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39 2020，，、、、，、，，，，，“”，“”，，，。
、
（）
2020，136100[1]，95%。34423，1498，4.
6%；，25398，9025，1174324。101677，806，0.
8%。
6%；，25398，9025，1174324。101677，806，0.
8%。
（）
The total income and total expenditures of the basic medical insurance fund (including maternity insurance) for the year were 2.
463861 billion yuan and 2.
094926 billion yuan, respectively.
The accumulated balance of basic medical insurance (including maternity insurance) at the end of the year was 3.
137338 billion yuan [2].
463861 billion yuan and 2.
094926 billion yuan, respectively.
The accumulated balance of basic medical insurance (including maternity insurance) at the end of the year was 3.
137338 billion yuan [2].
The income from the basic medical insurance fund (including maternity insurance) for employees in the whole year was 1,562.
461 billion yuan, a year-on-year decrease of 1.
4% [3]; of which, the collected income (including maternity insurance) was 1,479.
647 billion yuan.
Funds (including maternity insurance) expenditures were 1.
283399 billion yuan, a year-on-year increase of 1.
3%.
The employee basic medical insurance fund (including maternity insurance) had a total balance of 2,532.
351 billion yuan at the end of the year, of which the total balance of the overall planning fund was 1,539.
656 billion yuan, and the cumulative balance of personal accounts was 992.
695 billion yuan[4].
461 billion yuan, a year-on-year decrease of 1.
4% [3]; of which, the collected income (including maternity insurance) was 1,479.
647 billion yuan.
Funds (including maternity insurance) expenditures were 1.
283399 billion yuan, a year-on-year increase of 1.
3%.
The employee basic medical insurance fund (including maternity insurance) had a total balance of 2,532.
351 billion yuan at the end of the year, of which the total balance of the overall planning fund was 1,539.
656 billion yuan, and the cumulative balance of personal accounts was 992.
695 billion yuan[4].
The income of the basic medical insurance fund for urban and rural residents was 901.
401 billion yuan, a year-on-year increase of 5.
1%; expenditures were 811.
527 billion yuan, a year-on-year decrease of 0.
9%.
The accumulated balance at the end of the year was 604.
988 billion yuan.
401 billion yuan, a year-on-year increase of 5.
1%; expenditures were 811.
527 billion yuan, a year-on-year decrease of 0.
9%.
The accumulated balance at the end of the year was 604.
988 billion yuan.
2.
Maternity Insurance
Maternity Insurance
The number of people participating in maternity insurance throughout the year was 235.
46 million, an increase of 21.
29 million over the end of last year, an increase of 9.
9%.
The maternity insurance treatment expenditure was 90.
275 billion yuan, a year-on-year increase of 1.
8%.
46 million, an increase of 21.
29 million over the end of last year, an increase of 9.
9%.
The maternity insurance treatment expenditure was 90.
275 billion yuan, a year-on-year increase of 1.
8%.
3.
Poverty alleviation through medical insurance
Poverty alleviation through medical insurance
In order to decisively win the battle against poverty with medical security, in 2020, a total of 78.
372 million poor people (including dynamic transfers) will be funded to participate in basic medical insurance, 14.
02 billion yuan will be subsidized, and the per capita subsidy will be 178.
9 yuan.
The participation rate has stabilized above 99.
9%.
Various medical insurance and poverty alleviation policies have benefited 180 million people from poor people in total, reducing the burden of medical expenses on the poor by 118.
83 billion yuan.
372 million poor people (including dynamic transfers) will be funded to participate in basic medical insurance, 14.
02 billion yuan will be subsidized, and the per capita subsidy will be 178.
9 yuan.
The participation rate has stabilized above 99.
9%.
Various medical insurance and poverty alleviation policies have benefited 180 million people from poor people in total, reducing the burden of medical expenses on the poor by 118.
83 billion yuan.
In 2020, the central government will invest 26 billion yuan in medical assistance subsidies, an increase of 6% over last year, and another 4 billion yuan will be allocated to improve the medical security level of the rural poor in deeply impoverished areas such as the "three districts and three states", and 1.
5 billion will be allocated Yuan special transfer payment for medical assistance subsidy funds.
5 billion will be allocated Yuan special transfer payment for medical assistance subsidy funds.
4.
List of medical insurance drugs
List of medical insurance drugs
After the 2020 National Medical Insurance Drug List was adjusted, a total of 119 new drugs were added to the list, and 29 drugs in the original list were removed from the list.
The adjusted "National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalog (2020)" contains a total of 2,800 drugs, of which 1,426 are Western medicines and 1,374 are Chinese patent medicines.
The number of Chinese herbal medicines in the catalog has not been adjusted, and there are still 892 types.
The adjusted "National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalog (2020)" contains a total of 2,800 drugs, of which 1,426 are Western medicines and 1,374 are Chinese patent medicines.
The number of Chinese herbal medicines in the catalog has not been adjusted, and there are still 892 types.
Five, drug pharmnet.
com.
cn/news/yyzb/" target="_blank">procurement
com.
cn/news/yyzb/" target="_blank">procurement
In 2020, the total amount of online procurement orders nationwide through the provincial centralized drug procurement platform is estimated to be 931.
