管理式医疗
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落子管理式医疗 人保健康管理有限公司成立
Jin Rong Shi Bao· 2026-01-07 02:44
中国人保党委副书记、总裁赵鹏强调,人保健管公司要充分认识肩负的历史职责和时代使命,全面 贯彻党中央关于健康优先发展战略的决策部署,深刻把握医疗卫生事业从治疗为主转向预防优先、技术 应用从传统医疗转向智慧融合、资源配置从集中转向均衡发展的时代脉搏,高标准推进健康管理公司建 设。他提出三点要求:一是高标准健全业内领先的全域服务体系;二是高标准升级人保特色的健康管理 服务生态;三是高标准助力生物医药产业新质生产力发展。努力建设一流健康管理公司,打造一流健康 管理品牌。 人保健康党委书记、总裁邵利铎表示,人保健管公司的成立,是人保健康践行人民健康社会责任、 提升专业能力、实现集团高效协同、确保服务长期稳定供给的关键举措。面向"十五五"时期,人保健康 将锚定建设"一流健康险公司"的战略使命,把健康管理服务作为风险减量的重要手段,探索发挥健康保 险和健康管理融合互促的功能作用。人保健管公司将积极搭建覆盖全国的自有医疗健康服务网络,升级 优化集团统一健康管理平台,构建以互联网医院为中心的全生命周期健康医疗服务体系,投身长期护理 保险制度建设,助力银发经济发展,成为医疗机构、制药企业、保险公司及科技企业的合作枢纽,用专 业与 ...
盘点2025 | 万亿健康险转型深水区:政策破局、生态重构
Xin Lang Cai Jing· 2026-01-05 10:10
Core Insights - The establishment of the Ping An Health Management Company marks a significant step in the transformation of the health insurance sector, reflecting a shift towards a "managed care" model and the reconstruction of a new ecosystem in health insurance [1][16] - As of November 2025, the cumulative premium for commercial health insurance reached 943.9 billion yuan, with a year-on-year growth of 2.3%, indicating a stable market but falling short of the 2 trillion yuan target set for 2025 [1][16] - The Chinese commercial health insurance market is at a crossroads, focusing on high-quality development driven by regulatory guidance and innovation in health management and product offerings [1][16] Market Structure - The commercial health insurance market is maintaining stability amid slowing growth, with a shift in focus from scale expansion to quality improvement [3][18] - In the first 11 months of 2025, life insurance companies accounted for 76.8% of health insurance premiums, totaling 725.2 billion yuan, but their growth rate has stagnated, while property insurance companies saw a 10.2% increase in premiums [3][18] - The market's stability is evidenced by a monthly premium of 49.6 billion yuan in November 2025, with life insurance companies contributing 40.2 billion yuan and property insurance companies 9.4 billion yuan [3][18] Policy Support - Regulatory measures have been pivotal in driving the transformation of the health insurance industry, with multiple initiatives launched to enhance product standards and payment reforms [4][19] - The "Guiding Opinions on Promoting the High-Quality Development of Health Insurance" issued on September 30, 2025, outlines a vision for the role of health insurance in the national health security system by 2030 [4][19] - The policy emphasizes the integration of health insurance with health management, aiming to create a new health service guarantee system that combines prevention, management, and protection [4][19] Product Innovation - The health insurance sector is entering a phase of deep product innovation, with