According to news from the website of the National Medical Insurance Administration on the 10th, the "2022 National Medical Security Development Statistical Bulletin" (hereinafter referred to as the "Gazette") was released. List access negotiations, a total of 341 drugs were added to the list through negotiations, with an average price drop of more than 50%. In 2022, 180 million people will be reimbursed for 275 negotiated drugs during the agreement period. By negotiating price cuts and medical insurance reimbursement, the burden on patients has been reduced by more than 210 billion yuan during the year.
The "Gazette" shows that in terms of medical insurance, as of the end of 2022, the number of people participating in the national basic medical insurance (hereinafter referred to as basic medical insurance) is 1,345.92 million, and the insurance participation rate is stable at more than 95%. In 2022, the total income of the national basic medical insurance (including maternity insurance) fund will be 3,092.217 billion yuan, an increase of 7.6% over the previous year; the total expenditure of the national basic medical insurance (including maternity insurance) fund will be 2,459.724 billion yuan, an increase of 2.3% over the previous year; The current balance of basic medical insurance (including maternity insurance) funds is 632.493 billion yuan, and the accumulated balance is 4,263.989 billion yuan. Among them, the accumulated balance of personal accounts of employees' basic medical insurance (hereinafter referred to as employee medical insurance) is 1,371.265 billion yuan.
In terms of maternity insurance, in 2022, 246.21 million people across the country will participate in maternity insurance, an increase of 8.7 million or 3.7% over the previous year. 17.69 million person-times enjoyed various maternity insurance benefits, an increase of 4.48 million person-times or 34.0% over the previous year. In 2022, the maternity insurance fund expenditure will be 95.135 billion yuan.
In terms of medical assistance, in 2022, the national medical assistance expenditure will be 62.6 billion yuan, the medical assistance fund will subsidize 81.86 million people participating in basic medical insurance, and provide 118.29 million outpatient and inpatient assistance. The national average hospitalization assistance and outpatient assistance are 1226 respectively Yuan, 84 yuan. In 2022, the central government will allocate 31.1 billion yuan in medical assistance subsidies, an increase of 4% over the previous year. (Note: The number of participants funded by medical assistance does not include the number of participants funded by other departments.) In 2022, the participation rate of rural low-income population included in the monitoring scope will stabilize at more than 99%. Various medical insurance comprehensive support policies have benefited 145 million rural low-income people to seek medical treatment, reducing the burden of medical expenses on rural low-income population by 148.7 billion yuan.
In terms of the medical insurance drug catalog, the "National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalog (2022)" contains a total of 2,967 types of Western medicines and Chinese patent medicines, of which 1,586 are Western medicines and 1,381 are Chinese patent medicines. In 2022, 111 new drugs will be included in the adjustment. It also contains 892 kinds of decoction pieces of traditional Chinese medicine. Since the establishment of the National Medical Insurance Administration in 2018, it has carried out negotiations on the access to the medical insurance drug list for five consecutive years, and a total of 341 drugs have been added to the list through negotiations, with an average price drop of more than 50%. In 2022, 180 million people will be reimbursed for 275 negotiated drugs during the agreement period. By negotiating price cuts and medical insurance reimbursement, the burden on patients has been reduced by more than 210 billion yuan during the year.
According to the "Gazette", in terms of medical insurance payment reform, by the end of 2022, 30 national pilot cities and 71 regional point-based method total budgets and disease-based scores (DIP) will be implemented by the end of 2022. The pilot cities in the original country of payment are running smoothly. All localities took active actions to complete the goal of covering 40% of the coordinated areas in the three-year action plan for the DRG/DIP payment method reform. DRG/DIP actual payment has been realized in 206 coordinated regions across the country.
In terms of drug procurement, in 2022, the total amount of online procurement orders through provincial-level pharmaceutical centralized procurement platforms across the country will be 1,085.6 billion yuan, an increase of 51.6 billion yuan over 2021. Among them, western medicine (chemical medicine and biological products) is 881 billion yuan, and Chinese patent medicine is 204.6 billion yuan, an increase of 49.5 billion yuan and 2.1 billion yuan respectively compared with 2021. Drugs in the medical insurance catalog were 928.6 billion yuan, accounting for 85.5% of the total value of online procurement orders. In 2022, the seventh batch of state-organized centralized procurement of drugs will be carried out, involving 61 varieties, with an average price reduction of 48%. Guide the 4 provinces of Shanghai, Jiangsu, Henan, and Guangdong to take the lead in carrying out the continued procurement of the inter-provincial alliance after the agreement expires. Carry out the centralized procurement of high-value medical consumables for orthopedics and spine organized by the state, including 5 kinds of orthopedics consumables for spine, with an average decrease of 84%.
In terms of medical treatment in different places, in 2022, there will be 110.5 million outpatient and emergency outpatient visits, outpatient chronic special disease and inpatient medical treatment in other places, of which 72.99 million are medical insurance for employees and 37.51 million for residents. The national general outpatient and emergency department, outpatient chronic special disease and inpatient medical expenses in other places are 521.7 billion yuan, of which, the medical expenses for employees' medical insurance are 193.1 billion yuan, and the medical expenses for residents' medical insurance are 328.5 billion yuan. 8,758,700 people were hospitalized across provinces and places for medical treatment. The scope of direct settlement of inter-provincial and remote medical treatment has been further expanded. The number of designated medical institutions across provinces for inpatient and outpatient expenses has reached 62,700 and 88,700 respectively, and the number of designated retail pharmacies across provinces has reached 226,200, achieving at least one designated point in each county. Medical institutions can provide inter-provincial direct settlement services for medical expenses, including outpatient expenses. In 2022, 5.6879 million person-times of hospitalization expenses will be directly settled across provinces, reducing the advance payment of 76.233 billion yuan for the insured people; 32.4356 million person-times of outpatient expenses will be directly settled across provinces, reducing the advance payment of 4.685 billion yuan for the insured people.
In terms of medical insurance fund supervision and agreement management, in 2022, the national medical insurance system will inspect a total of 767,000 designated medical institutions and deal with 398,000 institutions that violated laws and regulations. 657; dealt with 39,253 insured persons, of which 5,489 were suspended from medical insurance card settlement, and 2,025 were handed over to judicial authorities. In 2022, a total of 18.84 billion yuan in medical insurance funds will be recovered. In 2022, the National Medical Insurance Administration organized 24 unannounced inspections, inspected 48 designated medical institutions and 23 medical insurance agencies in 23 provinces, and found 980 million yuan in funds suspected of violating laws and regulations. Among the inspected medical institutions, 13.87 billion yuan of funds were recovered through agreement processing, including 11.60 billion yuan of refusal and recovery of funds, and 1.89 billion yuan of liquidated damages were collected. The refusal or recovery of funds involved 142,000 designated medical institutions.
In terms of long-term care insurance, in 2022, a total of 169.902 million people will participate in long-term care insurance in 49 pilot cities, and 1.208 million people will enjoy benefits. In 2022, the fund income will be 24.08 billion yuan, and the fund expenditure will be 10.44 billion yuan. There are 7,679 designated service institutions for long-term care insurance, with 331,000 nursing service personnel.
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