To thoroughly implement the CPC Central Committee's decisions and plans for advancing the Healthy China initiative, we aim to promote the comprehensive establishment of a high-quality, efficient healthcare service system with Chinese characteristics, ensuring people have access to holistic, life-cycle health services. The following recommendations are hereby presented.

I. General Requirements

(1) Guiding Principles: Guided by Xi Jinping Thought on Socialism with Chinese Characteristics for a New Era, we will deeply implement the spirit of the 20th National Congress of the Communist Party of China. Prioritizing people’s health as a strategic imperative, we will uphold the Party’s guiding principles for health and wellness in the new era. Drawing lessons from our experience in COVID-19 prevention and control, we will remain committed to putting people’s health at the center, emphasizing preventive measures, upholding the public welfare nature of medical and healthcare services, and driving a transformative shift toward more substantive development approaches. We will also transition service models to focus more on systemic continuity and management practices to embrace more scientific governance. This will help expand high-quality medical resources, ensure their balanced regional distribution, and ultimately build a distinctive, high-quality, and efficient healthcare system tailored to China’s unique needs—steadily enhancing the people’s sense of gain, happiness, and security.

(II) Objectives. By 2025, the healthcare service system will be further strengthened, with gradual improvements in resource allocation and service equity. Key capabilities in preventing, controlling, treating major diseases, as well as managing emergencies, will be significantly enhanced. Moreover, the integration of traditional Chinese medicine and Western medicine will become more balanced, and positive progress will be made in establishing a structured system for orderly access to care and medical treatment. By 2035, an integrated healthcare service system will be fully established—complete in structure, clearly divided in roles, mutually complementary in function, continuously collaborative, highly efficient in operation, and resilient—aligning seamlessly with the goal of basically achieving socialist modernization. This system will markedly boost equity, accessibility, and the capacity to deliver high-quality healthcare services, ultimately leading to a significant improvement in the overall health of the population.

2. Optimize resource allocation, strengthen talent development, and advance capabilities toward modernization.

(1) Enhancing the Capacity of Health and Medical Personnel Strengthen and expand the healthcare workforce, with a primary focus on rural and community settings. Intensify efforts to cultivate and support talent in grassroots, remote, and specialized fields where shortages are most acute, thereby narrowing disparities in talent distribution between urban-rural areas, regions, and medical specialties. Promote targeted training programs for rural health professionals, ensure the effective implementation of the system requiring practicing physicians to serve in grassroots areas, and encourage doctors to practice at multiple locations—particularly in underserved rural, remote, resource-scarce, and other high-demand healthcare facilities. Incentivize village doctors to pursue higher education and obtain professional (assistant) physician qualifications, while advancing training programs for assistant general practitioners. Strengthen capacity-building in critical areas such as public health, general practice, pediatrics, critical care medicine, respiratory care, psychiatry, infectious diseases, and geriatric medicine—fields that currently face significant shortages. Simultaneously, refine mechanisms for developing integrated public health and clinical medicine expertise. Continue to bolster standardized residency training programs in general practice, implement specialized retraining initiatives for general practitioners, and steadily expand the ranks of family physicians. Foster stronger collaboration between medical education and clinical practice, ensuring robust postgraduate and continuing education pathways, and further improve the institutional framework for standardized residency training. Launch initiatives aimed at cultivating top-tier medical talent, nurturing a new generation of industry leaders. Additionally, advance initiatives focused on developing distinctive talent in traditional Chinese medicine.

(2) Enhance Public Health Service Capacity. Strengthen the public health system by improving the standardization of public health departments in specialized public health institutions, hospitals, and primary-level medical and health facilities. Refine staffing standards for various types of professional public health organizations, bolstering disease prevention and control capabilities as well as workforce development. Establish a robust public health laboratory testing network that fosters resource collaboration, ensures unified quality control, and enables seamless information sharing, thereby elevating overall testing and diagnostic capacity. Improve the monitoring and early warning systems to enhance the ability to detect major outbreaks at an early stage. Strengthen the infrastructure and emergency preparedness for responding to and managing critical public health crises, including establishing a well-structured, tiered, and triage-based mechanism for treating severe infectious diseases. Refine the public health emergency management system by assembling emergency response teams categorized according to severity levels. Develop a clear list of public health responsibilities for medical and healthcare institutions, specifying the roles and staffing requirements for public health personnel across different types of medical facilities—and integrate these responsibilities into performance evaluation frameworks. Further strengthen the public health physician system and explore granting public health physicians the authority to prescribe medications. Additionally, pilot programs could be introduced to facilitate training opportunities for military doctors stationed at grassroots levels to practice in local emergency medical services.

