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What China's Primary Care Reforms Mean for Foreign Founders Operating in China

China's National Health Commission has responded to public concerns about primary care, chronic disease prescriptions, and family doctor services. These reforms affect how foreign-invested enterprises can support employee healthcare and navigate the local medical system.

China's Primary Care Reforms: Implications for Foreign Founders

In response to public feedback on access to healthcare and medications at the community level, China's National Health Commission (NHC) has outlined measures to strengthen primary care. For foreign founders operating in China, understanding these changes can help in designing employee benefits, managing workplace health, and integrating with local medical services.

Strengthening County-Level and Primary Care Capacity

One citizen reported that a relative with acute cholecystitis could not be treated at a county hospital and had to be transferred over 700 kilometers to a provincial capital, where a simple surgical procedure resolved the issue without hospitalization. In response, the NHC's Department of Medical Administration acknowledged that such cases reflect insufficient service capacity in some local primary healthcare institutions.

To address this, regions are implementing the "Several Measures for Accelerating the Construction of a Tiered Diagnosis and Treatment System" issued in April this year. The goal is for general illnesses to be resolved at the city and county levels, and common ailments at the grassroots level.

Key measures include:

• Forming "tightly-knit medical consortia" led by stronger hospitals that partner with primary care institutions for resource sharing and division of labor.
• Requiring higher-level hospitals within these consortia to open clinics for common and chronic diseases at primary care institutions.
• Extending expert teams' general outpatient services to primary care institutions.
• Aiming for every township health center and community health service center to have long-term staffing support from mid- to senior-level personnel from higher-level hospitals.
• Promoting "general practice + specialty" joint clinics so residents can access both general practitioner health management and specialist guidance locally.
• Continuing mobile medical services to cover all counties with weak resources, and pairing urban public hospitals with county hospitals and community health centers.

For foreign founders, these reforms may lead to more reliable local healthcare options for employees, potentially reducing productivity losses due to long-distance medical travel.

Simplifying Chronic Disease Prescriptions

Citizens raised concerns about cumbersome prescription processes for common chronic conditions among the elderly, such as hypertension, diabetes, and emphysema. The NHC's Department of Primary Health responded by emphasizing the principle of "medication follows the disease" for common primary care conditions.

For patients with clear diagnoses, stable conditions, and long-term medication needs, healthcare providers now offer long-term prescriptions for up to 12 weeks per fill. Additionally, efforts are underway to ensure primary care institutions are stocked with medications for hypertension, type 2 diabetes, and chronic obstructive pulmonary disease (COPD), and to provide long-term prescription services and delivery for medications not in stock.

Foreign employers may find it beneficial to inform employees about these long-term prescription options, which can reduce time away from work for routine medication refills.

Enhancing Family Doctor Services

A university student noted that many residents still prefer higher-level hospitals for everyday care and medications, and that family doctor services often suffer from "signing without consulting." The student suggested deeper integration of contracted services with priority referrals.

The NHC explained that family doctor contracted services involve an 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 traditional Chinese and Western medicine, medication guidance, long-term prescriptions, and, in some places, appointments for higher-level hospital outpatient slots.

Next steps outlined by the NHC include:

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

These measures could improve continuity of care for employees with chronic conditions, potentially reducing absenteeism.

Practical Takeaways for Foreign Founders

While these reforms are primarily aimed at Chinese citizens, foreign-founded companies can benefit indirectly. A more robust primary care system means healthier employees and less downtime. When establishing operations, consider:

• Informing employees about long-term prescription services and family doctor contracts.
• Partnering with local clinics or hospitals within medical consortia for occupational health support.
• Factoring in improved local healthcare access when selecting office locations.

Foreign founders should note that these policies are evolving and implementation varies by region. For specific guidance on healthcare-related employment obligations, consult local authorities or professional advisors.

Call to Action: For assistance with company registration and operations in China, foreign founders can 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.