Beijing, Aug 18, 2026 — China’s National Health Commission, National Administration of Traditional Chinese Medicine, and National Disease Control Administration jointly issued a 10-point directive to overhaul family doctor contract services, expanding coverage from grassroots clinics to tier-two and tier-three public hospitals and private facilities while mandating artificial intelligence integration and wearable health devices across primary care networks by 2030.

Policy Snapshot

Attribute	Detail
Issuers	NHC General Office; NATCM General Office; NDCA General Office
Document	Notice on Deepening “Six Expansions” to Solidify Family Doctor Contract Services
File No.	Guo Wei Ban Ji Ceng Han〔2026〕273
Target year	2030
Core focus	Tiered diagnosis and treatment; primary care capacity building
Total measures	10 specific requirements

The Six Expansions

The directive mandates six structural coverage extensions:

1. Specialist inclusion — By end-2026, grassroots clinics must deploy internal medicine, pediatrics, and TCM specialists as family doctors; by end-2027, all other clinical specialties join after training.
2. Hospital integration — By end-2026, all general practitioners at tightly integrated medical consortium lead hospitals must provide contract services via grassroots platforms; by end-2027, physicians stationed at grassroots facilities for over one year must enroll.
3. Private sector entry — Private institutions with strong capacity and reputation may deliver contract services for elderly, pediatric, and mental health populations via multi-site practice arrangements.
4. Individual contracts — Shift from team-based to individual physician-patient contracts by end-2027, with the family doctor as the first accountable party.
5. Disease scope — By end-2027, expand from chronic disease management to combined chronic and infectious disease co-management, including respiratory, gastrointestinal, vector-borne diseases, tuberculosis, and HIV prevention. Family doctors may issue vaccine prescriptions where qualified.
6. Flexible terms — By end-2026, replace fixed contract cycles with adaptable durations; first-time contracts require face-to-face signing, renewals permitted online.

Key Implementation Timeline

Deadline	Requirement
End-2026	Internal medicine, pediatrics, TCM specialists at grassroots clinics enrolled as family doctors; tightly integrated consortium GPs deployed; flexible contract cycles available
End-2027	All clinical specialties eligible; stationed hospital physicians enrolled; individual contracts mandated; infectious disease co-management integrated

Additional Directives

• Gatekeeping mandate — Family doctors assume first-contact responsibility; patients beyond a doctor’s scope are referred within the same institution or upward via consortium green channels, with bidirectional referral IT platforms required.
• Segmented services — Elderly, children, pregnant women, and disabled groups sign via residence-based clinics; working populations sign via employer-based facilities; family-unit enrollment encouraged.
• Content optimization — Packages include health education, chronic disease follow-up, pediatric guidance, elderly assessments, medication counseling, TCM constitution identification, dietary therapy, medicinal tea substitutes, and Baduanjin exercise programs.
• Digital enablement — “AI+” contract services, online renewal/consultation/follow-up/referral, annual “health portraits” integrating electronic records and wearable device data, and real-time health monitoring systems.

Market Impact Analysis

The directive operationalizes Beijing’s broader tiered-care reform by tightening the gatekeeping role of family doctors—a structural pivot designed to divert patient flow from overloaded tertiary hospitals to primary facilities. The inclusion of tier-two and tier-three hospitals alongside private clinics signals a unified primary-care network rather than an isolated grassroots system.

The AI and wearable device mandates are particularly notable. By formally embedding artificial intelligence into family doctor workflows and mandating annual digital health portraits fed by wearable data, regulators are betting on technology to close the capacity gap at the primary level, where physician shortages have historically undermined contract-service quality. If executed at scale, the “AI+” push could reduce administrative burdens on grassroots clinicians and standardize chronic-disease monitoring across provinces.

The TCM integration—constitution identification, medicinal cuisine, and Baduanjin—creates a distinct regulatory moat for domestic traditional medicine providers while potentially limiting market access for foreign device and pharma companies in the primary care segment.