(3) Strengthen the grassroots healthcare service network in both urban and rural areas. Enhance the standardized development of township health centers and community health service centers, promote the establishment of community hospitals, and ensure comprehensive clinical department setups along with adequate equipment. Bolster capabilities in diagnosing and treating common and frequently occurring diseases, as well as in public health, health management, and traditional Chinese medicine services. Elevate the capacity for infectious disease screening and prevention, strengthen management of major chronic diseases, provide psychological health guidance to residents, and enhance the ability of township health centers to deliver routine medical services, including secondary-level and lower surgical procedures. Based on population distribution patterns, optimize the placement of community health service stations and village clinics, and establish centralized village health centers. For villages with smaller populations, facilitate access to healthcare through mobile medical services, extended care provided by neighboring or linked villages, or direct support from higher-level medical facilities stationed in the area. Additionally, innovate mechanisms for employing healthcare professionals in rural areas, strengthen integrated staffing and management of medical personnel across county-level regions, and, where feasible, adopt approaches such as county-managed but town-utilized or town-recruited yet village-employed models to make rural healthcare positions more attractive to talent.

(Four) Strengthen the leading role of county-level hospitals within their respective counties. Enhance the clinical specialty and management capabilities of county-level hospitals (including traditional Chinese medicine hospitals, hereinafter referred to as the same), while reinforcing their public health service functions. Develop key departments such as emergency medicine, obstetrics and gynecology, pediatrics, critical care, traditional Chinese medicine, psychiatry, geriatrics, rehabilitation medicine, and infectious disease management. Simultaneously, improve the capacity to diagnose and treat major diseases like cancer and cardiovascular and cerebrovascular conditions, and encourage the establishment of specialized centers for these conditions using existing resources. Comprehensively advance efforts to provide medical talent support in the form of collaborative teams to hospitals in nationally designated key counties for rural revitalization. Additionally, strengthen support from tertiary public hospitals to county-level hospitals through various means.

(5) Advance the development of medical and healthcare centers. Leverage high-level hospitals to establish National Medical Centers, and systematically implement the construction of national and provincial regional medical centers as planned. This will enhance both general medical services and capabilities for treating major infectious diseases, ultimately driving up the overall quality of healthcare delivery at both national and regional levels. Additionally, support leading hospitals in building specialized clinical centers focused on challenging, complex, rare diseases, along with talent-training hubs and platforms for medical innovation and technology translation. These initiatives will be guided by the critical needs of patients facing severe illnesses, strengthening clinical specialty development and fostering the formation of specialty alliances and telemedicine collaboration networks. Furthermore, encourage regions to back the establishment of outstanding, innovative teams in areas such as pressing public health issues, key clinical disciplines, underserved specialties, and emerging health industry sectors.

(6) Expand the supply of continuity-of-care services such as rehabilitation and nursing. By supporting regions rich in medical resources to convert some public healthcare facilities into nursing homes and rehabilitation hospitals, as well as encouraging private-sector involvement, we will increase the number of specialized medical institutions offering rehabilitation, nursing, and other related services. This will help refine and strengthen the continuity-of-care system, ensuring broader access to essential services like rehabilitation care, elderly nursing, disability care, maternal and infant care, community-based nursing, palliative care, and nutritional support. Meanwhile, we will standardize and guide the development of privately-run healthcare providers.

3. Strengthen division of labor and collaboration, promote tiered diagnosis and treatment, and advance integrated system management.

