The Poster News APP:

Sanming city's medical reform program has emerged as an important model for national medical reform, providing valuable insights for further improvements. Could you please outline the main approaches and results of implementing Sanming's medical reform model in the medical insurance sector? Thank you.

Zhang Ke: 

Thank you for your question. I'll answer it. The NHSA has consistently implemented the CPC Central Committee and the State Council's decisions and plans on promoting Sanming's medical reform experience. We've vigorously advanced its institutional achievements, incorporating its pioneering, innovative and locally adaptive spirit into all aspects of medical insurance work. First, I'd like to report that the NHSA's establishment itself reflects the implementation of Sanming's reform experience. Previously, we didn't have an independent medical insurance bureau. It was due to Sanming's successful model that the CPC Central Committee decided to establish dedicated health care security administrations at all levels nationwide. We are now stepping up efforts to advance the following reforms.

First, we're conducting centralized bulk procurement for drugs and medical supplies in a solid way. Drawing on Sanming's approach to cutting off improper interests in the pharmaceutical supply chain, the NHSA has actively promoted reforms in drug bidding and procurement systems. We've established a routine, standardized process for centralized bulk procurement. Nationally, we've organized nine batches of drug procurement and four batches of high-value medical supplies procurement. Provinces are also conducting centralized procurement either independently or in alliances. This has significantly reduced prices of commonly used drugs and medical supplies, creating favorable conditions for supply-side reform in medical services.

Second, we're gradually improving the medical service pricing mechanism. Driven by centralized procurement, we've achieved a more profound and higher-quality structural reform of medical services. The savings from centralized procurement are first used to deliver reform benefits to the public. They also create space for new drugs and diagnostic procedures that reflect new quality productive forces to enter clinical application, and create conditions for adjusting medical service prices. Since 2021, we've guided provinces to dynamically adjust medical service prices, conducted pilot reforms, and explored new pricing mechanisms that align with economic and social development, better reflect the government's role, ensure full participation of medical institutions, and reasonably represent the value of technical services. Since the reform, prices for technical procedures like surgeries and traditional Chinese medicine have increased in an orderly manner, while prices for exams and tests like CT scans have decreased reasonably. The pace of price adjustments matches economic and social development.

Third, we're continuously promoting efficient payment mechanisms. We've implemented a three-year action plan for payment reform, fostering a multi-component payment system primarily based on diagnosis-related groups (DRG). By the end of 2023, over 90% of coordinated areas nationwide had adopted DRG/DIP payment reforms. Results from the 2022 national performance evaluations of tertiary public hospitals showed a 0.7 percentage point increase in the proportion of revenue from medical services compared to the previous year.

To further implement General Secretary Xi Jinping's important instructions on Sanming's medical reform model and to further promote these experiences in the national medical insurance sector, the NHSA issued a notice in May of this year to further promote Sanming's medical reform experience and continuously advance innovation in medical insurance work. It requires local authorities to deeply understand the essence of Sanming's reforms and calls for exploring original and differentiated reform measures suited to local conditions and deepening the establishment of a multi-tiered medical security system. Following the document's release, local authorities have actively implemented these requirements. Some provinces have further detailed their own implementation plans based on the national document. For example, Guangxi Zhuang autonomous region has specifically developed task lists, measure lists, and responsibility lists for promoting Sanming's medical reform experience and advancing innovation in medical insurance work.

Next, the NHSA will guide the health care security departments at all levels to resolutely apply the important instructions of General Secretary Xi Jinping, take actions in line with local conditions, deepen the health care insurance reform, continuously enhance policies, management and services, foster greater synergy between the medical insurance system, medical treatment and medications, and deepen their reform and development while continuously improving health care insurance management services, so as to give our people a growing sense of fulfillment, happiness and security. Thank you.