Core Insights - The meeting held by the China Insurance Industry Association on January 22 focused on the high-quality development of health insurance, emphasizing its role in the multi-tiered medical security system during the "14th Five-Year Plan" period and the need for better integration into the health ecosystem in the "15th Five-Year Plan" [1] Expansion of Coverage - The commercial health insurance sector has seen a compound annual growth rate of over 20% over the past decade, with more than 11,000 medical insurance products available, providing robust support for public health [2] - By 2025, it is estimated that commercial health insurance will incur approximately 14.7 billion yuan in total claims for innovative drugs and medical devices, reflecting a 70% compound annual growth rate over four consecutive years [2] Regulatory Support - The "Guiding Opinions" issued by the National Financial Regulatory Administration aim to optimize existing policies and clarify future directions for health insurance, enhancing support for specialized operations within health insurance companies [3] - The focus is on promoting collaboration between health insurance and the health industry, improving the payment flexibility for innovative drugs and devices [3] Claims Efficiency - In 2025, ZhongAn Insurance reported a total claim payout of 17.9 billion yuan, processing approximately 2.9 million claims daily, with AI technology significantly enhancing the efficiency and user experience of the claims process [4] Infrastructure Development - The China Banking and Insurance Information Technology Management Company is enhancing the infrastructure for health insurance, including product verification, risk control, and claims support, to ensure the industry's stable operation and development [5] Asset Management - As of 2025, insurance asset management products directed towards the medical sector have exceeded 150 billion yuan, with direct investments in healthcare and elderly care nearing 30 billion yuan, supporting various sub-sectors such as biotechnology and medical devices [8] Service Expansion - The establishment of the Health Management Company by PICC aims to integrate health insurance with health management, creating a comprehensive health service network and contributing to the development of long-term care insurance [9] - The collaboration between healthcare and insurance sectors is exemplified by the successful service model of the Peking University Health Group, which has achieved high patient satisfaction rates [10]

Core Viewpoint - The health insurance sector in China is experiencing significant growth and transformation, driven by policy support and market demand, with a focus on high-quality development and integration into the broader health ecosystem [1][2][3]. Expansion of Coverage - The commercial health insurance market has seen an average annual growth rate of over 20% in the past decade, with more than 11,000 medical insurance products available, providing robust support for public health [2]. - By 2025, it is estimated that commercial health insurance will incur approximately 14.7 billion yuan in total claims for innovative drugs and medical devices, reflecting a compound annual growth rate of 70% over four consecutive years [2]. Regulatory Guidance - The "Guiding Opinions" issued by the National Financial Regulatory Administration aims to optimize existing policies and clarify future directions for health insurance, emphasizing specialized and professional operations [3]. - The insurance industry is encouraged to enhance collaboration with the health industry and support flexible payment methods for innovative medical technologies [3]. Claims Efficiency Improvement - In 2025, ZhongAn Insurance reported a total claim payout of 17.9 billion yuan, processing approximately 2.9 million claims daily, with a focus on leveraging technology to enhance claims service efficiency [4]. - AI integration in the claims process has enabled over 90% of health insurance users to submit claims with minimal effort, significantly improving transparency and user trust [4]. Infrastructure Development - The establishment of robust infrastructure is crucial for the sustainable operation of the health insurance industry, with a focus on data-driven services such as product verification, risk management, and claims support [5]. - The China Banking and Insurance Information Technology Management Company is enhancing product registration and monitoring industry risks through intelligent systems [5]. Asset Management and Investment - As of 2025, insurance asset management products directed towards the medical sector have exceeded 150 billion yuan, with investments in various healthcare-related fields [8]. - Insurance funds are playing a vital role in supporting the upgrade of the healthcare and elderly care industries, contributing to the development of new productive forces [7][8]. Service Space Expansion - The health insurance sector is evolving to include preventive care and health management, with companies like PICC Health establishing health management subsidiaries to integrate insurance with health services [9][10]. - The collaboration between insurance and healthcare providers is yielding positive results, enhancing patient satisfaction and reducing claims costs through coordinated care [9][10]. Industry Collaboration - The China Insurance Industry Association is actively promoting cross-industry collaboration and developing standardized terms for commercial health insurance, aiming for a cooperative development model with the healthcare sector [10].

