HMO管理式医疗保险
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预期升温背后:平安好医生打造中国HMO新样板
21世纪经济报道· 2025-12-18 02:59
Core Viewpoint - Morgan Stanley's recent report significantly raised the target price for Ping An from 70 yuan to nearly 90 yuan, predicting that Ping An Good Doctor's stock price could double within the year [1][13]. Group 1: Ping An Good Doctor's Performance - In the first three quarters of 2025, Ping An Good Doctor is expected to achieve a revenue growth of 13.6% year-on-year and a net profit surge of 72.6% [1]. - Despite being smaller than competitors like JD and Alibaba, Ping An Good Doctor's differentiated business model and vast potential have captured market attention [1]. Group 2: HMO Model and Its Significance - The HMO (Health Maintenance Organization) model, exemplified by UnitedHealth Group, integrates pre-paid premiums with exclusive medical services, shifting from traditional reimbursement to proactive health management [3][4]. - UnitedHealth's Optum division has become a growth engine, contributing over 50% of the company's revenue and profits, showcasing the sustainability of the "insurance + full-chain medical services" model [5]. Group 3: Ping An's Strategic Framework - Ping An aims to create a Chinese version of the HMO model by combining comprehensive financial services with healthcare, leveraging its resources from Ping An Good Doctor and other subsidiaries [7]. - The company has established a robust medical service network and a large healthcare database, which supports its "four services" framework: online, hospital, home, and enterprise services [8][10][11]. Group 4: Market Opportunities - The commercial health insurance market in China is expected to grow significantly, with an annual growth rate exceeding 20%, presenting a substantial opportunity for Ping An Good Doctor [11][12]. - Ping An Good Doctor has a leading position in corporate health management, having served over 56,000 corporate clients and 26 million employees, which positions it well for future growth [12]. Group 5: Future Outlook - Ping An Good Doctor is poised to leverage its internal service network and operational efficiencies to expand into external markets, including government healthcare systems, thereby diversifying its revenue streams [11][13]. - The potential market size and the company's strategic positioning suggest a promising future, with Morgan Stanley's target price adjustment reflecting confidence in its long-term growth potential [13].
预期升温背后:平安好医生打造中国HMO新样板
2 1 Shi Ji Jing Ji Bao Dao· 2025-12-17 13:46
2025年前三季度,平安好医生在2024年首次扭亏为盈基础上再创新高:营收同比增长13.6%;净利润同 比激增72.6%。虽然整体规模与京东、阿里仍有差距,但其差异化的商业模式与广阔前景令市场充满遐 想——平安好医生锚定美国联合健康Optum(医健服务公司)模式,服务中国平安"综合金融+医疗养 老"战略,作为平安医养服务战略板块核心旗舰,与综合金融、尤其是保险业务协同闭环,以打造中国 市场HMO管理式医疗保险新样板,建立差异化优势。 美国联合健康:HMO管理式医疗保险铸就行业标杆 1974年成立的美国联合健康,用半个世纪证明了HMO管理式医疗保险模式的商业魔力。 何为"HMO"?简单讲,是"预付保费+专属医疗服务"的一体化健康保障模式。其核心,是将医保/商保 (支付方)和医院、医生(服务方)整合起来,改变了传统的事后报销模式,而是主动的事前管理健 康、事中管控成本。对客户来说,先缴纳固定费用(保费),即可享受专属网络内的全面医疗服务,有 家庭医生当"健康守门人",给投保人带来省心、省时、又省钱的服务。对医疗机构而言,支付方提前给 服务方拨款,倒逼医院合理诊疗不浪费资源,同时通过健康管理减少大病支出,形成"保健 ...