证券研究报告 | 半年报点评 gszqdatemark 2025 09 07 年 月 日 新产业（300832.SZ） 国内短期承压，海外延续高增，期待 25Q3 国内业绩修复 股价走势 新产业发布 2025 年半年度报告。2025H1 公司实现营业收入 21.85 亿元，同 比下滑 1.18%；归母净利润 7.71 亿元，同比下滑 14.62%；扣非后归母净利 润 7.26 亿元，同比下滑 16.33%。分季度看，2025Q2 实现营业收入 10.60 亿 元，同比下滑 10.88%；归母净利润 3.34 亿元，同比下滑 30.06%；扣非后归 母净利润 3.09 亿元，同比下滑 34.00%。 观点：政策扰动导致收入端短期承压，利润端增速不及收入端主要系毛利率下 降及期间费用率抬升所致，预计 2025Q3 国内试剂迎来量、价双重修复，有 望看到业绩拐点。海外市场增长靓丽，海外本土化布局持续深化，收入与利润 有望迎来双击。中高端仪器装机进展顺利，带动高端客户群突破，奠定试剂销 售根基。 政策扰动导致业绩短期承压，利润端增速不及收入端主要系毛利率下降及期 间费用率提升所致，期待 25Q3 迎来业绩拐点。受带量 ...

Core Insights - The ongoing reform of medical insurance payment methods, primarily focusing on Diagnosis-Related Groups (DRG) and Disease-Related Payment (DIP), presents both opportunities and challenges for commercial health insurance [1][3] - There is a growing consumer demand for "out-of-hospital medication coverage," leading to a shift in preferences towards mid-to-high-end health insurance products that offer fewer restrictions on hospital choices [3][4] - Traditional million medical insurance products are facing challenges due to the new payment models, highlighting gaps in coverage that do not meet evolving patient needs [4][5] Industry Trends - The transition from "fee-for-service" to "value-based payment" under DRG/DIP reforms has resulted in increased outpatient treatment costs and a rise in demand for medications purchased outside hospitals [4][5] - Many insurance companies are responding to these changes by launching new products that include coverage for out-of-hospital medications and medical devices, addressing the gaps left by traditional million medical insurance [9][10] - The introduction of a diversified commercial health insurance system aims to meet the varied health protection needs of different consumer groups [10][11] Product Development - Insurance companies are iterating their products to lower deductibles and expand coverage to include outpatient services and private hospitals, while also removing restrictions on high-value medications [8][9] - New products, such as those from ZhongAn Insurance, are now offering coverage for out-of-hospital medications without disease or treatment limitations, reflecting a significant shift in product offerings [9] - The establishment of a comprehensive drug directory for commercial health insurance is seen as a crucial step in enhancing product design and improving customer experience through direct payment models [12]

Core Viewpoint - The implementation of the DRG/DIP reform in China's healthcare system is expected to lead to a decline in overall medical expenses, creating new opportunities for the commercial health insurance market, particularly for million medical insurance products, which have significant growth potential [1][2]. Group 1: Market Overview - China's medical expenditure consists of three parts: basic medical insurance expenditure, personal expenditure, and commercial health insurance payouts. The commercial health insurance currently accounts for only about 5% of the total medical payment system, indicating substantial growth potential [3]. - In 2024, the commercial health insurance premium scale reached 977.3 billion yuan, with medical insurance premiums expected to exceed 400 billion yuan. Million medical insurance is projected to account for approximately 20% of this market [3][4]. Group 2: Product Upgrades - The "Good Medical Long-term Insurance" series by PICC Health has undergone significant upgrades, including the introduction of new coverage for purchased drugs and medical devices, advanced drug and device coverage, and expanded access to specific diseases and advanced medical facilities [8][9][12]. - The upgraded flagship version for 2025 includes coverage for over 1,500 advanced drugs and devices, significantly expanding the previous list of 199 special drugs and 3 CAR-T anti-cancer injections [9]. - The insurance product has also relaxed the age limit for policyholders from 55 to 60 years, allowing more older individuals to obtain coverage [12][17]. Group 3: Target Demographics - The elderly population (60 years and above) in China is projected to reach 310.31 million by the end of 2024, with a significant portion suffering from chronic diseases. This demographic represents a growing market for health insurance products [17][20]. - The "Good Medical Long-term Insurance for the Elderly" has been specifically designed to cater to this demographic, offering low entry barriers and a 20-year guarantee for renewal, making it appealing to older consumers [20][22]. Group 4: Company Performance - PICC Health reported a total insurance premium income of 48.7 billion yuan in 2024, a year-on-year increase of 7.7%. The company maintains a leading position in the industry with a customer base of 76 million [24][25]. - In the first quarter of 2025, PICC Health achieved an insurance business income of 28.1 billion yuan, with a net profit of 2.43 billion yuan, reflecting a significant growth rate compared to the industry [24][25].