2 billion yuan, a decrease of 60.
1 billion yuan from 2019.
Among them, western medicine (chemical drugs and biological products) was 752.
1 billion yuan, and Chinese patent medicine was 179.
1 billion yuan, a decrease of 59.
4 billion yuan and 700 million yuan respectively from 2019.
The drugs in the medical insurance catalog accounted for 86.
5% of the total online procurement orders, and the amount was 805.
2 billion yuan.
2 billion yuan, a decrease of 60.
1 billion yuan from 2019.
Among them, western medicine (chemical drugs and biological products) was 752.
1 billion yuan, and Chinese patent medicine was 179.
1 billion yuan, a decrease of 59.
4 billion yuan and 700 million yuan respectively from 2019.
The drugs in the medical insurance catalog accounted for 86.
5% of the total online procurement orders, and the amount was 805.
2 billion yuan.
In 2020, the state organizes centralized procurement of the second and third batches of drugs, covering a total of 87 varieties, and the average price of selected products is reduced by 53%; the state organizes centralized procurement of coronary stents with an average price of 13,000 The yuan dropped to about 700 yuan.
At the same time, various provinces generally carry out centralized procurement of medicines and medical consumables in an independent or alliance manner, involving 229 kinds of medicines and 19 types of medical consumables.
At the same time, various provinces generally carry out centralized procurement of medicines and medical consumables in an independent or alliance manner, involving 229 kinds of medicines and 19 types of medical consumables.
6.
Medical insurance payment reform
Medical insurance payment reform
Continue to promote the reform of payment methods, and carry out DRG[5] paid national pilot work in 30 cities.
All 30 pilot cities have passed the pre-simulation evaluation and entered the simulation operation stage; in the mid-term, the total budget for 71 cities to implement the regional point method was determined And DIP[6] paid pilot work.
All 30 pilot cities have passed the pre-simulation evaluation and entered the simulation operation stage; in the mid-term, the total budget for 71 cities to implement the regional point method was determined And DIP[6] paid pilot work.
Seven, direct settlement of medical treatment in different places across provinces
As of the end of 2020, the number of designated medical institutions for direct settlement of hospitalization expenses across the provinces was 44,400, an increase of 16,800 or 60.
87% from the end of 2019.
The national platform directly settled 7,248,300 person-times, involving total medical expenses of 175.
9 billion yuan, and the medical insurance fund paid 103.
84 billion yuan.
87% from the end of 2019.
The national platform directly settled 7,248,300 person-times, involving total medical expenses of 175.
9 billion yuan, and the medical insurance fund paid 103.
84 billion yuan.
The pilot work of direct settlement of outpatient expenses was progressed steadily.
12 pilot provinces including Beijing-Tianjin-Hebei, Yangtze River Delta and 5 provinces (autonomous regions and municipalities) in southwest China opened 10,200 networked designated medical institutions and 11,800 networked designated pharmacies , and outpatient expenses cross-provincial A total of 3.
02 million person-times were directly settled, involving total medical expenses of 746 million yuan, and the medical insurance fund paid 429 million yuan.
12 pilot provinces including Beijing-Tianjin-Hebei, Yangtze River Delta and 5 provinces (autonomous regions and municipalities) in southwest China opened 10,200 networked designated medical institutions and 11,800 networked designated pharmacies , and outpatient expenses cross-provincial A total of 3.
02 million person-times were directly settled, involving total medical expenses of 746 million yuan, and the medical insurance fund paid 429 million yuan.
8.
Medical Security Fund Supervision
Medical Security Fund Supervision
Jointly launched a special campaign against fraudulent acquisition of medical security funds with relevant departments.
A total of 627,400 designated medical institutions were inspected , and 400,700 institutions that violated laws and regulations were investigated and dealt with.
Among them, 6,008 medical insurance agreements were lifted, 5,457 were administrative fines, and 286 were transferred to judicial organs.
.
A total of 26,100 people insured were investigated and dealt with, 3162 people were suspended from settlement of medical insurance cards, and 2062 people were transferred to judicial organs.
During the implementation of the special treatment in 2020, a total of 22.
311 billion yuan of medical insurance funds were recovered.
A total of 627,400 designated medical institutions were inspected , and 400,700 institutions that violated laws and regulations were investigated and dealt with.
Among them, 6,008 medical insurance agreements were lifted, 5,457 were administrative fines, and 286 were transferred to judicial organs.
.
A total of 26,100 people insured were investigated and dealt with, 3162 people were suspended from settlement of medical insurance cards, and 2062 people were transferred to judicial organs.
During the implementation of the special treatment in 2020, a total of 22.
311 billion yuan of medical insurance funds were recovered.
9.
Epidemic prevention and control, tax reduction and postponement
Epidemic prevention and control, tax reduction and postponement
In order to reduce the burden on enterprises and support the resumption of work and production, the payment of employee medical insurance units was halved in stages.
From February to July, 9.
75 million insured units were reduced by a total of 164.
9 billion yuan, of which more than 150 billion yuan was reduced for enterprises.
In order to do a good job in the prevention and control of the epidemic, local medical insurance departments allocated 19.
4 billion yuan in special funds to designated hospitals for patients with new coronary pneumonia.
