万亿元健康险加快转型，从“事后报销”转向“源头管理”

Core Viewpoint - The health insurance sector in China is approaching a premium scale of nearly one trillion yuan, with regulatory guidance emphasizing its critical role in the national health security system by 2030 [1] Group 1: Transformation of Health Insurance - The health insurance industry is shifting from a model of "passive risk compensation" to "active health management," focusing on proactive engagement in users' health throughout their lifecycle [3] - There is a call for a fundamental transformation in health insurance products, moving from one-time compensation to integrated solutions that combine insurance with services [1][3] - The integration of health management, medical services, and rehabilitation care into health insurance offerings is essential to meet evolving consumer demands [1][3] Group 2: Product Innovation and Market Development - Insurance companies are encouraged to innovate products, moving beyond traditional offerings to include long-term medical insurance, long-term care insurance, and tailored solutions for specific demographics such as the elderly and those with chronic conditions [2] - The development of differentiated products targeting specific groups, such as patients with pre-existing conditions and rare diseases, is crucial for creating specialized market brands [2] - The health insurance sector is expected to play a significant role in supporting the innovation of the biopharmaceutical industry, ensuring that patients can afford not only standard treatments but also innovative medications [2] Group 3: Integration with Basic Medical Insurance - Commercial health insurance must actively align with basic medical insurance to fill gaps in self-purchased medications and enhanced medical coverage [1] - The insurance industry is urged to participate in the management services of basic medical insurance, leveraging its expertise to improve the efficiency and quality of medical insurance services [1]