Since the outbreak of the epidemic, residents' health awareness and protection needs have increased significantly, and many enterprise employers have also realized the importance of employee health welfare support for the benign and sustainable development of enterprises. In addition, according to the main data of the seventh national census, the mainland population aged 60 and above is 264 million, accounting for 18.7%, and the population aged 65 and above is 190 million, accounting for 13.5%, and the problem of aging population structure is also increasing, and high-quality medical care is indispensable. The health protection needs of residents have become one of the current issues that the whole society must pay attention to. It is worth noting that the current national policies are also supporting the development of the "big health industry" to serve the national policy of "Healthy China 2030". The "14th Five-Year Plan for the Development of the Digital Economy" issued by the State Council includes Internet medical care in the cultivation project of new formats of the digital economy. In March last year, the National Development and Reform Commission and various departments jointly formulated the "Implementation Plan for Accelerating the Cultivation of New Consumption", and also proposed to actively develop "Internet + medical health". In the post-epidemic era, under the background of the continuous upgrading of the public's demand for various types of medical and health care and the enjoyment of quality services in different scenarios as the main demand, the medical and health industry, especially internet medical care, is ushering in a new round of development opportunities.
However, from the overall point of view, the domestic medical and health market still has problems such as resource imbalance, high-quality medical shortage, low resource utilization efficiency, and widespread market supply. The investment in the medical and health industry also focuses on clinical medical links and ignores large-scale health management according to inertial thinking, resulting in almost all of the existing medical and health expenditures concentrated in clinical treatment, which further aggravates the problem of insufficient supply of medical resources, and then makes everyone have many doubts about the degree of resource matching in insurance protection.
Therefore, the market gap has prompted relevant participants in the medical and health industry to urgently open up various service ports and promote synergy and cooperation to better meet the growing demand for health security.
Looking at the international health management environment, the "Health Maintenance Organization" (health maintenance organization) model (health maintenance organization) implemented by the leading institutions in the United States for decades provides a model for domestic reference. HMO advocates "prevention first, prevention and control combined", through the coordination of all medical resource allocation, and cooperate with health management services to improve the health level of insured persons, so as to achieve the purpose of avoiding excessive medical treatment and cost control. This is not only conducive to alleviating the pressure on domestic medical insurance funds, but also in line with the focus of the "Healthy China 2030 Planning Outline", that is, from clinical treatment to health management as the center. The future direction of HMO's market development can be described as very clear.
The HMO model of Chinese market research can be said to be in line with the trend. After the gradual popularization of Internet medical treatment, how institutions in the health care field have jumped out of a single online product and service to deepen multiple channels and improve the quality of user use has become their new growth strategy.
HMO mode breakout
Under traditional health insurance, insurance companies pay for services that patients receive, and patients choose to visit any hospital clinic at any time. However, this pattern can easily lead to over-medical treatment. Due to the need to control costs, managed medical care has emerged. As one of them, the HMO model has been practiced for decades in the field of health care in the United States and has produced successful experiences of leading institutions such as Kaiser Medical and United Health. In short, HMO is to provide a comprehensive medical service system for users in specific regions and actively insured users after charging fixed upfront fees, and it can jointly serve users with upstream medical services and midstream insurance companies, forming a commercial closed loop and resource synergy.
Among the many institutions that have laid out HMO, Ping An Health stands out.
In October last year, Ping An Healthcare Technology Co., Ltd. announced the plan for the upgrade of Ping An Health Strategy 2.0 at its Investor Open Day event: further deepening the strategic upgrade, integrating the three major models of HMO health management, family doctor membership system, and O2O medical services, to provide users with warm medical and health services. Among them, the HMO model is the highlight of this strategic upgrade.
Ping An has always been committed to the vertical and horizontal opening up of the medical ecosystem. Fang Weihao, chairman and CEO of Ping An Health, believes that insurance and health management are two sides of the same coin and are a symbiote. "Integration is not a simple insurance + health management, but the service content of health management is integrated into the design concept of insurance products. Health management services should also consider the characteristics of the insurance products provided. Nowadays, Ping An Health strengthens the HMO model, forms a new triangle closed loop of "hospital-patient-insurance company", and realizes the opening up of the "medical + insurance + health" industry ecology, which is also based on its own three major advantages.
Group experience: Ping An has 30 years of experience in health management, which can now cover more than 2,000 diseases remotely, AI has achieved more than 99% guidance accuracy and more than 95% auxiliary diagnosis accuracy, and the world's largest five major medical databases have become a strong backing for ping an's healthy development.
Huge customer base: A fully licensed financial institution, with 225 million Ping An financial customers, the number of employees served by enterprises has reached 70 million, and the total potential enterprise employee market size is about 310 million people, and the user base and future conversion potential are huge.
Ecological synergy: There are 1,100 famous doctors signed up, and cooperation has been established with more than 3,600 hospitals. The number of cooperative physical examination institutions exceeds 1,700, covering 321 cities across the country. The number of cooperative pharmacies reached 202,000, and the national coverage rate was about 34%. And has laid out more than 225 central warehouses, and in 140 cities to achieve 1 hour delivery.
The strong ability to coordinate and advance is inseparable from the two-way support and organic integration with the channel. From the perspective of visual performance at the business level, we can take the "Zhenxiang RUN" series of services as an example:
Ping An Health and Ping An Life Insurance jointly launched the "ZhenXiang RUN" series of services to cover critical illness insurance policy users, and the basic product package is incorporated into the policy, so that users can enjoy a number of rights and interests such as major illness project management service package, real-time audio and video consultation rights package, and health management service package without additional charge. During the reporting period, the per capita number of health management services and audio and video consultation services used by major illness insurance policy users increased significantly; customer recognition, trust and viscosity further improved, and gradually transformed into the company's high-quality customers. This is an intuitive manifestation of HMO's interoperability at the business level.