The total settlement of medical expenses for patients with new coronary pneumonia throughout the year was 2.
84 billion yuan, of which the medical insurance fund paid 1.
63 billion yuan.
From February to July, 9.
75 million insured units were reduced by a total of 164.
9 billion yuan, of which more than 150 billion yuan was reduced for enterprises.
In order to do a good job in the prevention and control of the epidemic, local medical insurance departments allocated 19.
4 billion yuan in special funds to designated hospitals for patients with new coronary pneumonia.
The total settlement of medical expenses for patients with new coronary pneumonia throughout the year was 2.
84 billion yuan, of which the medical insurance fund paid 1.
63 billion yuan.
Notes:
[1] All relevant data are summarized in the statistical bulletin reported by provinces and cities from January to December 2020.
Part of the data is rounded, and the total is slightly different from the sub-item total.
Part of the data is rounded, and the total is slightly different from the sub-item total.
[2] The cumulative balance of the fund is expressed in time points.
Affected by factors such as policies, the opening balance of 2020 will be fine-tuned, the same below.
Affected by factors such as policies, the opening balance of 2020 will be fine-tuned, the same below.
[3] Affected by the periodic halving of employee medical insurance unit contributions, employee medical insurance income fell year-on-year.
[4] The cumulative balance of personal accounts is the cumulative amount of personal account balances as of the end of 2020 since the establishment of the basic medical insurance system for employees.
[5] Pay according to the group related to the disease diagnosis.
[6] Pay according to the score of disease combination.
Main indicators of National Medical Insurance Express in 2020
(January-December 2020)
*Note: According to the "Opinions of the General Office of the State Council on Comprehensively Promoting the Implementation of the Combined Implementation of Maternity Insurance and Basic Medical Insurance for Employees" (Guobanfa [2019] No.
10), the income of maternity insurance funds is no longer listed separately, and the benefits of the basic medical insurance for employees are pooled.
Expenditures set up maternity treatment expenditure items.
The income and expenditure of the basic employee medical insurance fund in this table includes maternity insurance.
10), the income of maternity insurance funds is no longer listed separately, and the benefits of the basic medical insurance for employees are pooled.
Expenditures set up maternity treatment expenditure items.
The income and expenditure of the basic employee medical insurance fund in this table includes maternity insurance.
Medical Network, March 9th, in 2020, the national medical security system adheres to the guidance of Xi Jinping’s new era of socialism with Chinese characteristics, and fully implements the 19th National Congress of the Communist Party of China and the 19th National Congress of the Second, Third, Fourth and Fifth Plenary Sessions Spirit, in accordance with the decisions and deployment of the Party Central Committee and the State Council, adhere to the people-centered, forge ahead, overcome difficulties, coordinate epidemic prevention and control and high-quality development of medical insurance, do a solid job of "six stability", and fully implement the "six guarantees" task.
The medical security system is operating smoothly, the fund is safe and sustainable, and the reform and development of medical security has achieved remarkable results.
The medical security system is operating smoothly, the fund is safe and sustainable, and the reform and development of medical security has achieved remarkable results.
1.
Basic medical insurance
Basic medical insurance
(1) Participants
As of the end of 2020, the number of people participating in full-caliber basic medical insurance has reached 1,361 million[1], and the insurance coverage has stabilized at more than 95%.
Among them, 344.
23 million people participated in basic medical insurance for employees, an increase of 14.
98 million or 4.
6% over the same period of the previous year.
Among the people participating in basic medical insurance for employees, 253.
98 million employees and 90.
25 million retired employees increased from the end of the previous year.
11.
74 million and 3.
24 million.
The number of people participating in basic medical insurance for urban and rural residents was 1,06.
77 million, a decrease of 8.
06 million or 0.
8% from the previous year.
Among them, 344.
23 million people participated in basic medical insurance for employees, an increase of 14.
98 million or 4.
6% over the same period of the previous year.
Among the people participating in basic medical insurance for employees, 253.
98 million employees and 90.
25 million retired employees increased from the end of the previous year.
11.
74 million and 3.
24 million.
The number of people participating in basic medical insurance for urban and rural residents was 1,06.
77 million, a decrease of 8.
06 million or 0.
8% from the previous year.
(2) Fund income and expenditure
The total income and total expenditures of the basic medical insurance fund (including maternity insurance) for the year were 2.
463861 billion yuan and 2.
094926 billion yuan, respectively.
The accumulated balance of basic medical insurance (including maternity insurance) at the end of the year was 3.
137338 billion yuan [2].
463861 billion yuan and 2.
094926 billion yuan, respectively.
The accumulated balance of basic medical insurance (including maternity insurance) at the end of the year was 3.
137338 billion yuan [2].
The income from the basic medical insurance fund (including maternity insurance) for employees in the whole year was 1,562.
461 billion yuan, a year-on-year decrease of 1.
4% [3]; of which, the collected income (including maternity insurance) was 1,479.
647 billion yuan.
Funds (including maternity insurance) expenditures were 1.
283399 billion yuan, a year-on-year increase of 1.
3%.
The employee basic medical insurance fund (including maternity insurance) had a total balance of 2,532.
351 billion yuan at the end of the year, of which the total balance of the overall planning fund was 1,539.
