) and outgoings of RMB 2.44 trillion (USD 350 billion). The accumulated balance at the end of the year was RMB 4.25 trillion (USD 610 billion). COVID-19 pandemic prevention and controls accounted for RMB 4.3 billion (USD 617.2 million) in spending on nucleic acid detection alone. From 2021 to 2022, more than RMB 150 billion (USD 21.5 billion) worth of COVID-19 vaccine expenses were settled.<\/p>\n\n\n\n
As of the end of 2022, there were 63,000 inter-provincial hospitalization expense settlements. A total of 89,000 designated medical institutions and 226,000 designated retail pharmacies also now offer inter-provincial outpatient expense settlements.<\/p>\n\n\n\n
Administrations at all levels have been ramping up National Reimbursement Drug List (NRDL) negotiations, DRG\/DIP payment reforms, and drug and medical consumables volume-based procurement (VBP). In 2022, a total of 2,967 drug varieties were covered by the NRDL, including 1,586 western medicines, 1,381 Chinese patent drugs, and 892 traditional Chinese medicines prepared in ready-to-use forms.<\/p>\n\n\n\n
A total of 206 coordinated regions have realized DRG\/DIP treatment and payment controls. Among the actual payment regions, designated medical institutions paying via DRG\/DIP stood at 52%, the coverage of disease types reached 78%, and the proportion of medical insurance fund expenditure settling via DRG\/DIP reached 77% within the DRG\/DIP overall planning area.<\/p>\n\n\n\n