(1) Strengthen the family doctor system. Using primary-level medical and health institutions as the main platform, establish a family doctor contracting service model centered on general practitioners, featuring effective collaboration between general and specialized care, and seamless integration of medical services with disease prevention. This model will deliver comprehensive, continuous public health, basic medical, and health management services. Encourage general practitioners from secondary-level and higher hospitals to serve as family doctors themselves or join primary-level family doctor teams, providing contracted services, diagnosis, and treatment at grassroots medical facilities. Additionally, refine the funding mechanisms for these contracted services—regions with sufficient resources may explore allocating capitated payments from residents' outpatient medical insurance funds directly to primary-level healthcare providers or family doctor teams. Finally, improve the fee collection and payment system for contracted services, ensuring that enrolled residents benefit from differentiated policies regarding access to care, referrals, medication, and insurance coverage, ultimately fostering a service model where patients first consult their family doctors for initial care, followed by appropriate referrals and follow-up care at lower-tier facilities.

(2) Promote the development of urban healthcare consortia. In line with trends in new urbanization and an aging population, rationally plan healthcare facilities at all levels and types, clearly defining their respective roles and functions. In urban areas, establish a grid-based healthcare network comprising city-level hospitals, district-level hospitals, community health service centers, nursing homes, specialized rehabilitation institutions, and palliative care facilities. City-level hospitals will serve as the backbone, fostering collaboration with district-level hospitals through mechanisms such as business partnerships, talent development, and technical support. Meanwhile, district-level hospitals can explore integrated management models with community health service centers, among other innovative approaches, to create a development framework characterized by city-led district support, district-community integration, and diversified service delivery. This model will ensure seamless, two-way referral pathways that are both continuous and efficient. Privately-run medical institutions are encouraged to lead or join these healthcare consortia. Additionally, establish a unified and coordinated management system for the consortia, along with scientifically designed lists outlining the rights and responsibilities of all stakeholders involved in establishment, operation, and oversight.

(3) Promote the development of county-level integrated healthcare consortia. In rural areas, establish healthcare consortia centered around county-level units, with county hospitals taking the lead. These consortia would include several other county-level medical and health institutions, along with township health centers and community health service centers as member organizations. Actively advance the construction of tightly integrated county-level healthcare consortia, implementing unified management across county and township levels. Gradually achieve coordinated management in areas such as administration, human resources, finance, clinical operations, drug formularies, and information systems, fostering a collaborative framework built on shared responsibility, governance, services, and benefits. Additionally, set up open and shared centers for imaging, electrocardiography, pathology diagnostics, and medical laboratory testing, promoting grassroots-level examinations while encouraging higher-level hospitals to provide specialized diagnoses. Encourage the efficient allocation and utilization of hospital beds, appointment slots, and medical equipment both within and among healthcare consortia. Continue advancing the integrated management of rural healthcare services. Finally, refine performance evaluation mechanisms specifically tailored to healthcare consortia, assessing their overall performance based on metrics such as patient flow and treatment efficiency, healthcare service delivery capacity, resource utilization, and the effectiveness of medical insurance fund usage.

(Four) Strengthen the integration of prevention and treatment. Innovate mechanisms that foster collaboration and seamless integration between medical care and public health. Public healthcare institutions should establish dedicated departments, such as public health divisions, directly responsible for disease prevention and control activities. Comprehensively advance deep-level collaboration between medical facilities and specialized public health agencies by implementing mechanisms that promote talent mobility, cross-training, service integration, and information sharing. Explore opportunities for public health professionals to participate in medical consortiums, introduce a community-based responsibility system for disease prevention and control at the district level, and further refine the grassroots-level disease prevention and control network through a grid-like structure. Focus primarily on managing key populations and addressing critical diseases, optimizing public health services to deliver targeted health promotion and preventive care tailored to specific groups, including pregnant women, infants, students, working-age individuals, and seniors.

(5) Promote the integration of medical and elderly care services. Rationally plan and arrange elderly care institutions alongside geriatric departments in general hospitals, nursing homes, rehabilitation and wellness facilities, and palliative care centers, fostering a robust network of health services for seniors that emphasizes resource sharing, seamless coordination of mechanisms, and optimized functional integration. Establish and refine robust collaboration mechanisms between healthcare providers and elderly care facilities, actively facilitating streamlined access to appointment-based consultations and emergency services for residents of elderly care institutions. Strengthen the capacity of medical facilities operated within elderly care settings to deliver high-quality medical services and effective pharmaceutical management. Together, these efforts will enhance comprehensive chronic disease management, rehabilitation, and long-term care tailored to seniors. Additionally, encourage primary-level healthcare institutions to support essential services such as medical care for seniors, family-based hospital beds, and home nursing care.