保险家论道 保险与医疗健康领域的"支付+服务"融合趋势日益凸显，"医险协同"正成为健康险公司突破同质化竞争、打造品牌优势的核心赛道。面对政策 引导、需求升级与行业转型的多重机遇，健康险公司应如何超越"支付方"的传统角色，全面融入"医险协同"的价值链条？ 本期《清华金融评论》保险家论道专栏特邀平安健康保险、北大医疗集团董事长朱友刚 ，从专业健康险公司的视角，解析"医险协同"转型逻 辑与实践路径，为行业发展提供参考。 01 医险协同 专业健康险公司的必然转型方向 近年来，在政策引导、需求升级与行业转型的多重推动下，保险与医疗健康领域的融合不断深化。尤其对于专业健康险公司而言，单纯作为"支付 方"的角色已难以适应市场发展与客户期待。医险协同，即保险与医疗服务的深度结合，正成为健康险公司突破同质化竞争、构建核心竞争力的战略 路径。这一转型不仅是行业趋势，更是企业可持续发展的内在要求。 从外部环境看，我国医疗健康体系长期存在 "重治疗、轻预防与康复"的结构性短板，导致医疗资源分布不均、医疗费用持续攀升。与此同时，伴随 人口老龄化加速、慢性病发病率上升以及居民健康管理意识增强，公众对健康服务的需求已从"病后治疗"延伸至" ...

Group 1 - Ping An Group's strategic cooperation with large public hospitals aims to address the challenges of "difficult and expensive medical care" by integrating commercial insurance into the healthcare system, complementing public health insurance [1] - The three-way win model proposed by Ping An involves patients benefiting from better treatment options and financial support, hospitals gaining increased patient inflow and stable funding, and Ping An enhancing its brand value and customer loyalty through deeper involvement in healthcare [1] - The launch of partnerships with China Pharmaceutical University and nearly 40 top-tier public hospitals marks a significant milestone in Ping An's strategy to strengthen its medical insurance collaboration and expand quality healthcare resources [2] Group 2 - Ping An Health Insurance plans to leverage its resources to deepen cooperation with large public hospitals, focusing on innovative products like disease-specific insurance and long-term care insurance to meet diverse customer needs [3] - The "Health Management" model promoted by Peking University Health emphasizes a shift from treatment-centered to health-centered approaches, integrating insurance and healthcare to provide comprehensive health management services [4] - The collaboration aims to reduce insurance claim costs while offering proactive health management services, thus enhancing the long-term health value for customers [4]

冬日的北京，寒意渐浓。近日于北大国际医院内举行的开放日活动，却涌动着关乎生命与希望的暖流。在北京与深圳两地同步举行的这场活动中，两个普通 人惊心动魄却又充满温度的生命故事引人关注。一位企业高管在常规体检中被"截停"了即将爆发的心梗，一位23岁的青年在历经29次手术后重获"新生"。 他们的经历，如同两把钥匙，意外而精准地开启了观察中国平安"综合金融+医疗养老"战略核心业务成员北大医疗的一扇窗。面对医疗服务领域长期存在 的"重医不重防、检出无人问、院后无人管"的痛点，北大医疗集团所构建的"健—医—康"全周期服务闭环，正在尝试给出自己的答案。 生命"哨站"：北大国际医院的"防"与"断" "护士长过来跟他说，你不要紧张，120马上到了。"在开放日活动中，一位年轻的家属站上台，他代替无法到场的舅舅，讲述了一个关于"一次体检截停一场 心梗"的故事。 氧气面罩、急救药物、心电图监护迅速到位，120急救电话同步拨出。从体检中心的超声探头发现端倪，到救护车呼啸着将其送至最近的阜外医院，并在心 脏主要血管堵塞超过90%的危急情况下成功植入支架，全程未超过一小时。"他后来跟我说，特别后怕。如果再拖俩月，可能就见不着了。" 家属的感 ...

