BEIJING — China is changing how its people pay for healthcare and it’s starting to make a difference.
More than three-quarters of the country’s major medical regions now offer instant payment settlement for public health insurance claims, a move officials say is reducing financial stress for both patients and hospitals.
The National Healthcare Security Administration (NHSA) confirmed that 77% of coordinated regions have activated the system. These zones, often aligned with provincial or municipal boundaries, are at the heart of China’s push to unify how health insurance is handled across the country.
For patients, it means fewer upfront payments when receiving treatment outside their home region. For hospitals, it means quicker reimbursement, cutting down on the long-standing problem of delayed insurance payouts.
“This reform marks a significant step toward fairer and faster medical services,” said an NHSA spokesperson on Thursday. “It allows people to access care more easily, wherever they are.”
Since the start of 2025, when the current rollout began, over 300 billion yuan (£32.8 billion) has already been paid out through this new system. The NHSA says the goal is to reach 80% coverage across all regions by the end of the year.
There’s more to the reform than speed. To keep funds flowing smoothly, many regions have adopted flexible settlement schedules either weekly or monthly instead of waiting for end-of-quarter disbursements. The change helps hospitals plan their budgets better and avoid cash crunches.
Dr. Zhang Wei, director of a public hospital in Hebei Province, called it a “lifeline” for smaller facilities. “We used to wait months for reimbursement,” he said. “Now we can pay our staff on time and invest in better care.”
But challenges remain. Some rural areas have yet to catch up. “Connectivity and data integration still lag in the countryside,” noted Liu Ming, a healthcare policy researcher at Tsinghua University. “If reforms don’t reach them, it risks widening existing gaps.”
The government insists those gaps are being addressed. The NHSA says technical teams are working on expanding coverage to more remote regions, and public reporting mechanisms have been set up to track progress.
Experts say China’s model with its combination of real-time digital processing and regional coordination could offer lessons for other countries trying to modernize healthcare finance.
Whether it holds up under pressure remains to be seen. But for now, thousands of Chinese patients are already feeling the benefits. As one Beijinger put it after her recent hospital visit, “I just showed my card, and it was done. No fuss, no forms. That’s how it should be.”
