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Introduction Between 2015 and 2050, the number of people aged 60 years and over will more than double from 222 million to 480 million in China. The complex needs of its huge aging population require the integration of care across health and long-term care sectors. The provision and financing of health and care were separated in China which posed challenge for care integration. Description of policy context and objective To meet rapidly growing and complex demands, the State Council initiated opinions in 2013 to accelerate development of long-term care services and proposed to integrate health and long-term care. In 2015, the integration of health and long-term care was formally introduced as an independent policy and national pilots were established with various models. In 2016, integrated health and care was included as a critical part of the "Healthy China 2030" strategies. In the same year, long-term care insurance (LTCI) national demonstration was launched. Targeted population More than 42 million disabled elderly and 29 million elderly over 80 years old in mainland China, accounts for 30% of total elderly population. 2018 Annual Report on Elderly Health indicates expenditure on healthcare, pensions and other services for senior citizens will rise from 7.33% of GDP in 2015 to 26.24% in 2050. There were 180 million older people with at least one chronic disease in 2018, which was 75% of the total older population. Highlights Policy group of Peking Union Medical College, School of Health Policy and Management has conducted policy review tracking on care integration since 2016 with formulated analyses from the perspectives of service delivery and financing. National demonstration information is also collected to summarize on targeted population, intervention and outcomes. In this presentation, we will review policy evolvement since 2013 and summarize major policies, progress made and national initiatives and impacts created. Comments on transfer-ability The integration of health and long-term care remains a global challenge, Chinese government chose to take a top-level design and decentralized implementation approach, structure health insurance and LTCI under one administrative authority, explore models through local government supported demonstrations and engage private sectors in demonstration lowering market entry barriers, etc. are unique experiences to explore and adopt. Conclusions In addition to success and progress made, there are still issues to be or being addressed, such as lacking of value-driven financing incentives, population targeting and stratification mechanisms, standardized assessment and performance evaluation, overall economic impacts and considerations, and workforce development. [ABSTRACT FROM AUTHOR]

Introduction: In 2015, WHO proposed that the care for older people should be organized based on their intrinsic capacity and functional ability with a comprehensive and integrated approach and published Integrated Care for Older People (ICOPE)pathways and tool kits in 2019. Seven countries were selected for demonstration, with China included. In 2020, with support from WHO and funding from Beijing municipal government, an ICOPE pilot project was implemented in Chaoyang District of Beijing. Objectives: In China, although the concept of integrated care has been advocated over the past decade, the fragmentation between tertiary and primary care, health and social care is still substantial. There is a lack of implementation pathways, tools and qualified workforce to support care integration. The ICOPE pilot initiative is aimed to explore feasibility of integration mechanisms and ICOPE applications in context with China policy and cultural environments. Target population: A total of 33,504 Chaoyang District residents aged 65 and over were targeted received preliminary screening, among which 7,482 residents were identified with declining intrinsic capacity. After further assessment, 2,148 medium and high-risk residents were recruited and randomized into intervention (n=537) and control groups (n=1,611). In addition to health education received by the control group, the intervention group received various ICOPE intervention measures such as rehabilitation, nutrition improvement and cognitive stimulation delivered by integrated care teams both online and offline. The project was implemented from September 2020 to August 2021. Highlights: The project was led by a local management team, with experts from tertiary hospitals, community and home health agencies, who played an essential role in coordinating resources across different settings to form integrated care teams, determining payments, performing assessment, delivering needed care and evaluating outcomes. Guided by ICOPE guidelines, an integrated care plan was generated, explained and implemented by the integrated care team, with payment provided on per capita basis directly from the project. A unique feature is the systematic training of the care providers to enable their better understanding of integration concepts and ICOPE implementation. IT system is fully utilized to support real time decision makings and deliver timely interventions. Data were collected at the beginning of the project and six months after. The report showed ADL, physical, mental and nutritional status were improvements for both control and experimental groups, with significantly more improvement for the intervention group. Compared to service utilization for the second half of 2020, 7.7% of less medical visits and 14.3% lower medical expenses were reported. Conclusions: The study found essential elements for implementation include cross-organizational and cross-disciplinary coordination, system capacity building, standardized practice guidelines, interoperative IT platform, evidence-based data collection and incentivized payment system. In the future, locally-relevant interventions and innovative payment methods need to be further explored, developed and evaluated in promoting value-based integrated care and healthy aging. [ABSTRACT FROM AUTHOR]