Core Viewpoint - The high-quality development of commercial health insurance is both an internal requirement for the industry's transformation and an essential responsibility to support national strategies and ensure public welfare [1][10]. Group 1: Policy and Regulatory Framework - Nine government departments, including the Ministry of Commerce and the National Health Commission, jointly issued opinions to promote the high-quality development of the drug retail industry, emphasizing the construction of a commercial insurance payment guarantee system [1]. - The opinions encourage insurance institutions to develop commercial health insurance products that meet diverse public needs and support the establishment of risk-sharing mechanisms between drug retail enterprises and insurance institutions [1][10]. Group 2: Industry Collaboration and Development - The China Insurance Industry Association is actively promoting cross-industry communication and developing model clauses for commercial medical insurance, aiming to enhance public awareness of health insurance [2]. - The insurance industry will focus on responding to market demands and supporting national priorities, such as addressing population aging and promoting innovative drugs [2]. Group 3: Actuarial Insights and Cost Management - The Actuarial Association is focusing on cost measurement, experience analysis, and pricing optimization to ensure sustainable development in commercial health insurance [3]. - Key initiatives include compiling a net cost table for commercial medical insurance and conducting cost analysis for innovative drugs to align insurance rates with underwriting risks [3][4]. Group 4: Investment and Financial Support - Insurance funds are a significant source of long-term capital for the healthcare and elderly care industries, with over 150 billion yuan invested in medical-related fields by 2025 [6][7]. - Direct investments in healthcare and elderly care sectors have reached nearly 30 billion yuan, supporting various sub-sectors, including biotechnology and medical devices [6]. Group 5: Data Infrastructure and Information Sharing - The China Silver Insurance Company is building a data infrastructure to support the development of commercial health insurance, focusing on information sharing between medical insurance and commercial insurance [8][9]. - Efforts include creating intelligent product verification systems and enhancing data research to support decision-making in the industry [8]. Group 6: Market Growth and Future Outlook - The commercial health insurance sector has experienced explosive growth over the past decade, with an average annual growth rate exceeding 20% and over 11,000 medical insurance products available [10]. - By 2025, the total compensation for innovative drugs and devices is estimated to reach 14.7 billion yuan, reflecting a compound annual growth rate of 70% [11]. - The strategic positioning of commercial health insurance is becoming clearer, with a roadmap established for its role in the national health security system by 2030 [11][12].
一齐发声,精准发力:多方共促商保医保协同发展!
Sou Hu Cai Jing·2026-01-26 01:28