What did last year's health insurance numbers reveal?

Recently, the National Medical Insurance Administration released the "2021 Statistical Express on the Development of Medical Insurance"
.
Looking at the "doorway" from the numbers, comparing with the statistical data released over the years, what information did the "Express" reveal this time?

01.
Fund spending exceeds pre-pandemic levels

"Express" shows that in 2021, the number of people participating in basic medical insurance will reach 1,364.
24 million, and the coverage will be stable at more than 95%; the total income and total expenditure of basic medical insurance funds (including maternity insurance) will be 2,871.
028 billion yuan and 2,401.
109 billion yuan respectively.
Yuan
.

From a single point of view, in 2021, the annual employee medical insurance fund (including maternity insurance) income will be 1,896.
803 billion yuan, a year-on-year increase of 20.
6%, and the expenditure will be 1,486.
302 billion yuan, a year-on-year increase of 15.
5%; the annual urban and rural residents' medical insurance fund income will be 974.
225 billion yuan, a year-on-year increase.
6.
9%, and the expenditure was 914.
807 billion yuan, a year-on-year increase of 12%
.
Regarding the reasons for the large growth rate of income and expenditure, "Express" explained that "mainly due to the phased reduction of employee medical insurance premiums in 2020, which has a low year-on-year base" and "the number of visits to doctors has recovered after the normalization of epidemic prevention and control, and fund expenditures have increased.

Comparing with the 2019 National Statistical Bulletin on the Development of Medical Insurance, the employee medical insurance fund (including maternity insurance) had an income of 1,584.
5 billion yuan and an expenditure of 1,266.
3 billion yuan; the urban and rural residents' medical insurance fund had an income of 857.
5 billion yuan and an expenditure of 819.
1 billion yuan
.
Overall, it can be seen that the expenditure of the National Medical Insurance Fund in 2021 has exceeded that in 2019 before the outbreak of the new crown pneumonia epidemic

02.
The benefits of inter-provincial inpatient and outpatient settlements have expanded

"Express" shows that by the end of 2021, the number of designated medical institutions for direct settlement of hospitalization expenses across provinces will be 52,700; in 2021, the national platform will directly settle 4,405,900 person-times, involving a total medical cost of 107.
02 billion yuan, and medical insurance funds to pay 62.
463 billion yuan
.
In addition, the pilot work of cross-provincial direct settlement of outpatient expenses has been steadily advanced, with 45,600 networked designated medical institutions and 82,700 networked designated retail pharmacies; outpatient expenses have been directly settled across provinces for 12.

The direct settlement of inter-provincial inpatient and outpatient services has always attracted much attention
.
During the National People’s Congress in 2016, the “Government Work Report” proposed for the first time to accelerate the national networking of basic medical insurance and settlement for medical treatment in other places; the “Report on the Work of the Government” in 2018 proposed to expand the scope of direct settlement for medical treatment in other places across provinces, including grassroots hospitals and migrant workers, All foreign employment and entrepreneurial personnel are included; the 2020 "Government Work Report" proposes to carry out a pilot program of direct settlement of outpatient expenses across provinces

Obviously, through years of continuous advancement, the coverage and beneficiaries of inter-provincial inpatient and outpatient direct settlement work have continued to expand
.
The latest information from the National Medical Insurance Bureau shows that as of the end of February 2022, the number of networked and designated medical institutions for direct settlement of inpatient and outpatient expenses across the country has increased to 54,200 and 49,200 respectively.

03.
The fund 's ability to resist risks continues to improve

"Express" shows that by the end of 2021, the cumulative balance of basic medical insurance (including maternity insurance) is 3,612.
154 billion yuan, of which the cumulative balance of employee medical insurance personal accounts is 1,157.
543 billion yuan
.
In 2020, the cumulative balance of the national basic medical insurance fund (including maternity insurance) was 3,150 billion yuan, of which the cumulative balance of employee medical insurance personal accounts was 1,009.

Overall, it can be seen that in the past three years, the cumulative balance of basic medical insurance (including maternity insurance) has continued to increase, and the ability to resist risks has also continued to improve
.
As a result, attention has also been paid to the preservation and appreciation of the accumulated funds of basic medical insurance

04.
Intensifying efforts to crack down on fraud and insurance fraud

According to the "Express", in the past three years, China's medical insurance funds recovered by strengthening the supervision of medical insurance funds have also increased year by year
.
In 2019, a total of 11.

As a result, the National Medical Security Work Conference has made it clear that the crackdown on fraud and insurance fraud will be intensified, and special rectification actions will continue to be carried out with full coverage.
Connect, expand the application scenarios and application scope of the intelligent monitoring system, standardize and make good use of the reporting reward mechanism, and firmly hold the people's "life-saving money"
.