National Health Commission Promotes Sanming Healthcare Reform: 'Health Community' and 'Six-Disease Integrated Management' Emerge as Key Focus Areas
On August 30, the National Health Commission held a press conference to promote the experience of healthcare reform in Sanming, clarifying the goal of achieving nationwide coverage of the “Sanming model” within five years. The National Health Commission will guide the following entities to achieve new breakthroughs first: 11 provinces designated as comprehensive healthcare reform liaison provinces, provinces and municipalities that have signed co-construction agreements with the Commission, 30 demonstration cities for public hospital reform and high-quality development, 14 pilot hospitals for high-quality development of public hospitals, and other pilot hospitals within each province. Meanwhile, the Commission will guide other provinces to select two to three key regions annually to promote the Sanming experience.
As a national benchmark for deepening healthcare reform, the Sanming model has entered its 3.0 phase, with further reforms focusing on three key areas: first, upgrading “Medical Consortia” to “Health Consortia”; second, improving the standardized construction of the “Two Professionals and Two Centers” framework; and third, establishing a “Joint Management of Six Diseases” system. This provides clear pathways and robust mechanisms for provinces and municipalities across China to adapt and learn from the Sanming model according to local conditions.
In December last year, ten ministries and commissions jointly issued the “Guiding Opinions on Comprehensively Advancing the Construction of Close-Knit County-Level Medical Communities,” which clearly stipulated timelines and task schedules for localities in building close-knit county-level medical communities. Sanming City was among the first batch of cities to explore close-knit medical communities, pioneering and promoting various innovative models, including implementing an incentive mechanism of “global budgeting with surplus retention” and introducing a salary policy of “all-staff position-based annual compensation” for hospital directors and physicians.
To Build a Healthy China, We Must Strive to Reduce the Incidence of Disease, Delay Its Onset, and Prevent Serious Illnesses as Much As PossibleZhang Yuanming, Deputy Mayor of the Sanming Municipal People’s Government in Fujian Province, stated that Sanming will further deepen healthcare reform, starting by upgrading “Medical Consortia” into “Health Consortia.” Currently, Sanming has achieved positive results in building close-knit Medical Consortia based on county-level general hospitals. The next step is to establish a “Health Service Consortium” on this foundation, shifting the focus from “managing medical care” to “managing health,” and constructing a modern healthcare service system characterized by “comprehensive health management, guaranteed public health services, and high-quality medical care.”
Notably, since 2020, the Tianjin Municipal People’s Government has partnered with WeDoctor to launch a special healthcare reform initiative known as the “Tianjin Digital Health Community.” Centered on user health, leveraged by medical insurance payment mechanisms, empowered by technologies such as big data and AI, and driven by a health accountability system, this digital health community model integrates the capabilities of healthcare delivery, medical insurance, and pharmaceuticals. By focusing on chronic disease management and family doctor contract services, it has pioneered the implementation of payment methods such as “global bundled payment” and “capitated bundled payment” within the medical insurance system. This marks the first time at the provincial level that payers have assumed financial responsibility for health outcomes at a predetermined cost.
After several years of development and operation, the innovative model of the Tianjin Digital Health Community has achieved remarkable results, successfully realizing a win-win outcome for multiple stakeholders, including enrolled residents, healthcare providers, medical insurance payers, and enterprise platform operators. This initiative undoubtedly represents a creative promotion and elevated implementation of the experience gained from the Sanming healthcare reform.
Enhance the Development of the “Two Specialists and Two Centers” to Further Deepen the Integration of Medical Care and Disease Prevention
At the meeting, it was announced that to further improve the national health management system, the next step of the Sanming Medical Reform will be to enhance the standardized construction of the “Two Specialists and Two Centers” model. This involves establishing Health Management Centers and Disease Management Centers in all general hospitals across the city, thereby creating an “integrated medical and preventive care service model.”
