National Health and Family Planning Commission and Ministry of Civil Affairs Launch Selection of National Pilot Zones for Integrated Medical and Elderly Care Services

On May 17, the National Health and Family Planning Commission and the Ministry of Civil Affairs issued a notice announcing the selection of national-level pilot units for integrated medical and elderly care services. This initiative aims to encourage pilot regions to take the lead in pioneering efforts, establishing first an integrated service network for medical and elderly care that covers both urban and rural areas, features appropriate scale, rational functions, and comprehensive, continuous care.

The notice requires that each province (autonomous region, and municipality) nominate two pilot regions. The pilot regions must meet the following five requirements:

1. Pilot regions shall strengthen policy alignment and integration, establish inter-departmental communication and collaboration mechanisms, and coordinate the effective implementation of preferential support policies for the integration of medical care and elderly care.

2. Prioritize the improvement of investment and financing, fiscal, taxation, and pricing policies, and strengthen financial support for the integrated medical and elderly care sector.

3. The development needs of integrated medical and elderly care institutions shall be taken into comprehensive consideration in overall land use planning and urban-rural planning.

4. Explore the establishment of a long-term care insurance system and diversified insurance financing models. Include eligible medical, rehabilitation, and nursing care expenses within the scope of basic medical insurance coverage, and accelerate the nationwide network integration of basic medical insurance for the elderly and the implementation of cross-regional medical expense settlement.

5. Strengthen the development of the workforce by formulating policies for the training, deployment, and incentivization of professionals in integrated medical and elderly care services. Explore new internet-based models for delivering integrated medical and elderly care services.

The notice points out that local governments in pilot areas are the main bodies responsible for the work of integrating medical and elderly care. They are tasked with organizing, leading, and coordinating the pilot initiatives. The pilot plans must be reviewed and approved by the local governments in the pilot areas, which shall also establish a pilot work leadership group and its office, headed by the principal officials of the respective governments. The National Health and Family Planning Commission and the Ministry of Civil Affairs will establish an evaluation mechanism for the pilot work, conduct organizational assessments, implement dynamic management of the pilot areas, and ensure that the pilot initiatives achieve tangible results. Beneficial experiences gained during the pilot process will be promptly promoted nationwide.

Specific notice is as follows:

No. 511 [2016] of the General Office of the National Health and Family Planning Commission

To the Health and Family Planning Commissions and Civil Affairs Departments (Bureaus) of all provinces, autonomous regions, and municipalities directly under the Central Government:

To implement the spirit of the “Several Opinions of the State Council on Accelerating the Development of the Elderly Care Service Industry” (Guo Fa [2013] No. 35) and the “Notice of the General Office of the State Council Forwarding the Guiding Opinions of the National Health and Family Planning Commission and Other Departments on Promoting the Integration of Medical and Health Services with Elderly Care Services” (Guo Ban Fa [2015] No. 84, hereinafter referred to as the “Guiding Opinions”), further advance the integration of medical and elderly care services, create a favorable policy environment, improve institutional mechanisms, and foster innovative development models, it has been decided to select a batch of national-level pilot units for the integration of medical and elderly care services. The relevant matters are hereby notified as follows:

I. Work Objectives

By launching pilot programs for the integration of medical and elderly care services, we will encourage pilot regions to take the lead in implementation and exploration, proactively establishing a comprehensive, continuous network of integrated medical and elderly care services that covers both urban and rural areas, features appropriate scale, and has rational functionality. We aim to explore and establish institutional mechanisms for integrating medical and elderly care suited to China’s national conditions, introduce a set of sustainable and replicable institutional innovations and outcomes, innovate management mechanisms and service models for integrated care, and provide demonstrative experience for nationwide efforts in this field.

II. Work Requirements

(1) Implement Key Tasks. Pilot regions shall, in accordance with the requirements of the “Guiding Opinions,” coordinate resources from all parties to foster a policy and market environment conducive to the integrated development of medical and elderly care services, and fully implement the five key tasks of integrating medical and elderly care. Accelerate the transformation of government functions, innovate service delivery and funding assurance mechanisms, actively promote government procurement of services, stimulate the potential and vitality of various service providers, and enhance the quality and efficiency of integrated medical and elderly care services.