(6) Leverage the vital role of Traditional Chinese Medicine (TCM). Support the inheritance, innovation, and development of TCM, strengthen the construction of its service system, and highlight TCM's critical contributions in areas such as preventing diseases before they occur, treating major illnesses and aiding recovery, combating infectious diseases, and managing public health emergencies. Establish a clinical treatment and research framework for TCM-based infectious disease management, and rely on high-level TCM hospitals to build national TCM bases dedicated to epidemic prevention and control. Additionally, cultivate specialized TCM teams capable of responding swiftly to infectious disease outbreaks and providing emergency medical rescue. Enhance the integrated TCM-Western medicine consultation system and deepen collaborative clinical efforts between TCM and Western medicine in addressing complex and challenging health conditions. Implement initiatives to boost TCM’s rehabilitation service capabilities. Encourage qualified TCM hospitals to lead the establishment of medical consortia, while also bolstering the development of TCM clinics within grassroots healthcare facilities. Uphold the principle of drawing wisdom from the past to inform the present, staying true to our core values while fostering innovation. Firmly embrace cultural confidence, and drive the creative transformation and innovative evolution of TCM’s health and wellness traditions.

4. Enhance service quality, improve the service experience, and promote high-quality services.

(1) Ensuring the Quality and Safety of Medical Services. Establish a high-level medical quality management and control system, and strengthen the national, provincial, and municipal three-tiered medical quality control organizations that cover key specialties. Enhance medical quality and safety management systems and guidelines, and rigorously enforce core medical quality and safety protocols. Improve standards for medical service delivery, elevating the level of standardization and regularization in healthcare services. Healthcare institutions should establish robust, institution-wide quality management and control frameworks that encompass every stage of clinical care, with full implementation of clinical pathway management. Further refine results-oriented mechanisms for assessing, providing feedback on, and incentivizing improvements in service quality data systems. Additionally, explore the development of a medical service review system. Finally, enhance pharmaceutical supply assurance and elevate the quality of pharmacy services.

(2) Enhance the technical capabilities of healthcare and medical services. Strengthen the development and capacity-building of clinical medicine, public health, and medical device R&D systems, and advance cutting-edge medical technologies such as omics technologies, stem cell and regenerative medicine, next-generation vaccines, biotherapies, and precision medicine. Accelerate the establishment of an innovative science and technology system for health, emphasizing the role of healthcare institutions as hubs for concentrating innovation resources, and leverage high-level medical facilities to establish National Clinical Research Centers. Foster synergy between clinical research and patient care, reinforce the critical support provided by scientific research in addressing major public health challenges, and drive breakthroughs in areas like vaccines, diagnostic technologies, and new drug development related to major infectious diseases and other critical illnesses. Strive to overcome technological and equipment bottlenecks, and expedite efforts to address the shortage of advanced medical devices.

(3) Promote continuity of care. Enhance technical standards and operational mechanisms for tiered diagnosis and treatment. Encourage healthcare institutions to engage in service coordination, providing guidance and support for patient referrals. Strengthen multidisciplinary collaborative care and ward-round systems. Establish specialized centers dedicated to treating major acute conditions such as chest pain, stroke, critical maternal cases, critically ill newborns and children, and trauma, offering streamlined emergency pathways and integrated services. Additionally, explore the establishment of joint outpatient clinics for chronic diseases between primary-level healthcare facilities and higher-level medical institutions, enabling comprehensive management, prevention, and rehabilitation of common chronic illnesses.

(Four) Enhance Service Convenience. Actively leverage technologies such as the internet and artificial intelligence to continuously streamline service processes. Develop smart hospitals by implementing time-slot-based appointment systems for consultations, diagnostics, and lab tests, along with centralized appointment services. Expand in-clinic payment options, mobile payment solutions, online query features, and even medication delivery services. Integrate and connect various online service platforms seamlessly. Promote the widespread use of residents' electronic health records, refining authorization mechanisms for accessing and sharing these records while enhancing user-friendly interaction methods. Gradually expand day-care medical services and broaden the reach of telemedicine. Actively advance the integrated processing of multiple documents required for newborn-related paperwork. Furthermore, vigorously promote greater convenience in public health services like immunization programs. Finally, optimize direct settlement services for out-of-province medical treatments.