Forward-Looking Statement

Healthcare analysts expect the 10-point plan to accelerate consolidation of China’s primary-care market, creating partnership opportunities for private clinics, health-tech vendors, and wearable device manufacturers that can demonstrate AI-enabled diagnostic or patient-management tools. The mandate for tier-two and tier-three hospital participation may gradually blur institutional boundaries, potentially reshaping referral revenue streams. With the 2030 target date aligning with the 15th Five-Year Plan cycle, the directive sets the regulatory foundation for a nationwide family doctor network that could serve as the data and patient-flow backbone for future value-based care pilots. Pilot zones—including national primary care reform demonstration areas—are expected to roll out implementation templates by mid-2027.-China Health Reform Pulse

Policy Source: https://www.nhc.gov.cn/jws/c100073/202608/b42e53e6d1f54bb293a9b6d8ed25de1e.shtml

Beijing, Aug 26, 2026 — China issued a 10-point directive to overhaul its family doctor contract system, expanding services from grassroots clinics to tier-two and tier-three public hospitals and private facilities while mandating artificial intelligence integration across primary care networks.

Policy Snapshot

Attribute	Detail
Legal basis	State Council Government Work Report; Guo Ban Fa [2026] No. 11; Yi Bao Fa [2026] No. 7
Document	Notice on Deepening “Six Expansions” to Solidify Family Doctor Contract Services
Core focus	Tiered diagnosis and treatment; primary care strengthening
Total measures	10 specific requirements
Key tech mandate	“AI+” enabled contract services

The Six Expansions

The directive centers on six structural coverage extensions:

1. Specialist inclusion — Contract services expand from general practitioners to clinical and TCM specialists at primary institutions.
2. Hospital integration — Services extend from grassroots facilities to tier-two and tier-three public hospitals.
3. Private sector entry — Private medical institutions are progressively incorporated into the contract network.
4. Individual contracts — Shift from team-based to individual physician-patient contracts.
5. Disease scope — Broaden from chronic disease management to combined chronic and infectious disease co-management.
6. Flexible terms — Replace fixed contract cycles with adaptable durations based on patient needs.

Additional Directives

• Gatekeeping mandate — Family doctors assume first-contact responsibility; contracted residents must be prioritized at primary clinics and referred upward only when clinically indicated.
• Segmented services — Differentiated contracts for community residents, workplace populations, and general groups, with family-unit enrollment encouraged.
• Content optimization — Tailored service packages for key community groups, workplace cohorts, and general populations.
• Digital enablement — Accelerate “AI+” contract services, optimize the national health information platform, and deploy artificial intelligence to assist family doctors, serve contracted populations, and streamline administration under safety-controlled conditions.

Policy Impact Analysis

The directive operationalizes Beijing’s broader tiered-care reform by tightening the gatekeeping role of family doctors—a structural pivot designed to divert patient flow from overloaded tertiary hospitals to primary facilities. The inclusion of tier-two and tier-three hospitals alongside private clinics signals a unified primary-care network rather than an isolated grassroots system.

The AI mandate is particularly notable. By formally embedding artificial intelligence into family doctor workflows and national health platforms, regulators are betting on technology to close the capacity gap at the primary level, where physician shortages have historically undermined contract-service quality. If executed at scale, the “AI+” push could reduce administrative burdens on grassroots clinicians and standardize chronic-disease monitoring across provinces.

Implementation Requirements

Local health commissions are instructed to align the new measures with previously issued home-hospital-bed service guidelines and patient-experience enhancement policies, ensuring integrated rollout rather than fragmented compliance.

Forward-Looking Statement

Healthcare analysts expect the 10-point plan to accelerate consolidation of China’s primary-care market, creating partnership opportunities for private clinics and health-tech vendors that can demonstrate AI-enabled diagnostic or patient-management tools. The mandate for tier-two and tier-three hospital participation may gradually blur institutional boundaries, potentially reshaping referral revenue streams. With the 15th Five-Year Plan cycle underway, the directive sets the regulatory foundation for a nationwide family doctor network that could serve as the data and patient-flow backbone for future value-based care pilots.-China Health Reform Pulse

Policy Source: https://www.nhc.gov.cn/jws/c100072/202608/08427cd5ccb647e6bbf90dc196017d0f.shtml