Earnings can’t keep up with premiums, health insurance encounters growing pains-www.yyy13.com

Profits fail to meet premium health insurance and suffer from "growing pains". [Abstract] compared with the premium income rising linearly, the profitability of professional health insurance companies is divided. Compared with the medical institutions’ poor cooperation, vicious competition in the industry, long service chain and difficult risk management, compared with the rising premium income, professional health insurance company’s earnings differentiation. Poor cooperation with medical institutions, vicious competition in the industry, long service chain, and difficulty in risk management are the main reasons. Only by finding a good business model, developing high-quality products, so as to stimulate the market demand into business, professional health insurance companies can create value for participants in all aspects of the industry chain. Fosun joint health insurance Limited by Share Ltd before Chinese received CIRC approval, which means that after PICC Health, safe and healthy, healthy, harmonious and healthy Kunlun Taibao Allianz health, sixth domestic professional health insurance companies will be born. Data show that in the first half of 2016, the original insurance premium income of health insurance reached 235 billion 933 million yuan, an increase of 89.37%, nearly 241 billion 47 million yuan last year’s health insurance premium income. The proportion of the original insurance premium income of health insurance accounts for the total premium income of the whole insurance industry, also increased from 9.93% at the end of the year to 12.54% in the first half of this year. The rapid growth of data has also attracted all sorts of capital to compete in health insurance. Multi channel capital beachhead commercial health insurance refers to insurance companies through disease insurance, medical insurance, disability income loss insurance and care insurance and other means of health reasons caused by the loss of insurance payment of insurance. After the introduction of "ten new states" and "several opinions on accelerating the development of commercial health insurance", China’s health insurance has entered a period of vigorous development. At present, the health insurance tax policy has landed. Some experts predict that under the policy bonus move, health insurance will gradually narrow the gap between life insurance and property insurance, and by 2020, health insurance premiums are expected to reach 7000 to 10000 billion yuan, and become one of the three major business segments tied with life insurance and property insurance. By the end of 2015, the total population of China reached 1 billion 375 million, and the average life expectancy was 76.34 years. With the growth of population life and the release of the two child policy, the total population of China will maintain steady growth. To solve the health problems of 1 billion 375 million people will bring great business opportunities for commercial health insurance." Song Fuxing, President of the people’s health insurance company, told the Economic Daily reporters that the health service industry, including health insurance, is an important part of the modern service industry. At present, China’s health services GDP accounted for only about 5%, far lower than the United States 17% and other OECD countries around 10% level. From the