Core Viewpoint - The article discusses the complexities and challenges surrounding the issue of "decomposed hospitalization" in the healthcare system, particularly in the context of the DRG/DIP payment reform, highlighting the increase in readmission rates and the ambiguity in defining and regulating such practices [3][4][5]. Summary by Sections Hospitalization Costs and Readmission Rates - In 2024, the average personal burden of hospitalization costs is expected to decrease by 5%, while the total number of individuals enjoying hospitalization benefits is projected to increase by 4.48% [3][4]. - The decline in average costs raises questions about whether it reflects genuine improvements in medical service efficiency or if it is a result of hospitals engaging in practices like low-standard admissions and decomposed hospitalizations [4]. DRG/DIP Reform and Its Impacts - Since the implementation of DRG/DIP payment reforms, there has been a notable increase in the "readmission rate," which rose from 11% before the reform to 14.41% in 2023 in a specific province [7][8]. - The increase in readmission rates is linked to the financial pressures hospitals face under the DRG system, leading to practices that may not align with the intended cost-control objectives of the reform [9][10]. Challenges in Defining and Regulating Decomposed Hospitalization - There is no clear definition or standard for "decomposed hospitalization," making it difficult for regulatory bodies to monitor and enforce compliance effectively [14][15]. - The ambiguity in defining decomposed hospitalization allows hospitals to exploit loopholes, such as changing primary diagnoses to avoid penalties for repeat admissions [10][12]. Regulatory Approaches and Observations - Some regions have adopted a data-driven approach to flag potential cases of decomposed hospitalization, marking instances of readmission within a specific timeframe as "suspected decomposed hospitalization" [21][22]. - Effective governance of decomposed hospitalization requires not only stringent monitoring but also appropriate compensation policies to address the underlying financial incentives that drive such practices [22][23]. Variability in Readmission Rates Across Hospital Types - Readmission rates tend to be higher in secondary hospitals compared to tertiary hospitals, indicating that the financial pressures and motivations for decomposed hospitalization may vary significantly based on the type of institution [24].

一位国家医保局官员在最近的一次公开发言中透露，2024年次均住院费用的个人负担占比明显下降，降 幅达到了5%。 但可喜的数据背后，有学者结合另一项数据提出隐忧：2024年享受住院待遇总人次却增加4.48%。 两个数据的一增一减，背后是另一层隐秘：次均费用的下降，究竟是医疗服务效率提升、成本优化的真 实体现，还是医疗机构通过低标入院、分解住院等异常行为导致的 "数据虚像"？ 答案是模糊的。 而在医保相关从业人员的共识中，随着DRG/DIP改革的深化，若论存在的异常诊疗行为，医疗机构冲 量、低标入院、分解住院等是无法绕过的话题。在医院端这些"变形动作"中，分解住院的隐匿性最强。 要想量化分解住院，"15天非计划再入院率"（下文简称"再入院率"）是一个相对可靠的选择——统筹区 内有多少住院患者，出院时没有合理的再住院计划，却在15天内第二次住院，一定程度上反映了当地分 解住院是否严重。 但这一指标的应用也充满争议。用大白话来说：当患者在出院 15 天内再次入院，究竟是医院为追求利 益诱导患者重复住院？还是因当地医疗水平限制，患者确实需要二次治疗？ 很多情况下，要判断究竟是分解住院还是正常的诊疗行为，并无绝对正确的答 ...