The integration of urban and rural residents' medical insurance system is the key task of this year's 'Government Work Report'. In accordance with the requirements of the Opinions of the State Council on the Integration of the Basic Medical Insurance System for Urban and Rural Residents (Guo Fa (2016) No. 3) and the Opinions of the People's Government of Liaoning Province on the Implementation of the Integration of the Medical Insurance System for Urban and Rural Residents (Liao Zheng Fa (2019) No. 12), and in combination with the actual situation of Dalian, the Implementation Plan for Integration of Medical Insurance System for Urban and Rural Residents in Dalian was prepared and issued.

I. Background

In 2016, the State Council issued the Opinions of the State Council on the Integration of the Basic Medical Insurance System for Urban and Rural Residents (Guo Fa (2016) No. 3), requiring all localities to promote the integration of the medical insurance system for urban residents and the new rural cooperative medical insurance system. The Liaoning Provincial Government has decided that departments of Human Resources, Social Security and Health shall promote the work within their respective areas of responsibility. On January 20, 2019, the Municipal Medical Security Bureau was established to take over the management functions of urban residents' medical insurance and the New Rural Cooperative Medical System, and take the lead in promoting the integration of urban and rural residents' medical insurance system in the city. On July 24, 2019, the Liaoning Provincial Government issued 'Opinions on the Implementation of the Integration of Urban and Rural Residents' Medical Insurance System' (Liao Zheng Fa (2019) No. 12), requiring cities to introduce specific implementation plans for the integration of urban and rural residents' medical insurance system by September.

Up to the end of 2018, the medical insurance fund for urban residents of our city has been implemented as a whole at the municipal level, with unified service and information system throughout the city. The New Rural Cooperative Medical System of our city carries out the overall planning at the county level. There are 9 overall planning areas, cities and counties in the whole city, and the operational  service and information system have not been unified. 

II. Documentation Basis

According to: Opinions of the State Council on the Integration of the Basic Medical Insurance System for Urban and Rural Residents (Guo Fa (2016) No. 3); Opinions of the People's Government of Liaoning Province on the Implementation of the Integration of the Medical Insurance System for Urban and Rural Residents (Liao Zheng Fa (2019) No. 12).

III. The main content of the integrated implementation plan

The Implementation Plan for the Integration of Urban and Rural Residents' Medical Insurance System in Dalian mainly clarifies the specific tasks during the integration of urban and rural residents' medical insurance system in this year and next, including 5 aspects as the guiding ideology, basic principles, work objectives, work tasks and security measures. The timetable for integration is to complete the preparations for integration of operational services and unified information system by the end of 2019. From January 1, 2020, a unified medical insurance system for urban and rural residents will be implemented in all administrative areas at the municipal level.

(I) Integration of the basic health insurance system

Integrating the original basic medical insurance for urban residents and the new rural cooperative medical insurance system into the basic medical insurance system for urban and rural residents, this paper puts forward specific measures and requirements from six aspects of 'unified coverage, unified financing policy, unified security treatment, unified medical insurance catalogue, unified fixed-point management and unified fund management'. 

The coverage of the basic medical insurance system for urban and rural residents includes the existing medical insurance for urban residents and all the persons who should participate in the new rural cooperative medical insurance, that is, all urban and rural residents except those who should participate in the medical insurance for urban workers. Unify the funding standards for urban and rural residents, and continue to implement the funding method of combining individual contributions with government subsidies. Individual contributions are divided into adult residents, minor residents and college students according to the types of insured population. The basic medical insurance treatment policy for urban and rural residents shall be unified, and the specific treatment of emergency and outpatient prescribed diseases, outpatient coordination, inpatient medical treatment, birth medical treatment and off-site medical treatment shall be implemented in accordance with the Measures for the Implementation of the Basic Medical Insurance for Urban and Rural Residents of Dalian Municipality. The catalogue of medicines, medical treatment items and medical service facilities of Liaoning basic medical insurance and relevant regulations shall be uniformly implemented. To unify the administration of designated institutions for medical insurance for urban and rural residents. We will unify fund management, merge the New Rural Cooperative Medical Insurance Fund with the Urban Residents' Medical Insurance Fund, establish the Urban and Rural Residents' Basic Medical Insurance Fund, and realize the unified collection and expenditure of funds within the municipal administrative areas. 

(II) Unification of Major Illness Insurance Policy for Urban and Rural Residents

Establish a major illness insurance system linked with urban and rural residents' medical insurance. Major illness insurance covers all insured residents who participate in medical insurance for urban and rural residents. Major illness insurance funds shall be paid by the medical insurance fund for urban and rural residents, and no additional fees shall be charged to insured personnel. Unify the scope of major illness insurance coverage, funding standards, protection treatment, operating procedures and fund management throughout the city. The specific bidding procedures, contract management, financing treatment and other relevant provisions of major illness insurance shall be implemented in accordance with the Measures for the Implementation of Major Illness Insurance for Urban and Rural Residents of Dalian Municipality.

IV. Main Features of Urban and Rural Medical Insurance System Integration Scheme 

First, the basic medical insurance and major illness insurance system synchronously integrated. According to the requirements of provincial documents, when our city integrates the basic medical insurance system, it simultaneously implements the requirements of the 'Government Work Report' of the State Council, unifies the urban and rural major illness insurance policies, and improves the treatment level of major illness insurance. Second, promote the system integration and implementation of city-level co-ordination synchronously. The medical insurance system for urban residents in our city has realized the overall planning at the municipal level, but the new rural cooperative medical insurance system still carries out the overall planning at the county level. Our city takes the opportunity of system integration to synchronously complete the municipal overall planning and enhance the fund's anti-risk ability and management efficiency. Third, the 'six unifications' should be implemented simultaneously with the integration of the management system and the information system. The integration and optimization of medical insurance management system and information system is an important guarantee for the system integration and the implementation of the new system, which is conducive to the continuous improvement of medical insurance service quality and efficiency, and also conducive to the healthy and sustainable development of the national medical insurance system.