Over 500k disabled elderly individuals received services throughout the year. How can Shanghai's "Long-term Care Insurance" pilot program be further expanded?

Ask AI · How can Shanghai’s pilot experience drive innovation in the silver economy?

The long-term care insurance system, abbreviated as long-term care insurance (LTCI), is known as the “sixth insurance” in social security—after the five major insurance types: old-age, medical, unemployment, work injury, and maternity.

On March 25, the General Office of the CPC Central Committee and the General Office of the State Council issued the “Opinions on Accelerating the Establishment of a Long-Term Care Insurance System,” marking that this social security system concerning tens of millions of people with disabilities and needing care has officially moved from localized pilots to nationwide implementation. As early as 2017, Shanghai had already served as the first city nationwide to conduct comprehensive pilots at the provincial level, taking the first steps on this exploration path.

What core, replicable experiences does the “Shanghai model” provide to help establish a unified LTCI framework nationwide? On March 28, 2026, a reporter from The Paper learned from the Shanghai Municipal Medical Insurance Bureau that, from the very beginning of this system’s pilot in Shanghai, it coordinated urban and rural areas, used unified models, and unified operations. Led by standardization and regulation, it built a refined, integrated mechanism and system. Last year (2025), it cumulatively provided services to more than 500,000 elderly people with disabilities and needing care, delivering more than 60 million home-entry service visits, with fund payments of nearly RMB 4 billion.

Assessment is the gateway for LTCI. The Shanghai Municipal Medical Insurance Bureau revealed that, to explore the establishment of a unified needs assessment system for elderly care, Shanghai created a community family doctor assessment mechanism, established an assessment team of more than 5,000 family doctors, and built an objective, independent, professional socialized assessment system. It continuously optimized and improved a series of assessment-stage measures, including the application and processing procedures, standards and regulations, quality control management, personnel training, and performance appraisal, thereby guarding the system’s entry point from the source.

In terms of services, Shanghai has fully leveraged industry resources such as healthcare and civil affairs. It pioneered the development of an LTCI nursing service system centered on nursing stations and integrating medical care and elderly care. It built service models covering home, community, and institutional LTCI services. It developed nearly 1,200 LTCI nursing service institutions, cultivated a workforce of 60k professional and specialized nursing service personnel, established assessment and incentive mechanisms, and opened up career development pathways.

Shanghai’s LTCI exploration has also promoted the development of related industries. The Shanghai Municipal Medical Insurance Bureau pointed out that, through institutionalized LTCI services and stable fund payments, it has vigorously developed large-scale, branded, and chain-based professional nursing service institutions, supporting the cultivation of 27 nursing service brands. It also radiates high-quality resources in Shanghai to the Yangtze River Delta and across the country for outward expansion and output. At the same time, it has built a service+technology institutional mechanism, establishing face-to-face communication mechanisms between LTCI service institutions and innovation-and-science-and-technology fields such as the Dalinghao Bay elderly care technology industrial park and the Zhangjiang Robot Valley, guiding forward-looking deployments of frontier technologies such as humanoid robots in the LTCI field, strongly promoting high-quality development of the silver economy.

The Shanghai Municipal Medical Insurance Bureau stated that, currently, the country is accelerating the establishment of a long-term care system, and Shanghai is also actively keeping pace. Based on the existing pilot program, it will deepen research on system alignment—such as establishing a financing-and-premium-collection system, expanding the scope of the population, and optimizing the management and operation mechanism—so as to further improve an LTCI system that meets national requirements, fits Shanghai’s realities, and benefits people in need of long-term care.