656 billion yuan, and the cumulative balance of personal accounts was 992.
695 billion yuan[4].
461 billion yuan, a year-on-year decrease of 1.
4% [3]; of which, the collected income (including maternity insurance) was 1,479.
647 billion yuan.
Funds (including maternity insurance) expenditures were 1.
283399 billion yuan, a year-on-year increase of 1.
3%.
The employee basic medical insurance fund (including maternity insurance) had a total balance of 2,532.
351 billion yuan at the end of the year, of which the total balance of the overall planning fund was 1,539.
656 billion yuan, and the cumulative balance of personal accounts was 992.
695 billion yuan[4].
The income of the basic medical insurance fund for urban and rural residents was 901.
401 billion yuan, a year-on-year increase of 5.
1%; expenditures were 811.
527 billion yuan, a year-on-year decrease of 0.
9%.
The accumulated balance at the end of the year was 604.
988 billion yuan.
401 billion yuan, a year-on-year increase of 5.
1%; expenditures were 811.
527 billion yuan, a year-on-year decrease of 0.
9%.
The accumulated balance at the end of the year was 604.
988 billion yuan.
2.
Maternity Insurance
Maternity Insurance
The number of people participating in maternity insurance throughout the year was 235.
46 million, an increase of 21.
29 million over the end of last year, an increase of 9.
9%.
The maternity insurance treatment expenditure was 90.
275 billion yuan, a year-on-year increase of 1.
8%.
46 million, an increase of 21.
29 million over the end of last year, an increase of 9.
9%.
The maternity insurance treatment expenditure was 90.
275 billion yuan, a year-on-year increase of 1.
8%.
3.
Poverty alleviation through medical insurance
Poverty alleviation through medical insurance
In order to decisively win the battle against poverty with medical security, in 2020, a total of 78.
372 million poor people (including dynamic transfers) will be funded to participate in basic medical insurance, 14.
02 billion yuan will be subsidized, and the per capita subsidy will be 178.
9 yuan.
The participation rate has stabilized above 99.
9%.
Various medical insurance and poverty alleviation policies have benefited 180 million people from poor people in total, reducing the burden of medical expenses on the poor by 118.
83 billion yuan.
372 million poor people (including dynamic transfers) will be funded to participate in basic medical insurance, 14.
02 billion yuan will be subsidized, and the per capita subsidy will be 178.
9 yuan.
The participation rate has stabilized above 99.
9%.
Various medical insurance and poverty alleviation policies have benefited 180 million people from poor people in total, reducing the burden of medical expenses on the poor by 118.
83 billion yuan.
In 2020, the central government will invest 26 billion yuan in medical assistance subsidies, an increase of 6% over last year, and another 4 billion yuan will be allocated to improve the medical security level of the rural poor in deeply impoverished areas such as the "three districts and three states", and 1.
5 billion will be allocated Yuan special transfer payment for medical assistance subsidy funds.
5 billion will be allocated Yuan special transfer payment for medical assistance subsidy funds.
4.
List of medical insurance drugs
List of medical insurance drugs
After the 2020 National Medical Insurance Drug List was adjusted, a total of 119 new drugs were added to the list, and 29 drugs in the original list were removed from the list.
The adjusted "National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalog (2020)" contains a total of 2,800 drugs, of which 1,426 are Western medicines and 1,374 are Chinese patent medicines.
The number of Chinese herbal medicines in the catalog has not been adjusted, and there are still 892 types.
The adjusted "National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalog (2020)" contains a total of 2,800 drugs, of which 1,426 are Western medicines and 1,374 are Chinese patent medicines.
The number of Chinese herbal medicines in the catalog has not been adjusted, and there are still 892 types.
Five, drug pharmnet.
com.
cn/news/yyzb/" target="_blank">procurement
com.
cn/news/yyzb/" target="_blank">procurement
In 2020, the total amount of online procurement orders nationwide through the provincial centralized drug procurement platform is estimated to be 931.
2 billion yuan, a decrease of 60.
1 billion yuan from 2019.
Among them, western medicine (chemical drugs and biological products) was 752.
1 billion yuan, and Chinese patent medicine was 179.
1 billion yuan, a decrease of 59.
4 billion yuan and 700 million yuan respectively from 2019.
The drugs in the medical insurance catalog accounted for 86.
5% of the total online procurement orders, and the amount was 805.
2 billion yuan.
2 billion yuan, a decrease of 60.
1 billion yuan from 2019.
Among them, western medicine (chemical drugs and biological products) was 752.
1 billion yuan, and Chinese patent medicine was 179.
1 billion yuan, a decrease of 59.
4 billion yuan and 700 million yuan respectively from 2019.
The drugs in the medical insurance catalog accounted for 86.
5% of the total online procurement orders, and the amount was 805.
2 billion yuan.
In 2020, the state organizes centralized procurement of the second and third batches of drugs, covering a total of 87 varieties, and the average price of selected products is reduced by 53%; the state organizes centralized procurement of coronary stents with an average price of 13,000 The yuan dropped to about 700 yuan.
At the same time, various provinces generally carry out centralized procurement of medicines and medical consumables in an independent or alliance manner, involving 229 kinds of medicines and 19 types of medical consumables.
