Xin Lang Cai Jing·2026-01-28 06:40Core Viewpoint - The development of health insurance in China is transitioning from merely existing to improving quality, with a focus on enhancing service as a key driver for sustainable growth in the industry [1][20][21]. Group 1: Importance of Service in Health Insurance - Service is identified as a crucial element for driving customer engagement and sustainable operations in health insurance [2][21]. - The industry must balance three core relationships: alignment of healthcare supply with customer needs, collaboration between customer growth and diverse channel strategies, and interaction between medical inflation and risk reduction [2][21]. - The "service flywheel" concept illustrates how effective service can create a self-reinforcing cycle that enhances customer loyalty and attracts new clients [3][25]. Group 2: Service Flywheel Mechanism - The service flywheel effect describes how initial investments in customer service can lead to exponential growth in value through enhanced customer experience and retention [3][25]. - The flywheel's acceleration is driven by the "service multiplier" effect, where each health service provided generates greater value than the initial investment [3][25]. - A successful service flywheel can stabilize customer bases and mitigate the risks associated with long-term health insurance operations [4][25]. Group 3: Transition from Risk Pricing to Value Pricing - The shift from risk pricing to value pricing in health insurance is essential to address challenges such as medical inflation and changing customer expectations [16][36]. - Value pricing integrates health services into product design, allowing for a more comprehensive approach to customer needs and risk management [16][36]. - The industry is encouraged to expand coverage through innovative service combinations that address out-of-pocket expenses and provide dynamic protection throughout the customer lifecycle [18][37]. Group 4: Challenges and Solutions in Health Management - The integration of health management with insurance faces challenges such as low adherence to health management practices and difficulties in measuring effectiveness [34][35]. - Establishing a scientific mechanism for validating the impact of health services on risk reduction is crucial for aligning service investments with core business metrics [35]. - The use of artificial intelligence and data analytics can enhance personalized health management, improving adherence and breaking the linear cost growth pattern [35][36]. Group 5: Future Directions for Health Insurance - The health insurance sector must evolve from a reactive compensation model to a proactive health management partner, enhancing its role in the healthcare ecosystem [19][38]. - Companies are encouraged to deepen their engagement in health services to strengthen competitive advantages and avoid detrimental market practices [19][38]. - The establishment of a robust service framework is seen as a complex but necessary step for achieving high-quality development in commercial health insurance [19][38].