In the new practices of Sanming’s healthcare reform, the standardized development of the “Two Professionals and Two Centers” model—namely, health managers, disease managers, health management centers, and disease management centers—serves as a critical measure and approach to achieving tiered diagnosis and treatment and the integration of medical care with disease prevention. This model facilitates the transition of public hospitals from a “disease-centered” to a “health-centered” paradigm, extending the focus of health services upstream to enable early detection, early diagnosis, early treatment, and standardized management of diseases.
Specific measures include: establishing a service model for primordial and primary prevention that integrates clinical and public health approaches, through the standardized development of health management centers and the training of health management physicians, thereby enabling healthy and sub-healthy populations to avoid disease, reduce disease incidence, or delay disease onset.
Meanwhile, through the standardized development of disease management centers and the training of disease managers, we implement secondary and tertiary prevention measures alongside a tiered diagnosis and treatment service model featuring “three specialists serving one patient.” This approach ensures standardized management for individuals with chronic diseases, reduces recurrence and readmission rates, minimizes disability and mortality associated with these conditions, improves quality of life while living with illness, and alleviates the medical burden on individuals, families, and the nation.
The “Joint Management of Six Diseases,” a key highlight of this press conference, represents new practices and achievements of the Sanming healthcare reform as it advances into the 3.0 phase centered on health. Zhang Yuanming introduced that the next step for the Sanming healthcare reform will be to deepen cooperation and co-construction with leading domestic hospitals, provide targeted assistance, actively explore the establishment of a “Joint Management of Six Diseases” system, and accelerate the improvement of integrated diagnosis and treatment services encompassing prevention, screening, diagnosis, treatment, management, and rehabilitation across Sanming City.
In February this year, Shanghai Ruijin Hospital, the Sanming Municipal People’s Government, and WeDoctor jointly established China’s first “Six-Disease Co-Management” Center for full-lifecycle care. Leveraging advanced medical AI technologies, the center commenced its initial clinical operations in April. This “AI-driven Six-Disease Co-Management” model addresses key bottlenecks in building comprehensive chronic disease prevention and control systems and enhancing the service capabilities of medical consortia. By integrating Ruijin Hospital’s cutting-edge medical technologies and extensive experience in chronic disease management with WeDoctor’s digital intelligence support, the model has rapidly achieved seamless “transfer” of diagnostic and therapeutic techniques as well as management standards.
By integrating “Ruijin Medicine, the Sanming Model, and WeDoctor AI,” this approach has established a comprehensive care system encompassing prevention, screening, diagnosis, treatment, management, and rehabilitation, along with a multidisciplinary diagnostic and therapeutic model. It enables the coordinated treatment and management of six major chronic conditions: oncology, metabolic disorders, cardiovascular and cerebrovascular diseases, respiratory diseases, reproductive medicine, and geriatrics. This model not only emphasizes disease diagnosis and treatment but also places greater importance on disease prevention, health management, and rehabilitation. By creating a person-centered, digital, full-lifecycle co-management framework focused on these six key disease categories, it achieves a shift from “disease-centric” to “patient-centric” multi-morbidity management.
In recent years, China has prioritized the study and dissemination of the Sanming healthcare reform model as a key strategy for deepening healthcare system reforms, achieving positive results. Yang Jianli, Director of the Department of System Reform at the National Health Commission, emphasized that Sanming’s decade-long exploration has paved the way and set a benchmark for China’s healthcare reform efforts, with some of its experiences elevated to national policy. Moving forward, a monitoring and evaluation mechanism will be established to assess the promotion of the Sanming model from multiple dimensions, ensuring that reform measures are effectively implemented and yield tangible outcomes.
A new round of top-down, vigorous, and comprehensive promotion of the Sanming healthcare reform experience has gradually unfolded. It is foreseeable that rapidly focusing on key areas and precisely exerting efforts to “replicate” a reasonable, efficient, and locally adapted standardized model from Sanming has become the “new prescription” for various regions to accelerate the deepening of healthcare reform.