At the same time, various provinces generally carry out centralized procurement of medicines and medical consumables in an independent or alliance manner, involving 229 kinds of medicines and 19 types of medical consumables.
6.
Medical insurance payment reform
Medical insurance payment reform
Continue to promote the reform of payment methods, and carry out DRG[5] paid national pilot work in 30 cities.
All 30 pilot cities have passed the pre-simulation evaluation and entered the simulation operation stage; in the mid-term, the total budget for 71 cities to implement the regional point method was determined And DIP[6] paid pilot work.
All 30 pilot cities have passed the pre-simulation evaluation and entered the simulation operation stage; in the mid-term, the total budget for 71 cities to implement the regional point method was determined And DIP[6] paid pilot work.
Seven, direct settlement of medical treatment in different places across provinces
As of the end of 2020, the number of designated medical institutions for direct settlement of hospitalization expenses across the provinces was 44,400, an increase of 16,800 or 60.
87% from the end of 2019.
The national platform directly settled 7,248,300 person-times, involving total medical expenses of 175.
9 billion yuan, and the medical insurance fund paid 103.
84 billion yuan.
87% from the end of 2019.
The national platform directly settled 7,248,300 person-times, involving total medical expenses of 175.
9 billion yuan, and the medical insurance fund paid 103.
84 billion yuan.
The pilot work of direct settlement of outpatient expenses was progressed steadily.
12 pilot provinces including Beijing-Tianjin-Hebei, Yangtze River Delta and 5 provinces (autonomous regions and municipalities) in southwest China opened 10,200 networked designated medical institutions and 11,800 networked designated pharmacies , and outpatient expenses cross-provincial A total of 3.
02 million person-times were directly settled, involving total medical expenses of 746 million yuan, and the medical insurance fund paid 429 million yuan.
12 pilot provinces including Beijing-Tianjin-Hebei, Yangtze River Delta and 5 provinces (autonomous regions and municipalities) in southwest China opened 10,200 networked designated medical institutions and 11,800 networked designated pharmacies , and outpatient expenses cross-provincial A total of 3.
02 million person-times were directly settled, involving total medical expenses of 746 million yuan, and the medical insurance fund paid 429 million yuan.
8.
Medical Security Fund Supervision
Medical Security Fund Supervision
Jointly launched a special campaign against fraudulent acquisition of medical security funds with relevant departments.
A total of 627,400 designated medical institutions were inspected , and 400,700 institutions that violated laws and regulations were investigated and dealt with.
Among them, 6,008 medical insurance agreements were lifted, 5,457 were administrative fines, and 286 were transferred to judicial organs.
.
A total of 26,100 people insured were investigated and dealt with, 3162 people were suspended from settlement of medical insurance cards, and 2062 people were transferred to judicial organs.
During the implementation of the special treatment in 2020, a total of 22.
311 billion yuan of medical insurance funds were recovered.
A total of 627,400 designated medical institutions were inspected , and 400,700 institutions that violated laws and regulations were investigated and dealt with.
Among them, 6,008 medical insurance agreements were lifted, 5,457 were administrative fines, and 286 were transferred to judicial organs.
.
A total of 26,100 people insured were investigated and dealt with, 3162 people were suspended from settlement of medical insurance cards, and 2062 people were transferred to judicial organs.
During the implementation of the special treatment in 2020, a total of 22.
311 billion yuan of medical insurance funds were recovered.
9.
Epidemic prevention and control, tax reduction and postponement
Epidemic prevention and control, tax reduction and postponement
In order to reduce the burden on enterprises and support the resumption of work and production, the payment of employee medical insurance units was halved in stages.
From February to July, 9.
75 million insured units were reduced by a total of 164.
9 billion yuan, of which more than 150 billion yuan was reduced for enterprises.
In order to do a good job in the prevention and control of the epidemic, local medical insurance departments allocated 19.
4 billion yuan in special funds to designated hospitals for patients with new coronary pneumonia.
The total settlement of medical expenses for patients with new coronary pneumonia throughout the year was 2.
84 billion yuan, of which the medical insurance fund paid 1.
63 billion yuan.
From February to July, 9.
75 million insured units were reduced by a total of 164.
9 billion yuan, of which more than 150 billion yuan was reduced for enterprises.
In order to do a good job in the prevention and control of the epidemic, local medical insurance departments allocated 19.
4 billion yuan in special funds to designated hospitals for patients with new coronary pneumonia.
The total settlement of medical expenses for patients with new coronary pneumonia throughout the year was 2.
84 billion yuan, of which the medical insurance fund paid 1.
63 billion yuan.
Notes:
[1] All relevant data are summarized in the statistical bulletin reported by provinces and cities from January to December 2020.
Part of the data is rounded, and the total is slightly different from the sub-item total.
Part of the data is rounded, and the total is slightly different from the sub-item total.
[2] The cumulative balance of the fund is expressed in time points.
Affected by factors such as policies, the opening balance of 2020 will be fine-tuned, the same below.
Affected by factors such as policies, the opening balance of 2020 will be fine-tuned, the same below.
[3] Affected by the periodic halving of employee medical insurance unit contributions, employee medical insurance income fell year-on-year.
[4] The cumulative balance of personal accounts is the cumulative amount of personal account balances as of the end of 2020 since the establishment of the basic medical insurance system for employees.
