医保支付改革背景下，商业医疗险如何突破“低频低黏性”瓶颈？

Group 1 - The core viewpoint of the articles highlights the ongoing transformation in the commercial health insurance sector driven by DRG/DIP payment reforms and the increasing demand for innovative drugs and high-quality medical services [1][2][5] - The demand for mid-to-high-end medical services is on the rise, with consumers increasingly willing to pay for innovative drugs and diverse outpatient treatments, leading to a significant growth in demand for mid-to-high-end health insurance [2][3] - The integration of advanced technologies, particularly AI, is reshaping the efficiency and service experience in health insurance, with a projected compound annual growth rate of 85% for generative AI in the medical insurance sector [3][4] Group 2 - Commercial health insurance innovation must address three core tasks: comprehensive coverage, service upgrades, and innovative inclusivity to better serve a wider population [2][3] - Challenges in collaboration between commercial health insurance and the medical industry include limited scale and payment capacity, insufficient integration depth, and difficulties in data interoperability, which hinder the efficiency of commercial health insurance [2][4] - The introduction of one-stop settlement solutions aims to enhance the service experience by reducing the burden on patients to pay upfront and navigate complex reimbursement processes, thus facilitating better integration between commercial and public health insurance [4][5]