The key to achieving a balanced distribution of high-quality healthcare resources lies in the restructuring and upgrading of the healthcare service system. In the past, regional medical institutions operated independently, resulting in prominent issues such as scattered resources, duplicate tests, impeded referrals, and weak specialty care. Challenges such as patients shuttling between facilities for medical treatment and the outflow of health insurance funds have long troubled the primary-level medical institutions. During the 14th Five-Year Plan period, Huai'an, based on its citywide healthcare development framework, has made the establishment of closely integrated medical communities and urban medical groups its core driver, breaking down administrative and resource barriers between medical institutions, systematically reshaping the primary healthcare service system, and fully unleashing the intrinsic momentum for the coordinated operation of regional medical resources.

Huai'an has restructured the management framework of medical institutions and established four closely integrated urban medical groups and 10 closely integrated county-level medical communities that cover all primary healthcare institutions across the city. On that basis, Huai'an has built an integrated organizational management system characterized by "shared responsibility, shared benefits, and coordinated services." It has steadily advanced reforms in medical insurance payment methods, pioneering a bundled payment model for health insurance funds based on "global budget, retention of surpluses, and reasonable sharing of cost overruns" in Huaiyin District and Lianshui County to promote a smooth referral mechanism. Moreover, Huai'an has innovated staffing management and launched a pilot program for personnel quota management within a closely integrated county-level medical community in Huaiyin District to effectively revitalize the primary healthcare workforce. It has precisely optimized institutional layout by implementing a "one county, one policy" approach to dynamically integrate and optimize primary healthcare resources, consolidating township (subdistrict) health centers citywide from 137 to 104 and achieving a qualitative upgrade from "full institutional coverage" to "full coverage of quality services."