Within the same insurance area, lower-level hospitals should reimburse a larger share, with roughly ten-percentage-point steps
For comparable eligible inpatient costs, China's policy favors higher reimbursement at lower-level institutions, with approximately ten percentage points between successive levels. Choosing a higher-level hospital for care that primary care can provide can increase your share by roughly a tenth of the eligible bill. Additional annual insurance funding is also directed toward primary care.
What it takes
Nothing to compare the options. The challenge is resisting an unnecessary visit to a major hospital.
What you may gain
Localities are instructed to create appropriate differences in inpatient reimbursement by institutional level, generally about ten percentage points between successive levels within the same pooling area. With that difference, moving up one level would add about 10% of the same eligible inpatient costs to the patient's share. New annual health insurance funds are also to favor primary care.
Context & considerations
For a large inpatient bill, the difference between primary care and a tertiary hospital could amount to thousands of RMB. Use primary care for conditions it can manage; this does not mean every illness belongs in a community clinic.
Research & references
General Office of the State Council (2026). Measures to accelerate development of the tiered diagnosis and treatment system. The measures call for locally appropriate inpatient reimbursement differences, generally around ten percentage points between successive levels within a pooling area. Where conditions permit, localities may also differentiate outpatient reimbursement in line with tiered care. https://www.gov.cn/zhengce/zhengceku/202604/content_7065031.htm