a focus on dual attributes of "protection + returns" in dividend insurance products [7][22] - Personal account-based long-term medical insurance is highlighted as a key area supported by policy, addressing the industry's challenges with traditional short-term medical insurance [7][22] - The mid-to-high-end medical insurance market is expanding, with major players enhancing their offerings to include comprehensive solutions beyond mere reimbursement [8][23] Ecosystem Reconstruction - The competition in the health insurance industry is shifting towards building an ecosystem, with a consensus on the "insurance + health management" model [10][26] - Major insurance companies are establishing health management firms to create a comprehensive health service system, moving from post-claim reimbursement to full-cycle health management [10][26] - The establishment of health management companies by leading insurers is seen as a localized innovation of the mature "managed care" model from developed markets, aiming to enhance service quality and sustainability [12][27] Technological Empowerment - The application of new technologies such as AI, big data, and blockchain is deepening in the health insurance sector, enhancing efficiency across product design, underwriting, and customer service [13][28] - Ping An has integrated AI into its health strategy, creating a comprehensive service system that covers various health service scenarios [13][28] - The focus on digitalization and the development of personalized health management platforms are expected to improve user experience and support dynamic pricing and risk control [13][28]
保险延伸健康管理服务
Jing Ji Ri Bao· 2026-01-05 01:40
近日,众安保险迭代发布"尊享e生2026版"百万医疗险产品。从条款来看,"尊享e生2026版"以"治疗+康 复"作为产品核心升级方向,将保障范围延伸至术后康复关键阶段,推动百万医疗险向"全流程健康服 务"转型,为消费者提供更完整的就医解决方案。近年来,人民群众健康保障需求日益提升,健康保险 重要性不断增强,已经成为连接医疗卫生等产业,发挥保险业筑牢社会保障网功能的重要险种。 多位业内人士在接受经济日报记者采访时表示,健康管理服务是能够促进保险公司和被保险人双赢的举 措。保险公司既可以购买第三方健康管理公司的服务,也可以构建适合自身发展模式的健康管理体系, 本质上是把健康管理作为风险减量的重要手段。保险公司通过提升健康管理服务能力,一方面为客户提 供"医+药+康+护+健+险"闭环式服务,另一方面通过服务获得的数据和经验促进健康保险产品创新,在 满足客户多样化需求的同时,降低疾病理赔支出成本。 2025年9月,国家金融监督管理总局印发《关于推动健康保险高质量发展的指导意见》,提出构建"事前 预防、事中管理、事后保障"相结合的新型健康服务保障体系。支持通过提供医疗、康复、护理等服务 的形式履行对被保险人的健康保障责 ...
福瑞医科整改境外子公司内控缺失,H股上市前补课监管警示问题
Cai Jing Wang· 2026-01-04 09:00
近日刚刚完成证券简称变更、正积极推进H股上市的福瑞医科(300049)12月31日晚间发布整改报告。 2025年12月31日晚,福瑞医科发布整改报告称,公司收到内蒙监管局于2025年12月10日出具的《关于对 内蒙古福瑞医疗科技股份有限公司采取责令改正措施并对相关责任人员采取出具警示函措施的决定》 (以下简称"《决定书》"),要求公司对《决定书》中指出的境外子公司管理内部控制不完善、公司收 入核算不规范等问题进行整改。 《决定书》显示,福瑞医科对境外子公司管理内部控制不完善。福瑞医科未建立母公司对重要境外子公 司的内部控制及风险管理制度,公司内设部门未对境外子公司开展检查和监督。 对此,福瑞医科表示,公司已制定《福瑞股份:境外子公司管理办法》,完善母公司对重要境外子公司 的内部控制及风险管理制度框架,进一步明确了重要境外子公司在战略规划、重大决策、合规经营等方 面的管理要求。 福瑞医科还表示,公司审计部已对重要境外子公司发出审计通知书,同时委托专业机构协助公司对重要 境外子公司开展专项内部审计,保障内审工作的专业性和执行效果。福瑞医科将严格依据《福瑞股份: 境外子公司管理办法》,落实对重要境外子公司的常态化检 ...
