Published by ChinaMNC · Yicheng

China's Primary Healthcare Reforms: What Foreign Founders Need to Know

The National Health Commission outlines measures to improve primary care, including tighter medical alliances, longer prescriptions for chronic diseases, and a bigger role for family doctors. These changes could affect healthcare access for foreign entrepreneurs and their employees in China.

China's Primary Healthcare Reforms: What Foreign Founders Need to Know

Foreign founders setting up operations in China often need to understand the local healthcare system—both for themselves and for their employees. Recent guidance from China's National Health Commission (NHC) sheds light on how primary care is being strengthened, with potential implications for access to medical services. The NHC was responding to public concerns about seeing doctors and getting prescriptions at the community level. Below is a summary of the key points and what they might mean for foreign-invested enterprises.

1. Stronger 'tight' medical alliances to boost local care

One citizen complaint described a case where a county hospital could not treat acute cholecystitis, forcing a transfer to a provincial capital over 700 kilometers away, where a simple procedure resolved the issue without hospitalization. The NHC acknowledged that such cases reflect insufficient service capacity at some primary healthcare institutions. In response, regions are implementing measures under the Several Measures for Accelerating the Construction of the Tiered Diagnosis and Treatment System, issued in April this year. The goal is for general illnesses to be handled within cities and counties, and common ailments at the grassroots level.

To achieve this, areas are forming 'tight' medical alliances led by stronger hospitals in partnership with primary care institutions. These alliances are designed to share resources and divide responsibilities. Key requirements include:

• Upper-level hospitals within tight alliances must open outpatient clinics for common and chronic diseases at primary care institutions.
• Expert teams from upper-level hospitals should extend general outpatient services to primary care facilities.
• Every township health center and community health service center should have long-term placement of mid- to senior-level staff from upper-level hospitals for support.
• Promote 'general practice + specialty' joint clinics so residents can access both general practitioner health management and specialist guidance at the local level.
• Continue mobile medical services covering all counties with weak resources, and pair urban public hospitals with county hospitals and community health centers.

For foreign founders, these reforms could mean that routine medical needs of expatriate staff and local employees may be more easily met closer to home or workplace, reducing the need for long-distance travel for minor conditions.

2. Longer prescriptions for chronic diseases

Citizens also raised concerns about cumbersome prescription processes for chronic conditions such as hypertension, diabetes, and emphysema, which are common among older adults. The NHC's Department of Primary Health responded by emphasizing the principle of 'medicines follow the disease.' For patients with clear diagnoses, stable conditions, and need for long-term medication, primary care institutions are to provide long-term prescriptions for up to 12 weeks per fill. Additionally, support is being given to ensure that primary care facilities stock medicines for hypertension, type 2 diabetes, and chronic obstructive pulmonary disease (COPD), and to guarantee that chronic disease patients can obtain long-term prescriptions and registration and delivery services for medicines in short supply.

This policy could benefit foreign companies whose employees include older workers or those with chronic conditions, as it simplifies access to necessary medications and reduces administrative burdens.

3. Enhancing the role of family doctors

A student from a Beijing university shared findings from field research indicating that many residents still prefer going to higher-level hospitals for everyday care and prescriptions, and that family doctor services suffer from a 'signed but not utilized' phenomenon. The suggestion was to integrate contracted services with priority referral measures. The NHC agreed, explaining that family doctor contracted services involve a signed agreement between a family doctor and a resident to provide basic medical care, public health services, and agreed health management. Services include diagnosis and treatment of common and frequent diseases using both Chinese and Western medicine, medication guidance, and long-term prescription services. In some places, family doctors also make appointments for referred patients to upper-level hospitals.

Next steps planned by the NHC include:

• Encouraging more secondary and tertiary hospitals to allocate a certain proportion of expert appointments and inpatient beds to family doctors, enabling them to provide outpatient, examination, and hospitalization services.
• Further implementing long-term prescriptions for chronic diseases and aligning primary care medication lists with those of secondary and tertiary hospitals to better safeguard patient medication.
• Strengthening proactive contact with contracted residents and providing services such as home hospital beds for those in genuine need.

For foreign founders, a more robust family doctor system could mean better care coordination for employees and their families, potentially reducing sick leave and improving productivity.

Practical takeaways for foreign founders

While these reforms are primarily aimed at Chinese citizens, they signal a broader effort to improve primary care accessibility and efficiency. Foreign-invested enterprises may find it easier to arrange healthcare for their staff as local clinics become better equipped and linked to higher-level hospitals. However, it's important to note that specific implementation varies by region, and foreign nationals may have different eligibility criteria for certain services. Founders should consult local health authorities or experienced HR providers to understand how these policies apply to their workforce.

Staying informed about healthcare policy changes can help foreign founders make better decisions about employee benefits and business continuity. As the system evolves, opportunities may arise to partner with local healthcare providers or integrate health management into corporate wellness programs.

Call to action: For assistance with company registration and ongoing operations in China, including navigating healthcare and social insurance requirements, contact ChinaMNC on WhatsApp/WeChat at +86 153 1898 8535.

This summary is based on information published by the relevant Chinese government website and is general information, not legal or tax advice.