Medical insurance funds will be tilted toward primary healthcare institutions.

People’s Financial News, March 16 — The National Healthcare Security Administration, the National Development and Reform Commission, and the National Health Commission issued the “Guiding Opinions on Supporting the Development of Primary Healthcare Services” on March 16. The document clarifies that as the quality and efficiency of primary healthcare institutions improve, the proportion of medical insurance funds allocated to these institutions will gradually increase, and additional annual medical insurance funds may be appropriately tilted toward primary healthcare institutions.

In addition to medical insurance funds, the opinions also propose that inpatient reimbursement policies for basic medical insurance will favor primary healthcare institutions, and differentiated treatment policies will be improved based on local conditions. Regions can reasonably determine inpatient deductibles for primary healthcare institutions by considering fund support capacity, patient medical needs, and the capacity of primary healthcare services.

For insured patients who are referred step-by-step within the region from primary healthcare institutions to higher-level hospitals, the inpatient deductible at higher-level hospitals can be calculated continuously. Patients transferred from higher-level hospitals to primary healthcare institutions for the same disease within the same treatment cycle will no longer have a separate deductible.

The opinions also put forward specific measures in areas such as drug supply security, medical insurance services, and payment methods to promote the development of primary healthcare services. For example, in drug supply security, a linkage mechanism for medication use at county, township, and village levels will be improved, and restrictions on drug varieties and quantities at the township and village levels will be moderately relaxed. The construction of pharmacy centers within medical communities will be accelerated to ensure standardized prescription circulation and precise matching of medication needs. The scope of centralized procurement policies will be further expanded to include common and chronic disease medications for primary healthcare institutions.

The opinions also propose standardizing fund settlement processes, targeted measures to ease the capital turnover pressure on primary healthcare institutions, and encouraging regions with conditions to reduce the proportion of medical insurance service quality guarantees for primary healthcare institutions. (Xinhua News Agency)