(II) Strengthening Safeguard Measures. Pilot regions shall, in accordance with the requirements of the “Guiding Opinions,” prioritize meeting the basic health and elderly care needs of the elderly, with the aim of ensuring the effective implementation of central government policies and improving local supporting policies. They shall enhance policy coordination and integration, establish inter-departmental communication and collaboration mechanisms, and comprehensively implement preferential support policies for the integration of medical and elderly care services. Priority shall be given to improving policies on investment and financing, fiscal and taxation, and pricing, while increasing financial support for the sector of integrated medical and elderly care. The development needs of institutions providing integrated medical and elderly care services shall be taken into account in overall land use planning and urban-rural planning, with proper arrangements for land use layout. Efforts shall be made to explore the establishment of a long-term care insurance system and actively diversify insurance funding models. Medical, rehabilitation, and nursing expenses that meet regulatory requirements shall be included in the scope of medical insurance coverage, and the nationwide networking of basic medical insurance for the elderly and the settlement of cross-regional medical expenses shall be accelerated. Workforce development shall be strengthened by formulating policies for the training, utilization, and incentivization of professionals in integrated medical and elderly care services, ensuring they receive treatment equivalent to that afforded to medical personnel in healthcare institutions. Information technology support shall be enhanced, and new internet-based models for integrated medical and elderly care services shall be explored.

(3) Formulate Pilot Implementation Plans. Pilot regions shall develop pilot implementation plans, which should include: an overview of the pilot region, the foundational status of integrated medical and elderly care services, key tasks and timeline schedules, and organizational safeguards. The plans must feature reasonable positioning, clear objectives, well-defined tasks, and distinctive characteristics.

(4) Clarify the organizational structure. Local governments in pilot areas shall serve as the primary entities responsible for integrated medical and elderly care services, undertaking organizational leadership and overall coordination for pilot initiatives. Pilot implementation plans must be reviewed and approved by the local people’s governments of the pilot areas. A pilot work leading group and its office, headed by the principal official of the local government, shall be established to coordinate and resolve issues arising during the pilot process, thereby ensuring the smooth progress of pilot work. Local health and family planning departments and civil affairs departments shall, under the leadership of local governments, carry out specific implementation tasks. Provincial-level health and family planning departments and civil affairs departments shall strengthen policy guidance and actively coordinate with relevant departments to address existing difficulties and challenges. The National Health and Family Planning Commission and the Ministry of Civil Affairs, in conjunction with other relevant departments, shall be responsible for providing macro-level guidance, reviewing plans, conducting supervision and inspections, and performing overall evaluations of the pilot work, and shall promptly report progress to the State Council.

III. Application Requirements

(I) Submission of Pilot Regions. Each province (autonomous region, municipality directly under the Central Government) shall, based on actual working conditions, select and recommend prefecture-level cities (districts) with a certain operational foundation and willingness to pioneer as national-level pilot regions, with each province (autonomous region, municipality directly under the Central Government) submitting applications for two pilot regions.

(II) Submission of Pilot Program Plans. Each pilot region shall formulate its own pilot program plan, with the word count limited to no more than 3,000 words, and submit it through the respective provincial-level governments (including provinces, autonomous regions, and municipalities directly under the central government).

IV. Organization and Implementation

(I) Local Application. The provincial health and family planning departments and civil affairs departments shall jointly conduct a preliminary review of the pilot application materials in their respective regions, and submit the application materials jointly to the National Health and Family Planning Commission and the Ministry of Civil Affairs by May 20, 2016. The application materials include: 1. A request from the provincial health and family planning departments and civil affairs departments for launching the pilot work on integrating medical care with elderly care; 2. The pilot plan for integrating medical care with elderly care in the pilot areas; 3. The meeting minutes indicating the approval of the local government in the pilot areas for the application.

(II) Deliberation and Determination. The National Health and Family Planning Commission and the Ministry of Civil Affairs will organize relevant experts to conduct a comprehensive review based on the applications, taking into account factors such as the aging population status and the foundational progress in integrating medical care with elderly care in the pilot regions, so as to determine the designated pilot areas.

(3) Official Announcement. Following expert review and the determination of pilot regions, the National Health and Family Planning Commission and the Ministry of Civil Affairs shall jointly issue a notice to announce the list of pilot regions.

(4) Summary and Evaluation. Pilot regions shall promptly report on the progress of pilot work in accordance with the tasks and timelines specified in the pilot program. A progress report on the pilot work shall be submitted every six months to the National Health and Family Planning Commission and the Ministry of Civil Affairs, with copies sent to the provincial-level health and family planning authorities and civil affairs departments. The National Health and Family Planning Commission and the Ministry of Civil Affairs will establish an evaluation mechanism for the pilot work, conduct organizational assessments, and implement dynamic management of pilot regions to ensure effective outcomes. Beneficial experiences gained during the pilot process will be promptly disseminated nationwide.