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Direct settlement health insurance to grow

Hu Yongqi
Updated: Aug 25,2018 7:07 AM     China Daily

China will begin operating a nationally unified medical insurance system next year to directly settle medical reimbursement, including cross-provincial cases, a high-ranking official said on Aug 24.

The system will include insured in urban and rural areas.

Two cross-province direct settlement platforms — introduced last year for urban residents’ basic medical insurance and rural residents’ new cooperative medical reimbursement — feature easier procedures for cross-regional applications, said Li Tao, deputy head of the State medical insurance administration. They have seen a surge in reimbursements, Li said.

Insured people can submit records to medical insurance agencies in their home regions and choose designated medical institutions in other provincial regions for direct reimbursement, Li said at a policy briefing hosted by the State Council Information Office on Aug 24.

The briefing came after a State Council executive meeting on Aug 22. Meeting participants decided to ensure at least one designated medical institution for the direct reimbursement settlement in each county-level region by the end of this year.

Direct settlement of cross-province medical reimbursements means eligible insured people will have to pay only for the share of medical expenses for which they are responsible. Other expenses will be paid by home medical insurance agencies to medical institutions where they receive treatment, according to the State medical insurance administration.

The administration was established following a plan on deepening reform of Party and State institutions that was released by the Communist Party of China Central Committee in March. It integrates some functions related to medical insurance, previously governed by the Ministry of Human Resources and Social Security and other departments under the State Council, China’s Cabinet.

In the first half of the year, more than 480,000 people received direct medical reimbursements on the two platforms, 2.4 times the number in 2017, Li said. As of June, more than 2.67 million users had registered on the platforms along with more than 10,000 designated medical institutions, including 95 percent of key hospitals nationwide.

However, Li said the number of eligible people in key groups should be expanded. That is particularly so for migrant workers and those who work in nonlocal and startup businesses, as the State Council executive meeting decided, Li said. The ratio of direct settlement is not as high as expected, with many people having to go back to home regions to settle cases with complicated reimbursement procedures, she said.

The move toward direct settlement has strengthened people’s sense of advancement and helps promote healthy economic and social development with easier flow of human resources, Li said.

Direct settlement provides a new way to relieve financial burdens for patients, who had to pay all expenses before getting a refund, and eases the complicated reimbursement process, said Huang Huabo, in charge of the office for the leading group for direct settlement of cross-province medical reimbursement.