人保健康管理有限公司揭牌成立
Zheng Quan Ri Bao Wang· 2025-12-31 11:53
本报讯 (记者冷翠华)12月31日,中国人民健康保险股份有限公司(以下简称"人保健康")全资设立的子公司——人保健 康管理有限公司(以下简称"人保健管公司")在北京正式揭牌成立。 作为国内第一家专业健康保险公司,人保健康以提高人民健康水平为根本,深入推进大健康生态建设和"健康工程"实施, 持续做优"6+1"业务格局,着力构建"保险+健康服务+科技"新商业模式,把健康管理服务作为风险减量的重要手段,坚持健康 保险和健康管理双轮驱动、融合互推,构建覆盖全流程的健康管理服务体系,有效降低了客户疾病和失能风险发生率,助力人 民群众从"被动医疗"向"主动健康"转变。近年来,人保健康高质量发展不断取得新成效、新突破,呈现出服务大局走深走实、 经营质效全面向好、创新变革见行见效的良好发展态势。 健康管理作为人保健康的专业优势和核心竞争力,在客户获取、市场拓展、系统建设、人才队伍、医疗资源等方面具备领 先优势。目前,人保健康已构建覆盖全国的"医、药、康、护、健、险"大健康生态体系。设立健康管理子公司,是人保集团大 健康大养老生态建设的核心环节,也是专业健康险公司实现"管理式医疗"的关键举措。人保健管公司的成立标志着人保健康 ...
人保健康管理公司在北京揭牌成立
Jing Ji Guan Cha Wang· 2025-12-31 11:26
经济观察网2025年12月31日,中国人民健康保险股份有限公司(以下简称人保健康)全资设立的子公司 ——人保健康管理有限公司(以下简称人保健管公司)在北京正式揭牌成立。这是2019年原银保监会成立 以及2023年国家金融监督管理总局组建后批准设立的首家健康管理公司。 设立健康管理公司是人保集团推进大健康、大养老生态建设的核心环节,也是专业健康保险公司实 现"管理式医疗"的关键举措,标志着人保健康从"传统费用报销"模式向"管理式医疗"转型迈出关键一 步。 健康管理是人保健康的专业优势和核心竞争力,公司已在客户获取、市场拓展、系统建设、人才队伍及 医疗资源等方面形成领先优势。目前,人保健康已构建起覆盖全国的"医、药、康、护、健、险"一体化 大健康生态体系。全系统健康管理队伍规模已超过450人,建立了涵盖8大类、30项服务的多维度健康管 理服务体系。 在优质资源整合方面,人保健康搭建了由1万余家医院、23万家药店、2500家体检中心、3000家口腔诊 所以及近千家护理机构组成的医疗合作生态网络。此外,人保健康还在全国累计建设了80个企业联合医 务室,涵盖云诊、嵌入和全面三种服务模式,为40万家法人客户提供"健康企业 ...
人保健康管理有限公司在北京揭牌成立
Sou Hu Cai Jing· 2025-12-31 10:41
Core Viewpoint - The establishment of the Health Management Company by China People's Health Insurance Co., Ltd. marks a significant step towards integrating health management services into the insurance model, aiming to enhance public health and transition from reactive to proactive health management [1][3]. Group 1: Company Development - The Health Management Company is the first specialized health insurance company in China, aligning its development with national strategies and the goals of the China People's Insurance Group [1]. - The company aims to create a new business model that combines insurance, health services, and technology, focusing on a comprehensive health management service system to reduce disease and disability risks [1][5]. - The company has achieved significant progress in high-quality development, demonstrating improved operational efficiency and innovative transformations [1]. Group 2: Health Management Advantages - Health management is identified as a core competitive advantage for the company, with a nationwide ecosystem covering medical, pharmaceutical, rehabilitation, and insurance services [2]. - The health management team has over 450 members and offers a diverse range of 30 service products, supported by a robust digital health service platform [2]. - The company has established partnerships with over 10,000 hospitals and 230,000 pharmacies, providing health management services to over 100 million individuals [2]. Group 3: Strategic Goals - The establishment of the Health Management Company is a key initiative for the China People's Insurance Group's broader health and elderly care ecosystem, transitioning from traditional reimbursement to managed care [3]. - The company aims to develop a new health service guarantee system that integrates prevention, management, and post-care support, contributing to the "Healthy China" initiative [3][4]. - The leadership emphasizes the importance of building a leading service system, upgrading health management services, and supporting the development of the biopharmaceutical industry [4]. Group 4: Future Directions - The company plans to enhance its health management services as a means of risk reduction, focusing on integrating health insurance and management functions [5]. - It aims to create a nationwide self-owned medical health service network and optimize a unified health management platform centered around internet hospitals [5]. - The company is committed to contributing to the aging economy and becoming a collaborative hub for medical institutions, pharmaceutical companies, insurance firms, and technology enterprises [5].
