Today (17th), the National Medical Insurance Administration held a press conference on the theme of "Protecting People's Health and Empowering Economic Development" by the medical insurance department. Relevant person in charge of the National Medical Insurance Administration said that since 2019, the payment of hospitalization expenses by disease group (DRG) and disease type score (DIP) has been launched. At present, DRG/DIP payment has basically achieved full coverage of coordinated regions, reforming regional medical institutions has become more standardized, medical service efficiency has been improved, time and cost consumption index has decreased, and the average hospitalization day has been shortened, saving patients' medical expenses and time costs, the people's sense of gain has been enhanced, and the medical insurance fund has maintained a stable and safe overall situation, effectively ensuring the "life-saving money" of the medical insurance fund.

In 2024, on the basis of extensive listening to the opinions of medical institutions, the National Health Insurance Administration conducted statistical analysis of more than 100 million case data in 169 cities. Relying on academic groups such as the Chinese Medical Association and the Chinese Stomatology Association, they fully conducted argumentation, and formed and released the DRG/DIP2.0 version grouping plan, focusing on optimizing and improving 13 disciplines including critical care medicine, blood, immunity, tumors, burns, oral and maxillofacial surgery, as well as joint surgery and compound surgery issues, effectively responding to clinical demands, and reflecting the value orientation of "medical insurance and medical treatment to move in line with each other and coordinated development". At the same time, the medical insurance department also clearly requires local governments to establish and improve five supporting mechanisms, including special case consultation, advance payment, opinion collection, negotiation and consultation, and data working groups, to promote coordination of medical and medical insurance reform. By December last year, 116 coordinated regions had launched the 2.0 version of the grouping plan ahead of schedule, and the rest of the coordinated regions had also completed preparations for detailed grouping, data calculation, etc., and switched the grouping version on time in early January this year. Medical institutions generally reflect that the new version of the grouping is closer to clinical reality and meets the development needs of medical institutions.

In terms of supporting mechanisms, more than 70% of the coordinated areas have established prepayment mechanisms, and more than 95% of the coordinated areas have established and improved special case discussions, opinions collection, communication and consultation and data working group mechanisms. Especially the Data Working Group, this is an innovative work proposed by the medical insurance department to regularly disclose the operation of medical insurance funds, DRG/DIP payments, etc. to designated medical institutions, and actively "show off the family's assets" and enhance mutual understanding and trust in medical and medical insurance. We require that before March 31 this year, all data working groups in coordinated areas must be put into actual operations and publish data to medical institutions. We also hope that medical institutions can actively cooperate with relevant work, build consensus on reform, and form a joint force for reform.

(CCTV reporter Zhang Ping and Zheng Yizhe)