[5] Pay according to the group related to the disease diagnosis.
[6] Pay according to the score of disease combination.
Main indicators of National Medical Insurance Express in 2020
(January-December 2020)
*Note: According to the "Opinions of the General Office of the State Council on Comprehensively Promoting the Implementation of the Combined Implementation of Maternity Insurance and Basic Medical Insurance for Employees" (Guobanfa [2019] No.
10), the income of maternity insurance funds is no longer listed separately, and the benefits of the basic medical insurance for employees are pooled.
Expenditures set up maternity treatment expenditure items.
The income and expenditure of the basic employee medical insurance fund in this table includes maternity insurance.
10), the income of maternity insurance funds is no longer listed separately, and the benefits of the basic medical insurance for employees are pooled.
Expenditures set up maternity treatment expenditure items.
The income and expenditure of the basic employee medical insurance fund in this table includes maternity insurance.
Medical Network, March 9th, in 2020, the national medical security system adheres to the guidance of Xi Jinping’s new era of socialism with Chinese characteristics, and fully implements the 19th National Congress of the Communist Party of China and the 19th National Congress of the Second, Third, Fourth and Fifth Plenary Sessions Spirit, in accordance with the decisions and deployment of the Party Central Committee and the State Council, adhere to the people-centered, forge ahead, overcome difficulties, coordinate epidemic prevention and control and high-quality development of medical insurance, do a solid job of "six stability", and fully implement the "six guarantees" task.
The medical security system is operating smoothly, the fund is safe and sustainable, and the reform and development of medical security has achieved remarkable results.
The medical security system is operating smoothly, the fund is safe and sustainable, and the reform and development of medical security has achieved remarkable results.
1.
Basic medical insurance
1. Basic medical insurance
Basic medical insurance
(1) Participants
(1) Participants As of the end of 2020, the number of people participating in full-caliber basic medical insurance has reached 1,361 million[1], and the insurance coverage has stabilized at more than 95%.
Among them, 344.
23 million people participated in basic medical insurance for employees, an increase of 14.
98 million or 4.
6% over the same period of the previous year.
Among the people participating in basic medical insurance for employees, 253.
98 million employees and 90.
25 million retired employees increased from the end of the previous year.
11.
74 million and 3.
24 million.
The number of people participating in basic medical insurance for urban and rural residents was 1,06.
77 million, a decrease of 8.
06 million or 0.
8% from the previous year.
Among them, 344.
23 million people participated in basic medical insurance for employees, an increase of 14.
98 million or 4.
6% over the same period of the previous year.
Among the people participating in basic medical insurance for employees, 253.
98 million employees and 90.
25 million retired employees increased from the end of the previous year.
11.
74 million and 3.
24 million.
The number of people participating in basic medical insurance for urban and rural residents was 1,06.
77 million, a decrease of 8.
06 million or 0.
8% from the previous year.
(2) Fund income and expenditure
(2) Fund income and expenditure The total income and total expenditures of the basic medical insurance fund (including maternity insurance) for the year were 2.
463861 billion yuan and 2.
094926 billion yuan, respectively.
The accumulated balance of basic medical insurance (including maternity insurance) at the end of the year was 3.
137338 billion yuan [2].
463861 billion yuan and 2.
094926 billion yuan, respectively.
The accumulated balance of basic medical insurance (including maternity insurance) at the end of the year was 3.
137338 billion yuan [2].
The income from the basic medical insurance fund (including maternity insurance) for employees in the whole year was 1,562.
461 billion yuan, a year-on-year decrease of 1.
4% [3]; of which, the collected income (including maternity insurance) was 1,479.
647 billion yuan.
Funds (including maternity insurance) expenditures were 1.
283399 billion yuan, a year-on-year increase of 1.
3%.
The employee basic medical insurance fund (including maternity insurance) had a total balance of 2,532.
351 billion yuan at the end of the year, of which the total balance of the overall planning fund was 1,539.
656 billion yuan, and the cumulative balance of personal accounts was 992.
695 billion yuan[4].
461 billion yuan, a year-on-year decrease of 1.
4% [3]; of which, the collected income (including maternity insurance) was 1,479.
647 billion yuan.
Funds (including maternity insurance) expenditures were 1.
283399 billion yuan, a year-on-year increase of 1.
3%.
The employee basic medical insurance fund (including maternity insurance) had a total balance of 2,532.
351 billion yuan at the end of the year, of which the total balance of the overall planning fund was 1,539.
656 billion yuan, and the cumulative balance of personal accounts was 992.
695 billion yuan[4].
The income of the basic medical insurance fund for urban and rural residents was 901.
401 billion yuan, a year-on-year increase of 5.
1%; expenditures were 811.
527 billion yuan, a year-on-year decrease of 0.
9%.
The accumulated balance at the end of the year was 604.
988 billion yuan.
401 billion yuan, a year-on-year increase of 5.
1%; expenditures were 811.
527 billion yuan, a year-on-year decrease of 0.
9%.
The accumulated balance at the end of the year was 604.
988 billion yuan.
2.
Maternity Insurance
2. Maternity Insurance
Maternity Insurance
The number of people participating in maternity insurance throughout the year was 235.
46 million, an increase of 21.
29 million over the end of last year, an increase of 9.
9%.
The maternity insurance treatment expenditure was 90.
275 billion yuan, a year-on-year increase of 1.
8%.
46 million, an increase of 21.
29 million over the end of last year, an increase of 9.
9%.
The maternity insurance treatment expenditure was 90.
275 billion yuan, a year-on-year increase of 1.
8%.
3.
Poverty alleviation through medical insurance
3. Poverty alleviation through medical insurance
Poverty alleviation through medical insurance
In order to decisively win the battle against poverty with medical security, in 2020, a total of 78.
372 million poor people (including dynamic transfers) will be funded to participate in basic medical insurance, 14.
02 billion yuan will be subsidized, and the per capita subsidy will be 178.
9 yuan.
The participation rate has stabilized above 99.
9%.
Various medical insurance and poverty alleviation policies have benefited 180 million people from poor people in total, reducing the burden of medical expenses on the poor by 118.
83 billion yuan.
372 million poor people (including dynamic transfers) will be funded to participate in basic medical insurance, 14.
02 billion yuan will be subsidized, and the per capita subsidy will be 178.
9 yuan.
The participation rate has stabilized above 99.
9%.
Various medical insurance and poverty alleviation policies have benefited 180 million people from poor people in total, reducing the burden of medical expenses on the poor by 118.
83 billion yuan.
In 2020, the central government will invest 26 billion yuan in medical assistance subsidies, an increase of 6% over last year, and another 4 billion yuan will be allocated to improve the medical security level of the rural poor in deeply impoverished areas such as the "three districts and three states", and 1.
5 billion will be allocated Yuan special transfer payment for medical assistance subsidy funds.
5 billion will be allocated Yuan special transfer payment for medical assistance subsidy funds.
4.
List of medical insurance drugs
Fourth, Medicare drugs drugs drugs directoryList of medical insurance drugs
After the 2020 National Medical Insurance Drug List was adjusted, a total of 119 new drugs were added to the list, and 29 drugs in the original list were removed from the list.
The adjusted "National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalog (2020)" contains a total of 2,800 drugs, of which 1,426 are Western medicines and 1,374 are Chinese patent medicines.
The number of Chinese herbal medicines in the catalog has not been adjusted, and there are still 892 types.
The adjusted "National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalog (2020)" contains a total of 2,800 drugs, of which 1,426 are Western medicines and 1,374 are Chinese patent medicines.
The number of Chinese herbal medicines in the catalog has not been adjusted, and there are still 892 types.
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In 2020, the total amount of online procurement orders nationwide through the provincial centralized drug procurement platform is estimated to be 931.
2 billion yuan, a decrease of 60.
1 billion yuan from 2019.
Among them, western medicine (chemical drugs and biological products) was 752.
1 billion yuan, and Chinese patent medicine was 179.
1 billion yuan, a decrease of 59.
4 billion yuan and 700 million yuan respectively from 2019.
The drugs in the medical insurance catalog accounted for 86.
5% of the total online procurement orders, and the amount was 805.
2 billion yuan.
2 billion yuan, a decrease of 60.
1 billion yuan from 2019.
Among them, western medicine (chemical drugs and biological products) was 752.
1 billion yuan, and Chinese patent medicine was 179.
1 billion yuan, a decrease of 59.
4 billion yuan and 700 million yuan respectively from 2019.
The drugs in the medical insurance catalog accounted for 86.
5% of the total online procurement orders, and the amount was 805.
2 billion yuan.
In 2020, the state organizes centralized procurement of the second and third batches of drugs, covering a total of 87 varieties, and the average price of selected products is reduced by 53%; the state organizes centralized procurement of coronary stents with an average price of 13,000 The yuan dropped to about 700 yuan.
At the same time, various provinces generally carry out centralized procurement of medicines and medical consumables in an independent or alliance manner, involving 229 kinds of medicines and 19 types of medical consumables.
At the same time, various provinces generally carry out centralized procurement of medicines and medical consumables in an independent or alliance manner, involving 229 kinds of medicines and 19 types of medical consumables.
6.
Medical insurance payment reform
6. Medical insurance payment reform
Medical insurance payment reform
Continue to promote the reform of payment methods, and carry out DRG[5] paid national pilot work in 30 cities.
All 30 pilot cities have passed the pre-simulation evaluation and entered the simulation operation stage; in the mid-term, the total budget for 71 cities to implement the regional point method was determined And DIP[6] paid pilot work.
All 30 pilot cities have passed the pre-simulation evaluation and entered the simulation operation stage; in the mid-term, the total budget for 71 cities to implement the regional point method was determined And DIP[6] paid pilot work.
Seven, direct settlement of medical treatment in different places across provinces
Seven, direct settlement of medical treatment in different places across provinces As of the end of 2020, the number of designated medical institutions for direct settlement of hospitalization expenses across the provinces was 44,400, an increase of 16,800 or 60.
87% from the end of 2019.
The national platform directly settled 7,248,300 person-times, involving total medical expenses of 175.
9 billion yuan, and the medical insurance fund paid 103.
84 billion yuan.
87% from the end of 2019.
The national platform directly settled 7,248,300 person-times, involving total medical expenses of 175.