人保健康出资2亿元成立全资健康管理子公司
Zhong Guo Jing Ying Bao· 2025-12-31 03:11
人保健康方面彼时回应本报记者采访时表示,将以专业健康管理公司为抓手,加强健康保险和健康管理 融合发展的生态布局,进一步推动实现健康险商业模式由传统费用报销型向管理式医疗转型,持续提升 健康管理服务能力,为客户提供"医+药+康+护+健+险"闭环式健康医疗保障服务体系,有效促进健康保 险产品市场创新,满足客户多样化健康需求,降低疾病理赔支出成本。中经记者 陈晶晶 北京报道 【人保健康出资2亿元成立健康管理子公司】《中国经营报》记者注意到,近日,中国人民健康保险股 份有限公司(以下简称"人保健康")出资2亿元正式成立了人保健康管理有限公司,持股比例100%。 国家企业信用信息公示系统显示,该公司经营范围包括健康咨询服务(不含诊疗服务);第一类医疗器 械销售;第二类医疗器械销售;第一类医疗设备租赁;第二类医疗设备租赁;数字技术服务;人工智能 应用软件开发;人工智能通用应用系统;人工智能双创服务平台;人工智能硬件销售;可穿戴智能设备 销售等。 此前在2025年9月,国家金融监督管理总局已批复人保健康设立专门的健康管理公司。 ...
保险延伸健康管理服务
Jing Ji Ri Bao· 2025-12-30 22:08
来自金融监管总局的数据显示,2025年上半年全国健康险保费收入超过6200亿元。健康管理服务通常涵 盖健康咨询、预防保健、就医绿色通道等,而对于有慢性疾病的人群,健康管理服务则可以拓展到预约 挂号、远程问诊、送药上门、康复指导等。随着健康险保费规模扩容,不少保险公司开始以专业健康管 理为抓手,加强健康保险和健康管理融合发展的生态布局,进而推动健康险商业模式由传统费用报销型 向管理式医疗转型。 近日,众安保险迭代发布"尊享e生2026版"百万医疗险产品。从条款来看,"尊享e生2026版"以"治疗+康 复"作为产品核心升级方向,将保障范围延伸至术后康复关键阶段,推动百万医疗险向"全流程健康服 务"转型,为消费者提供更完整的就医解决方案。近年来,人民群众健康保障需求日益提升,健康保险 重要性不断增强,已经成为连接医疗卫生等产业,发挥保险业筑牢社会保障网功能的重要险种。 2025年9月,国家金融监督管理总局印发《关于推动健康保险高质量发展的指导意见》,提出构建"事前 预防、事中管理、事后保障"相结合的新型健康服务保障体系。支持通过提供医疗、康复、护理等服务 的形式履行对被保险人的健康保障责任,推动全社会健康风险减量和 ...
人保健康出资2亿元成立健康管理子公司
Zhong Guo Jing Ying Bao· 2025-12-30 16:45
Group 1 - China People's Health Insurance Co., Ltd. (referred to as "Puhua Health") has invested 200 million yuan to establish Puhua Health Management Co., Ltd., holding a 100% stake [1] - The newly established company will focus on health consulting services, medical device sales and rentals, digital technology services, artificial intelligence application software development, and sales of wearable smart devices [1] - In September 2025, the National Financial Supervision and Administration Bureau approved the establishment of a specialized health management company by Puhua Health [2] Group 2 - Puhua Health aims to enhance the integration of health insurance and health management, transitioning from a traditional fee-for-service model to a managed care model [2] - The company plans to improve its health management service capabilities and provide a comprehensive health care protection service system that includes medical, pharmaceutical, rehabilitation, and insurance services [2] - This initiative is expected to promote innovation in health insurance products and meet diverse health needs while reducing disease claim costs [2]