Strategy 2.0 deepens the leading edge
Through in-depth understanding of Ping An Health's HMO model, it is found that its advantage of being able to break through is very obvious, that is, the strong client composition - relying on Ping An's perfect membership system, whether it is the stickiness of the C-end or the diversion of the B-end, ping An Health's "transformation-reflux" potential is huge. HMO has good anti-cyclicality and stable output in the independent and close synergistic model characteristics of insurance and health services, which also promotes the high valuation of Ping An Health in the health and medical track.
Multi-channel: Improve user service
From 2014 to the beginning of 2020, Ping An Health built an Internet medical model, focusing on online consultation, online commodity drugs and online services, and achieved the first place in user registration and online consultation through the establishment of scenarios and the strategy of expanding C-end user traffic.
Since mid-2020, Ping An Health, which has entered Strategy 2.0, has deepened its medical and health services. In terms of user expansion, in addition to improving the original C-end services, it also focuses on multi-channel and B2C drainage. For example, through the enterprise employee health management plan, it can serve 225 million financial customers of Ping An Group and 70 million employees of large and medium-sized enterprises in its channels, with a total potential enterprise employee market size of about 310 million people. At present, Ping An Health has accelerated its layout and penetration in the enterprise customer channel. For example, in the HMO insurance direct compensation project cooperated with a large state-owned enterprise, Ping An Health, as a service provider, relies on Ping An Health Insurance as a payment bridge to provide the central enterprise with direct compensation for drug purchase, online consultation, video consultation, outpatient registration, famous doctor registration, and hospitalization of famous doctors, and settles with health insurance. By the end of last year, the total amount of the project was 11.18 million, the user penetration rate was 44%, and the average number of consultations was 2.47 times, which was highly praised by customers.
From the initial physical examination service, Ping An Health has now customized its employee health management plan according to the needs of enterprise customers - employee physical examination report interpretation ability, health records and health management service upgrades, and create customized employee files. At the same time, relying on the mature O2O system, employees can obtain a smooth online and offline multi-scenario service process when receiving medical services; combined with the empowerment of the family doctor membership system, employees and their families can get a better consultation experience, alleviating the pain points of difficulty in seeing a doctor and the shortage of local medical resources caused by the uneven distribution of medical resources.
Therefore, the comprehensive upgrading of user service quality not only benefits the C-side, but also allows the B-side to find that the insurance protection purchased is no longer just a literal "welfare", but a temperature service that is accurately implemented into various health and medical scenarios of employees.
Multi-gripper: Activates more potential
In the process of HMO mode and O2O closed loop, family doctor members are made into a long-life cycle companion service, which plays an important bridge role and deepens user stickiness.
The family doctor membership system is mainly composed of three aspects: 1 family doctor + 5 professional services + 1 member health file. The family doctor membership system will take the family doctor as the core, and match the resources of the five major scenarios of health management, sub-health management, disease management, chronic disease management, and pension management for users as needed, help each user generate a member file, and coordinate and arrange medical and health-related services from online to offline.
When the membership system is combined with the O2O model, it links the multi-dimensional health service supply system of medical, consumer medical, health institutions and testing institutions, opens up online and offline closed loops, and improves the user's medical journey. In addition, since HMO is deeply involved in the coordination of medical resources inside and outside the Ping An system, once the family doctor membership service embedded in the ping An Group's user financial account system is activated, the HMO model can string together both the supply and demand ends, and better achieve the improvement of social medical efficiency.
Another HMO model that empowers ping an health is the technology gene.
Relying on the models and outputs produced by Ping An Group's unique medical product library, disease library, prescription treatment library, personal health library, and medical resource library, Ping An Health can remotely diagnose and treat more than 2,000+ diseases, and AI achieves more than 99% guidance accuracy and more than 95% auxiliary diagnosis accuracy, and its diagnosis and treatment level has been improved and recognized by users. Moreover, the self-owned medical team and AI auxiliary diagnosis and treatment system can quickly respond to user needs within 7 * 24 hours, and the more than 48,000 internal and external doctor teams and healthiers, nutritionists and psychological counselors accumulated on the platform can fully cover the user's health, sub-health, disease, chronic disease, pension and other multi-dimensional needs.
From the recently released 2021 annual performance report, it can also be seen that Ping An Health's overall revenue has grown steadily, with total revenue reaching 7.334 billion yuan, an increase of 7% year-on-year. Among them, the revenue contributed by medical services reached 2.288 billion yuan, an increase of 8% year-on-year, accounting for 31.2% of the total revenue. With the practice of HMO health management + family doctor membership system + O2O medical service business model, Ping An Health's cumulative number of paid users has grown rapidly to more than 38 million, the cumulative number of registered users has reached 420 million, the cumulative consultation volume has maintained a leading position in the industry, reaching 1.27 billion person-times, and the conversion rate of paid users has increased to 24.8%, which can be described as high potential and high growth value, leading the medical and health investment field.
In addition, because the HMO model is based on the core requirements of medical services, it can also gradually fill the gap in health security needs. The 14th Five-Year Plan for the Mainland will focus on improving a multi-level social security system that covers the whole people, integrates urban and rural areas, is fair, unified and sustainable. As health care is one of the top priorities for people's livelihood protection, the Ping An Health HMO model that can give birth to innovative business closed-loop, continue overseas successful experience, and precipitate local advantages will also benefit more users and all aspects of society.
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