New rural cooperative medical improvements in 2014 and major tasks for 2015

(en.nhfpc.gov.cn)

Updated: 2015-02-12

National Health and Family Planning Commission Feb 6, 2015

China’s new rural cooperative medical program ran smoothly nationwide in 2014 and covered a large number of farmers while increasing their benefits. And management of the program continues to improve and has made much headway in the following ways:

First, the financing for the program has improved and has given farmers more medical guarantees so that, in 2014, the rate of joining the rural medical insurance program stayed above 95 percent. Subsidies from local governments rose to 320 yuan per person, and the level of individual payments went up as well so that farmers can now get 75 percent of their hospitalization expenses reimbursed and 50 percent of their outpatient service costs can be covered.

Second, the spread of insurance covering serious illnesses has moved rapidly so that, by the end of last November, the serious illness insurance program covered 219 cities and 1,563 counties (county-level cities and districts) and Henan, Jilin, Gansu and Qinghai have province-wide programs. The fund for treating serious illnesses totals 9.7 billion yuan and benefits 1.15 million people each year, while actual compensation has gone up approximately 12 percentage points, on top of the basic compensation rate for the new rural cooperative medical program.

Third, information-sharing for the program has improved markedly, with long-distance medical settlements for farmers in the rural cooperative medical insurance program settled quickly in most parts of the country. There has been optimal use of the program's national information site and it is connected to nine provincial sites and large medical institutions at the provincial level, thus paving the way for work on trans-provincial medical cost settlements, which is already in place in some areas.

And, fourth, the program’s management and services continue to improve, with every region moving steadily ahead in getting commercial insurance agencies involved, which in turn helps facilitate services for farmers and improves government functions. The payment reform, which changed from a post-payment method to pay-in-advance, now covers 80 percent of the regions and has helped guide farmers in seeking medical treatment and keeping unreasonable medical expenses in check.

The National Health and Family Planning Commission will continue to follow the guidelines that the State Council established to improve the new rural cooperative medical program and, in 2015, it will be focusing on the following:

One, it will keep on improving government financing for the program, with annual government subsidies expected to be raised to 380 yuan per person, and with individual payments expected to rise accordingly.

Two, it will increase the reimbursement rate for outpatient services to 50 percent and hospitalization costs to 75 percent and more will be done to narrow the gap between policy-covered and actual reimbursement amounts.

Three, it will summarize and publicize the best experiences of the payment system for the new rural cooperative medical program and contribute to the reform of county-level hospitals overall.

Four, it will expand the critical illness coverage for more illnesses and improve the reimbursements for related patients. The commission will sum up its experiences with insurance for 22 major diseases, such as congenital heart disease in children to improve the new case-based payment system and combine coverage of general diseases and critical diseases.

And, finally, it will fully push the instant settlement for long-distance medical treatment within provinces and do pilot work on trans-provincial medical expense verification and settlements.