international point of view, when a country’s economic development to a certain extent, the health care industry will flourish. According to the data of developed countries, the big health industry usually accounts for 11% to 15% of the national GDP, and its volume can not be ignored." Ping An health insurance marketing director of teaching and research said. Although China’s health insurance market is still in the early stages of development, but with the rapid development of economy, the big health industry is undoubtedly a potential development area. Reporter understands.

盈利赶不上保费 健康险遭遇“成长的烦恼” [摘要]相较于直线上升的保费收入,专业健康险公司的盈利状况出现分化。与医疗机构合作不畅、行业恶性竞争、服务链条长、风险管理难…相较于直线上升的保费收入,专业健康险公司的盈利状况出现分化。与医疗机构合作不畅、行业恶性竞争、服务链条长、风险管理难度大是主因。只有找到好的商业模式,开发优质的产品从而把市场需求激发出来转化成业务,专业健康险公司才能为产业链条上各个环节的参与者创造价值。复星联合健康保险股份有限公司日前获中国保监会批准筹建,这意味着继人保健康、平安健康、昆仑健康、和谐健康以及太保安联健康之后,国内第6家专业健康险公司即将诞生。数据显示,2016年上半年,健康险业务原保险保费收入达2359.33亿元,同比增长89.37%,接近去年全年2410.47亿元的健康险保费收入。健康险原保险保费收入占整个保险业原保险保费收入的比例,也由去年底的9.93%上升为今年上半年的12.54%。飞速增长的数据,也吸引了各路资本竞逐健康险行业。多路资本抢滩商业健康保险是指保险公司通过疾病保险、医疗保险、失能收入损失保险和护理保险等方式对因健康原因导致的损失,给付保险金的保险。在保险“新国十条”和《关于加快发展商业健康保险的若干意见》出台后,我国健康险迎来蓬勃发展期。目前,健康险税优政策也已落地。有专家预测,在政策红利的撬动下,健康险将逐步缩小与寿险、产险的差距,到2020年,健康险保费有望达到7000至10000亿元,成为与寿险、产险并列的三大业务板块之一。“截至2015年底,我国总人口达到13.75亿,人均预期寿命达76.34岁。随着人口寿命的增长和二孩政策的放开,我国总人口还将保持稳定增长。解决13.75亿人的健康问题,将为商业健康保险带来巨大商机。”中国人民健康保险公司总裁宋福兴告诉《经济日报》记者,包括健康保险在内的健康服务业是现代服务业的重要组成部分。目前,我国健康服务业GDP占比仅为5%左右,远低于美国的17%和其他经合组织国家10%左右的水平。“从国际上看,当一个国家的经济发展到一定程度,医疗健康产业也将蓬勃发展。发达国家数据显示,大健康产业通常占国家GDP的11%至15%,其体量不容忽视。”平安健康保险营销总监尚教研说。虽然我国的健康险市场尚处于发展初期,但随着经济的快速发展,大健康产业无疑是极具潜力的发展领域。记者了解到,截至目前,递交保监会成立专业健康险公司的牌照申请已达50多张。“之所以资本对于健康险牌照如此看重,更多的是寄望于健康险的发展潜力。”业内专家表示,布局大健康产业、联动业务整合,是再次激起资本青睐专业健康险的主要因素。从传统保险公司对医疗健康领域的运作来看,未来险企想要创造更大的附加值,实现产业联动、优质转型,发展健康险、完善医疗体系是关键一步。“尽管当下国内健康险发挥的作用还没有达到预期,但这并不影响资本对健康险的热衷,因为更多资本瞄准的是今后大健康产业的发展,特别是国内老龄化社会即将到来,大健康产业的前景无可限量。”中国人民大学财政与金融学院副教授何林说,目前拥有大数据资源的互联网公司和一些医药行业龙头也寄望与保险公司实现业务联动,为健康险行业带来多元化的发展路径。公开消息显示,阿里巴巴、康美药业(600518,股吧)、东软集团(600718,股吧)等也纷纷表示计划申请专业健康险牌照。盈利状况分化相较于直线上升的保费收入,专业健康保险公司的盈利状况出现分化。公开信息显示,在国内5家专业健康险公司中,2015年人保健康和平安健康都亏损了1亿元以上,太保安联健康去年亏损5600万元。实现盈利的仅有和谐健康和昆仑健康,其中,昆仑健康实现净利润1.52亿元。此外,根据5家公司最新公布的2016年二季度偿付能力报告,除了太保安联健康、和谐健康以外,其余3家都呈亏损状态。太保安联健康相关人士认为,健康保险公司出现亏损最重要的原因是与医疗机构合作不畅。保险公司无法介入医疗诊断来控制医疗成本支出,另外,在社保系统对接方面,各地医保IT系统平台并不统一,导致系统开发维护成本高,资源效率低下,无法获得完整有效的信息。行业恶性竞争也是一些公司出现亏损的原因。不少综合型保险公司将价格压得很低,导致大多数公司利润空间缩小,再加上服务缺乏创新,疾病保险和医疗保险业务基本都在中低端客户中争夺资源。此外,由于医疗健康产业经营跨行业较多,不仅涉及社会保障、医疗卫生,还辐射到保健养生等多个领域,服务链条较长,风险管理难度较大也是出现亏损的原因。“商业健康险本身是一个微利行业,即使像美国联合健康险公司,保费做到千亿美金以上,能够有效地分摊成本,但其综合赔付率也在90%以上。目前,我国商业健康险公司的市场规模相对于产险、寿险很小,规模最大的重疾险保费也仅有1000多亿元,无法应对当前每年3万至4万亿元的医疗支出。”尚教研告诉《经济日报》记者,“如此大的市场规模下仅有千亿元的保费,无法产生规模效益。未来,商业健康险的保费规模做大后,将成本摊薄,风险得到更有效管理,才能实现盈利”。发展路径渐明在业内看来,作为极具专业性的商业健康保险,相对于传统寿险和产险,遇到的风险更复杂,对产品精算的要求更高。其与普通寿险业务在精算原理、风险控制和经营模式等方面都有明显不同。目前国内健康险主要是按寿险的发展思路来设计产品和经营,另外还有参与到城镇居民基本医疗保险业务、大额医疗救助业务等社会基本医疗保障之中的产品以及引入第三方医疗机构,增加对健康保险风险管理模式的相关产品。无论何种模式,都需要构建包括预防、治病、疗养的人身健康管理闭环,实现健康风险管理产业链与相关产品的充分融合,如此,专业健康保险公司才能在市场上发挥独特竞争优势。“对专业健康险公司而言,找到好的商业模式、开发优质的产品从而把市场需求激发出来转化成业务,才能为参保人、医疗体系创造价值。”尚教研说。目前,商业健康险公司在发展中面临的问题有些类似。即除了为大众提供基本的保障外,还有如何为客户提供优质的医疗服务,包括涉及门诊、住院方面的服务等。而这需要与全国成千上万家医疗服务机构搭建起全面的医疗服务合作。这单凭一家公司是无法做到的。太保安联健康相关人士认为,“健康险未来发展需要政策助推医疗大数据应用发展,建立起商业保险公司与医保数据相关联的医疗控费系统,并向健康产业延伸布局。同时,健康险服务能力提升后,将从事后理赔逐渐走向事前健康干预,健康管理发展路径将呈现多样化的态势”。宋福兴认为,医疗健康上下游企业应从各自优势领域出发,加大力度搭建大健康生态圈。面对新的市场格局,公司应学习借鉴国际经验,结合自身实际,积极整合医、养、药、护等上下游产业资源,加快推进“做平台、建生态圈”,构建全生命周期的健康管理服务链,当好客户的家庭医生。业内专家表示,未来,健康险公司如果在精算数据、费率厘定以及开发水准方面深入创新,细分产品、细化风险,真正做好专业健康管理服务,一定会获得更快的发展。相关的主题文章: