National Medical Insurance Bureau: The 3.0 version of the diagnosis-based payment grouping plan is expected to be released in July this year

According to the latest news from the National Healthcare Security Administration, version 3.0 of the Diagnosis-Related Group (DRG) payment grouping plan is expected to be released in July this year and officially implemented in January 2027.
Medical insurance based on diagnosis-related group payment refers to grouping or converting scores for disease diagnosis and treatment, implementing “bundled payment” from medical insurance to healthcare institutions.
Among them, the grouping plan is the technical core of diagnosis-related group payment.
This adjustment will focus on factors such as age and complications, which are more commonly discussed in clinical opinions, and will specifically improve grouping rules for age subdivisions, unilateral/bilateral/multi-site surgeries, obstetrics grouping, radiotherapy and chemotherapy for malignant tumors, and combined surgeries.
The main adjustments for DRG (Diagnosis-Related Group) will target core and subdivided groups, while for disease scores (DIP), the core disease library will be mainly adjusted.
At the same time, attention will be paid to the future integration of DRG and DIP, coordinating related technical foundations to ensure smooth development.
(Xinhua)