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

The National Health Commission's recent responses to public concerns about local medical services reveal key policies on hierarchical diagnosis and treatment, long-term prescriptions for chronic diseases, and family doctor services. Here's how these changes could affect the healthcare options for foreign founders and their employees in China.

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

For foreign founders setting up operations in China, understanding the local healthcare system is more than a matter of personal wellbeing—it directly affects employee benefits, productivity, and overall business costs. Recent public complaints about access to medical care at the community level, and the National Health Commission's (NHC) official responses, shed light on ongoing reforms that could shape how your team accesses healthcare.

In October 2026, the NHC addressed concerns raised by netizens regarding the quality of primary care, the process for obtaining chronic disease medications, and the role of family doctors. The responses, published on the government website, outline current policies and future plans. Below we summarize the key points and explain their practical implications for foreign-invested enterprises.

Strengthening Primary Care Through Tight Medical Partnerships

One netizen 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. The NHC's Medical Administration Department acknowledged that such cases reflect insufficient capacity at some grassroots medical institutions.

To address this, the government is implementing the "Several Measures for Accelerating the Construction of the Hierarchical Diagnosis and Treatment System," issued in April 2026. The goal is for common illnesses to be treated within cities and counties, and routine ailments at the grassroots level. The key mechanism is the "tight medical consortium" (紧密型医联体), led by stronger hospitals in a region and joined by primary care facilities. Under this model:

• Higher-level hospitals within the consortium must open clinics for common and chronic diseases at primary care institutions.
• Expert teams from higher-level hospitals will extend general outpatient services to grassroots facilities.
• Every township health center and community health service center aims to have mid- to senior-level staff from higher-level hospitals stationed long-term for support.
• Joint "general practice + specialty" clinics will be promoted, allowing patients to receive both general practitioner health management and specialist guidance at the local level.
• Mobile medical teams will cover all counties with weak resources, and urban public hospitals will provide paired support to county hospitals and community health centers.

Implication for foreign founders: If your company operates in smaller cities or industrial parks, your employees may soon have better access to quality care locally, reducing the need for long-distance travel for treatment. This could lead to shorter sick leaves and lower medical evacuation costs.

Long-Term Prescriptions for Chronic Conditions

Netizens also raised concerns about the cumbersome process for obtaining medications for chronic conditions such as hypertension, diabetes, and emphysema, which are common among older adults. The NHC's Primary Health Department responded that the policy follows the principle of "medication follows the disease." For patients with clear diagnoses, stable conditions, and the need for long-term drug therapy, healthcare providers can issue long-term prescriptions for up to 12 weeks per fill. Additionally, primary care facilities are supported in stocking medications for hypertension, type 2 diabetes, and chronic obstructive pulmonary disease (COPD), and they must offer long-term prescription services and medication registration and delivery for drugs that are out of stock.

Implication for foreign founders: Expatriate employees or local staff with chronic conditions can benefit from simplified medication access. Companies may consider including chronic disease management in their health benefit packages, as the reduced frequency of clinic visits can improve productivity.

Enhancing the Role of Family Doctors

A student from a Beijing university noted that many residents still prefer higher-level hospitals for routine care and that family doctor services often suffer from "signing without consulting" (签而不约). The NHC's Primary Health Department explained that family doctor contracted services involve a signed agreement between a 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 prescriptions. In some places, family doctors also make appointments for specialist outpatient visits at higher-level hospitals for their contracted residents.

Going forward, the NHC plans to:

• Encourage more secondary and tertiary hospitals to allocate a certain proportion of specialist appointment slots and inpatient beds to family doctors, enabling them to provide outpatient, examination, and hospitalization services.
• Further implement long-term prescriptions for chronic diseases and align grassroots medication availability with that of secondary and tertiary hospitals.
• Strengthen proactive contact with contracted residents and provide home hospital beds for those in genuine need.

Implication for foreign founders: As family doctor services become more integrated with higher-level hospitals, your employees may find it easier to navigate the healthcare system through a trusted primary care provider. This could reduce time spent on referrals and improve overall health management.

What This Means for Your Business

These reforms signal a continued push to make healthcare more accessible and efficient at the local level. For foreign founders, this translates into potential cost savings on health insurance, reduced absenteeism, and a more predictable healthcare environment for both expatriate and local staff. While the policies are still being rolled out, understanding them can help you make informed decisions about employee benefits and location strategies.

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

For assistance with registering and operating a company in China, including navigating healthcare and social insurance requirements, contact ChinaMNC on WhatsApp / WeChat at +86 153 1898 8535.