(5) Enhance Service Comfort. Improve the patient care environment, optimize facility layouts, and accelerate the development of age-friendly healthcare institutions. Support the provision of at-home services for elderly individuals with mobility challenges, as well as those who are disabled, partially disabled, or severely handicapped. Strengthen healthcare providers' service mindset, enhance communication between doctors and patients, foster a culture of humanistic care, and ensure patient privacy is fully protected. Implement high-quality nursing standards and continuously expand clinical services such as psychological support, anesthesia and pain management, medication guidance, and nutritional counseling. Establish robust systems for medical social work and volunteer services. Additionally, leverage the primary role of people's mediation to create a sustainable mechanism for resolving medical disputes, ultimately fostering harmonious doctor-patient relationships.

5. Strengthen scientific management, ensure accountability, and promote refined management practices.

(1) Strengthen the modern hospital management system. Uphold and enhance the Party's overall leadership over hospital operations, firmly implementing the president-responsibility system under the leadership of the Party committee. Improve the decision-making mechanisms in public hospitals, establishing a working framework characterized by unified Party leadership, clear division of responsibilities between Party and administrative bodies, and coordinated operations. Develop a new operational model for public hospitals that safeguards public welfare, motivates staff enthusiasm, and ensures long-term sustainability. Implement comprehensive budgeting and performance management across the board. Conduct thorough performance evaluations of public hospitals, refining a performance assessment system that prioritizes public welfare while emphasizing health outcomes and service quality. Increase the weight assigned to indicators related to tiered medical care, and carry out differentiated assessments tailored to different management levels and hospital types. Further streamline the governance structure and operational mechanisms of university-affiliated hospitals, adhering to the principle of aligning authority with responsibility.

(II) Enhance Management of Specialized Public Health Institutions. Advance reforms in the public health service system, optimize and refine the functional structure of disease prevention and control organizations, and standardize the provision of public health technical services to the public. Select and appoint outstanding leaders, implement tiered and categorized management based on job roles, and increase the proportion of highly skilled professional personnel. Strictly enforce technical standards, strengthen quality control, risk management, and performance evaluation systems.

(III) Strengthen management of primary-level healthcare institutions. Enhance the competency standards for these facilities, further clarifying requirements for resource allocation, service capacity, and the development of management systems. Establish a robust evaluation and review framework tailored to the unique functions and service characteristics of primary care settings. Strengthen quality management in primary healthcare by integrating it into the national medical quality management and control system. Intensify performance assessments, focusing on key metrics such as service quality and volume, operational efficiency, and patient satisfaction, while ensuring that assessment results are effectively shared and applied across the system.

6. Deepen institutional and systemic reforms, enhance momentum, and advance the scientific approach to governance.

(1) Enhance the government’s investment mechanism. Establish a stable funding system for public health initiatives, ensuring that the government fulfills its responsibility to provide adequate financial support to specialized public health institutions and essential public health services. Additionally, implement policies that guarantee funding for medical institutions undertaking public health service tasks. Strengthen the regulatory role of regional health planning and healthcare facility layout planning in optimizing the allocation of medical resources. Fully comply with government investment policies for public hospitals aligned with regional health plans, while increasing financial support specifically directed toward traditional Chinese medicine (TCM) hospitals and primary-level healthcare facilities. Finally, create a sustained and diversified investment framework to promote the ongoing development of TCM.

(2) Strengthen the service procurement mechanism. Deepen reforms in medical service pricing by establishing a system characterized by categorized management, hospital involvement, scientific determination, and dynamic adjustments. Refine fee policies for "Internet+" healthcare services and at-home medical care delivery. Advance reforms in medical insurance payment methods, enhancing diversified and composite approaches to coverage. Develop robust medical insurance payment models tailored to the unique features of traditional Chinese medicine. Explore implementing capitation payments for tightly integrated healthcare consortia, while strengthening oversight and performance evaluation—allowing surplus funds to be retained by providers and ensuring that any excess costs are fairly shared among stakeholders. Gradually increase the proportion of services delivered by primary-level healthcare facilities within both total medical service volumes and overall medical insurance fund expenditures. Additionally, establish a long-term care insurance system and actively promote the growth of commercial health insurance offerings.