中证报中证网讯（记者 齐金钊）日前，第二届北大医疗集团开放日在北京、深圳两地同步举行，集中 展示了北大医疗集团的年度服务成果与未来战略蓝图。北大医疗集团董事长朱友刚介绍，作为中国平 安"综合金融+医疗养老"战略的核心业务成员，北大医疗集团凭借"健-医-康"全周期服务的创新实践， 2025年业绩实现高质量增长，其中非医保收入增速达35%，门急诊人次突破320万人次，聚焦学科建 设，三四级手术量同比增长20%，门诊患者满意度、住院患者满意度双双创下历史最佳纪录。 打造"健-医-康"三大板块 据介绍，北大医疗集团深度依托平安集团的战略与业务优势，携手北京大学医学部深化协同，通过"管 理+学科+科研+品牌"四维赋能，共建公立与社会办医协同发展典范。 朱友刚表示，北大医疗的核心竞争力源于"北大底蕴"的深厚积淀与"平安特色"的战略赋能，二者共同为 北大医疗构建起不可复制的发展优势。 朱友刚表示，北大医疗将积极响应国家政策，依托平安集团"综合金融+医疗养老"生态协同优势，坚 持"一切为了患者"的初心，用"北大品质"筑牢医疗根基，以"平安特色"激活服务生态，持续夯实综合医 北大医疗集团总经理刘雅娟介绍，"医险协同"模式已显现 ...

Group 1 - The core focus of the news is on the development of a comprehensive healthcare model by Beijing University Health Group, which is part of China Ping An's strategy to integrate finance, healthcare, and elderly care [1] - Beijing University Health Group aims to address pain points in the healthcare sector by creating a full-cycle service model that connects health management, medical services, and rehabilitation, shifting from passive treatment to proactive health management [1] - By 2025, the group anticipates that outpatient and emergency visits will exceed 3.2 million, with inpatient admissions increasing by 13%, and bed occupancy rates at Beijing International Hospital reaching 98% and at Beijing Rehabilitation Hospital reaching 115% [1] Group 2 - In Shenzhen, there is a significant shortage of rehabilitation beds, with a need for 60,000 beds according to international standards, while currently, there are fewer than 5,000, resulting in a shortfall of 55,000 beds [2] - Shenzhen's demographic is relatively young, with an average age of 32.5 years and a nearly 50% participation rate in sports, leading to a shift in rehabilitation needs towards sports injuries and chronic disease management [2] - The aging population in Shenzhen is projected to increase, with over 1.5 million residents aged 60 and above, expected to rise to 10% by 2029, which will further exacerbate the demand for rehabilitation services [3] Group 3 - The trend of Hong Kong residents seeking medical services in Shenzhen is increasing, with a new agreement allowing 21 hospitals in the Greater Bay Area to accept Hong Kong medical vouchers, presenting both challenges and opportunities for Shenzhen's healthcare system [3] - Shenzhen North Medical Rehabilitation Hospital is pioneering a comprehensive rehabilitation model that integrates multidisciplinary teams for physical recovery, psychological support, and advanced rehabilitation technologies, aiming to fill the regional bed shortage [3] - The "medical-insurance collaboration" model is gaining traction, with successful examples such as remote rehabilitation guidance for injury claims, which improves patient outcomes and reduces insurance payouts [4]

本报讯 （记者丁蓉）1月22日，第二届北大医疗产业集团有限公司（以下简称"北大医疗集团"）开放日 在北京、深圳两地同步举行。活动以"一切为了患者——走进今天的北大医疗"为主题，集中展示年度服 务成果与未来战略蓝图。 基于"健－医－康"闭环，2025年北大医疗集团收获了一张逆势增长的成绩单。北大医疗集团党委书记、 董事长朱友刚介绍，凭借"健－医－康"全周期服务的创新实践，2025年，北大医疗集团业绩实现稳健增 长，其中非医保收入增速达35%，门急诊人次突破320万人次，聚焦学科建设，三四级手术量同比增长 20%，门诊患者满意度、住院患者满意度双双创下历史最佳纪录。 打造"健－医－康"三大板块 作为中国平安保险（集团）股份有限公司（以下简称"中国平安"）"综合金融+医疗养老"战略的核心业 务成员，北大医疗集团携手北京大学医学部深化协同，通过"管理+学科+科研+品牌"四维赋能，共建公 立与社会办医协同发展典范。 "领军专家"是核心支柱，北大医疗集团以灵活的机制吸引30多位国家一级学会主委/副主委，60多位各 级学会主委/副主委领军的专业团队。 "价值医疗"强保障。北大医疗集团聚焦客户核心用药需求，覆盖超过350款独 ...

"保险办医"的实践 朱友刚以一组对比数据阐释这种重塑的初步成效。在"筛、管、治、康"的全流程服务体系下，北大医疗 的体检客户转化为门诊就诊的比例达到10%-30%，门诊患者复诊率在20%-35%，住院患者转入康复治疗 的比例亦有10%-20%。 "这些数字意味着，我们设计的健康与医疗的服务链条正在被'接通'，患者在不同场景下的需求被有效 地衔接和管理起来，而不是像过去那样，检后无人管、出院即失联。"朱友刚说道。 他进一步表示， "我们的目标，是打造一个'平安版的华西医疗+凯撒医疗'。华西代表的是中国顶级的医 疗品质、学科实力和教学科研能力，这是我们的'北大底蕴'要坚守的根基。而凯撒模式，代表了保险与 医疗服务一体化的高效闭环，支付方与服务方利益高度一致，共同追求让会员更健康、费用更可控。两 者融合，并非简单相加，而是一次代际升级。"他坦言，这条道路挑战巨大，但亦是平安与北大医疗必 须坚定的长期战略。 北大医疗的探索，置身于中国医改深水区的大背景之下。国家医保局主导的DRG/DIP支付方式改革全面 推行，旨在控费提质，促使医院从粗放式扩张转向精细化运营。 公开数据显示，近年来已有大量医院面临运营困境。在此背景下 ...

Core Viewpoint - The essence of commercial health insurance is not risk compensation but a systematic extension of health management, reflecting the core logic of the insurance industry's transformation and China's exploration of the "insurance-medical collaboration" strategy [1][3]. Group 1: Health Insurance Transformation - China Ping An is shifting from "post-claim" to "prevention, management, and rehabilitation," using insurance as a lever to initiate a health service revolution that covers the entire life cycle [3][4]. - The "Health China 2030" plan emphasizes the transition of healthcare services from a disease-centered approach to a health-centered one, creating a new historical mission for commercial health insurance [4]. - Ping An Health Insurance has proposed a dual-driven strategy of "health insurance + medical services," launching a digital health management platform in 2024 to provide continuous health support [4][6]. Group 2: Service Efficiency and Cost Savings - The "three savings" concept—saving worry, time, and money—underpins Ping An's health insurance collaboration system [5]. - The "post-hospital rehabilitation follow-up" project exemplifies professional closed-loop services, providing personalized training plans and real-time supervision for patients [6]. - Digital integration has reduced outpatient revisit frequency by 30%, and the time from accident report to hospitalization has been accelerated by 80% [6]. - Patients receiving follow-up care save an average of over 2000 yuan in medical expenses, while targeted rehabilitation interventions in auto insurance cases save an average of 22,000 yuan per case [6]. Group 3: Comprehensive Service Network - Ping An has established a vast service network through collaboration with Peking University Medical Group, including hospitals, rehabilitation centers, and health management centers across the country [7]. - Innovations such as "no companion wards" and "healthcare on wheels" are designed to meet the "three savings" goals, ensuring that insurance services are effectively implemented [7]. Group 4: Smart Rehabilitation and Long-term Care - The opening of Shenzhen Beida Rehabilitation Hospital marks a significant step in Ping An's "insurance-medical-health" ecosystem, featuring a family-oriented and intelligent rehabilitation environment [8][10]. - The hospital aims to provide seamless services by integrating medical insurance, commercial insurance, and cross-border insurance payment channels [10]. - Ping An is focusing on preventive health management, particularly for chronic diseases and the elderly, by developing specialized insurance products and integrating advanced healthcare technologies [10][11]. Group 5: Broader Vision and Commitment - Ping An's approach emphasizes that the ultimate value of insurance lies in extending life quality and safeguarding health dignity, moving beyond mere risk transfer [11]. - The company is building a comprehensive health ecosystem that encompasses prevention, diagnosis, rehabilitation, and elderly care, positioning insurance as an active health manager [11]. - The vision is to ensure that everyone can age healthily and gracefully, reflecting Ping An's commitment to the "Healthy China" strategy through the integration of finance, technology, and healthcare [11].