9 billion yuan, and the medical insurance fund paid 103.
84 billion yuan.
The pilot work of direct settlement of outpatient expenses was progressed steadily.
12 pilot provinces including Beijing-Tianjin-Hebei, Yangtze River Delta and 5 provinces (autonomous regions and municipalities) in southwest China opened 10,200 networked designated medical institutions and 11,800 networked designated pharmacies , and outpatient expenses cross-provincial A total of 3.
02 million person-times were directly settled, involving total medical expenses of 746 million yuan, and the medical insurance fund paid 429 million yuan.
Pharmacy pharmacy pharmacy12 pilot provinces including Beijing-Tianjin-Hebei, Yangtze River Delta and 5 provinces (autonomous regions and municipalities) in southwest China opened 10,200 networked designated medical institutions and 11,800 networked designated pharmacies , and outpatient expenses cross-provincial A total of 3.
02 million person-times were directly settled, involving total medical expenses of 746 million yuan, and the medical insurance fund paid 429 million yuan.
8.
Medical Security Fund Supervision
8. Medical Security Fund Supervision
Medical Security Fund Supervision
Jointly launched a special campaign against fraudulent acquisition of medical security funds with relevant departments.
A total of 627,400 designated medical institutions were inspected , and 400,700 institutions that violated laws and regulations were investigated and dealt with.
Among them, 6,008 medical insurance agreements were lifted, 5,457 were administrative fines, and 286 were transferred to judicial organs.
.
A total of 26,100 people insured were investigated and dealt with, 3162 people were suspended from settlement of medical insurance cards, and 2062 people were transferred to judicial organs.
During the implementation of the special treatment in 2020, a total of 22.
311 billion yuan of medical insurance funds were recovered.
Medicine Medicine MedicineA total of 627,400 designated medical institutions were inspected , and 400,700 institutions that violated laws and regulations were investigated and dealt with.
Among them, 6,008 medical insurance agreements were lifted, 5,457 were administrative fines, and 286 were transferred to judicial organs.
.
A total of 26,100 people insured were investigated and dealt with, 3162 people were suspended from settlement of medical insurance cards, and 2062 people were transferred to judicial organs.
During the implementation of the special treatment in 2020, a total of 22.
311 billion yuan of medical insurance funds were recovered.
9.
Epidemic prevention and control, tax reduction and postponement
9. Epidemic prevention and control, tax reduction and postponement
Epidemic prevention and control, tax reduction and postponement
In order to reduce the burden on enterprises and support the resumption of work and production, the payment of employee medical insurance units was halved in stages.
From February to July, 9.
75 million insured units were reduced by a total of 164.
9 billion yuan, of which more than 150 billion yuan was reduced for enterprises.
In order to do a good job in the prevention and control of the epidemic, local medical insurance departments allocated 19.
4 billion yuan in special funds to designated hospitals for patients with new coronary pneumonia.
The total settlement of medical expenses for patients with new coronary pneumonia throughout the year was 2.
84 billion yuan, of which the medical insurance fund paid 1.
63 billion yuan.
Enterprise business enterpriseFrom February to July, 9.
75 million insured units were reduced by a total of 164.
9 billion yuan, of which more than 150 billion yuan was reduced for enterprises.
In order to do a good job in the prevention and control of the epidemic, local medical insurance departments allocated 19.
4 billion yuan in special funds to designated hospitals for patients with new coronary pneumonia.
The total settlement of medical expenses for patients with new coronary pneumonia throughout the year was 2.
84 billion yuan, of which the medical insurance fund paid 1.
63 billion yuan.
Notes:
Notes: [1] All relevant data are summarized in the statistical bulletin reported by provinces and cities from January to December 2020.
Part of the data is rounded, and the total is slightly different from the sub-item total.
Part of the data is rounded, and the total is slightly different from the sub-item total.
[2] The cumulative balance of the fund is expressed in time points.
Affected by factors such as policies, the opening balance of 2020 will be fine-tuned, the same below.
Affected by factors such as policies, the opening balance of 2020 will be fine-tuned, the same below.
[3] Affected by the periodic halving of employee medical insurance unit contributions, employee medical insurance income fell year-on-year.
[4] The cumulative balance of personal accounts is the cumulative amount of personal account balances as of the end of 2020 since the establishment of the basic medical insurance system for employees.
[5] Pay according to the group related to the disease diagnosis.
[6] Pay according to the score of disease combination.
Main indicators of National Medical Insurance Express in 2020
(January-December 2020)
*Note: According to the "Opinions of the General Office of the State Council on Comprehensively Promoting the Implementation of the Combined Implementation of Maternity Insurance and Basic Medical Insurance for Employees" (Guobanfa [2019] No.
10), the income of maternity insurance funds is no longer listed separately, and the benefits of the basic medical insurance for employees are pooled.
Expenditures set up maternity treatment expenditure items.
The income and expenditure of the basic employee medical insurance fund in this table includes maternity insurance.
10), the income of maternity insurance funds is no longer listed separately, and the benefits of the basic medical insurance for employees are pooled.
Expenditures set up maternity treatment expenditure items.
The income and expenditure of the basic employee medical insurance fund in this table includes maternity insurance.