(3) Enhance staffing and personnel systems. Develop and implement rational staffing standards for public healthcare institutions, and establish a dynamic mechanism for adjusting staffing levels as needed. Promote the practice of separately determining staffing quotas for public healthcare institutions within medical consortia while enabling centralized resource allocation; simultaneously, standardize the unified recruitment and management of staff across these institutions. Reform the job management system in public hospitals, refining recruitment criteria and procedures for primary-level medical personnel. Further advance the reform of the professional title system for health professionals, emphasizing ethics, competence, and performance. Establish scientifically sound evaluation standards that prioritize medical ethics and professional conduct in talent assessment.

(Four) Deepen the reform of the salary system. Implement the requirement that "medical and healthcare institutions be allowed to exceed the current salary control levels for public institutions, with revenue from medical services—after deducting costs and setting aside required funds as per regulations—primarily used for staff incentives." On this basis, establish and improve a robust salary system tailored to the unique characteristics of the healthcare industry. Comprehensively advance salary reforms in public hospitals. Appropriately determine the total amount and benchmark levels of performance-based pay for specialized public health institutions, ensuring fair compensation for public health physicians. Meanwhile, ensure that personnel working in public health departments of medical institutions earn no less than the average salary level of staff within their respective organizations, and explore the establishment of corresponding allowances and subsidies. Fully implement performance-based pay policies for primary-level medical and healthcare institutions, carefully setting both the overall budget and individual pay levels. Additionally, roll out targeted salary incentive measures for high-caliber professionals working at the grassroots level who meet eligibility criteria. Finally, ensure adequate compensation for rural doctors and strengthen social security programs specifically designed to support them.

(5) Leverage the supporting role of information technology. Develop "Internet + Healthcare," build an industrial internet platform tailored for the healthcare sector, and accelerate the integration of technologies such as the Internet, blockchain, IoT, artificial intelligence, cloud computing, and big data into medical and health services. Strengthen the establishment of a robust framework for sharing, exchanging, and safeguarding health and medical big data. Additionally, establish cross-departmental and cross-institutional mechanisms for public health data sharing and scheduling, along with intelligent, multi-point early warning systems. Promote unified operation and seamless interoperability of information systems within healthcare consortia, while enhancing digital management practices. Finally, expedite the development of a secure healthcare data infrastructure, bolster data security monitoring and alert systems, enhance the data protection capabilities of healthcare institutions, and strengthen safeguards for critical information.

(6) Strengthen comprehensive oversight. Enhance the diversified and integrated regulatory framework, innovate regulatory approaches, and place particular emphasis on overseeing service access criteria, quality and safety, public health, institutional operations, workforce practices, service delivery, medical costs, industry order, and the health-related economy. Establish and refine a robust system for fostering professional ethics within the healthcare sector, launch targeted initiatives to promote integrity in practice, step up inspection, supervision, and enforcement efforts, and safeguard the public welfare nature of public healthcare institutions. Additionally, ensure that privately-run medical facilities operate in full compliance with the law. Strengthen the rule of law by advancing the development and revision of relevant laws and regulations. Finally, improve the system of joint legal sanctions, reinforcing accountability mechanisms and coordinated responses to breaches of duty.

7. Organization and Implementation

(1) Strengthen organizational leadership. Uphold and enhance the Party's overall leadership, reinforcing the responsibility of local Party committees at all levels to guide the reform and development of the healthcare service system. Governments of all provinces (autonomous regions, and municipalities directly under the central government) must place great emphasis on building a high-quality, efficient healthcare service system, incorporating it into their government work and performance evaluation goals. They should formulate specific implementation plans, ensure the timely completion of all tasks, and tailor institutional and systemic innovations to suit local conditions.

(II) Refine supporting measures. All relevant departments should diligently fulfill their responsibilities, collaboratively advancing the construction of the healthcare service system. They should promptly formulate and implement complementary policies, strengthen interagency coordination, and foster a unified team effort. Focusing on regional units and overall performance, a monitoring and evaluation mechanism for the healthcare service system should be established.

(3) Strengthen communication and guidance. Focusing on the reform objectives and key tasks, actively publicize progress and achievements, provide clear policy explanations and relevant training, promptly summarize and promote effective local practices and lessons learned, and proactively address public concerns—creating a positive social environment conducive to the reform and development of the healthcare service system.

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