Director of the National Healthcare Security Administration, Zhang Ke: "Strengthening a multi-level medical security system to establish a solid bottom-line for people's livelihood security."

Question: The "Suggestions" put forward the need to improve the multi-level medical security system, promote provincial level coordination of basic medical insurance, optimize drug procurement, medical insurance payment, and surplus fund utilization policies. How will this be implemented in the future? During the "14th Five-Year Plan" period, the National Healthcare Security Administration will promote the formation of a comprehensive security pattern with clear boundaries, mutual complementarity, and coordinated functions for various security systems. Improve the national unified medical insurance information platform, build basic service facilities with the core elements of health data for the entire population, and provide basic and strategic support for the construction of a multi-level medical security system. At the same time, enhance the security functions of basic medical insurance, catastrophic insurance, medical assistance, etc., support and guide the orderly development and continuous growth of commercial health insurance, charity, labor unions, and other sectors. Regarding the promotion of provincial level coordination of basic medical insurance, currently, 20 provinces nationwide are promoting provincial level coordination. To further advance this work, the National Healthcare Security Administration, in conjunction with relevant departments, is researching and drafting documents to promote provincial level coordination of basic medical insurance, proposing standardization of funding and treatment policies, prudently handling the transition and connection of security levels, establishing a sound fund coordination mechanism, reasonably determining the fund management model for provincial level coordination, allowing provinces with conditions to implement overall fund pooling and allocation, while other provinces can implement fund transfers, primarily based on pre-allocation of fund income. In terms of designated allocation of medical resources, we will guide pilot regions to optimize the layout of designated medical institutions according to local conditions, continuously improve resource allocation, and make the structure more scientific. In April 2025, 54 pilot regions will be selected nationwide to carry out trials and develop experience and practices that can be replicated and promoted. By 2026, the pilot work will be fully expanded based on the situation of the pilot work. In terms of improving medical insurance payment policies, during the "14th Five-Year Plan," we will continue to deepen the reform of payment methods, strengthen total budget management, improve the calculation of core elements of disease payment, determine medical insurance payment standards reasonably, implement effective incentives for retaining surpluses, and more effectively support the standardized management and efficient service of medical institutions. In terms of expanding the coverage and effectiveness of immediate settlement reform, during the "14th Five-Year Plan" period, the National Healthcare Security Administration will continue to adopt multiple measures, continuously expand the coverage of immediate settlement funds and medical institutions, empower high-quality development of medical institutions. Accelerate fund settlement, increase prepayment to designated medical institutions, promote "one code payment," "mobile payment," and "credit payment" for insured patients seeking medical treatment. In terms of continuing to optimize drug procurement, the National Healthcare Security Administration will promote the institutionalization and standardization of procurement work on a regular basis, effectively improve the level of national and local organized drug procurement. Accelerate direct settlement between medical insurance and pharmaceutical companies, promote the inclusion of procured drugs in grassroots medical institutions, private medical institutions, and retail pharmacies. Continuously optimize procurement measures, focus more on clinical needs, quality, and supply guarantee, making the public feel more confident and reassured about their medication.