Image source@Visual China
Text: Tidal Business Review
Joy, who was plagued by "health anxiety", decided to give herself a full-body examination, and after a search on the Internet, she found that not only physical examination institutions, but also major hospitals can now have physical examinations. "I feel that the prices are similar, should I choose a public or medical examination institution?" Joy was puzzled.
With the awakening of Chinese people's health awareness in recent years, topics such as "dare not read physical examination reports" and "young people are riddled with geriatric diseases such as diabetes" have aroused heated discussions on the Internet from time to time.
Under the general trend of "all people pay attention to health", early detection and early prevention of physical examination have become a rigid need. On the social platform Xiaohongshu, the search for notes related to "physical examination" reached 1.55 million, and even in the live broadcast room of the head anchor, physical examination products have become frequent visitors.
According to the "2022 Workplace Health Insight Report" jointly released by Dr. Ding Xiang and Future, nearly sixty percent of employees believe that physical examinations should not be taken lightly. At the same time, 63% of employees believe that the frequency of physical examination should be guaranteed at least once a year.
It's just that Joy, who was in a hurry to give herself a physical examination, was in a difficult position when faced with a dazzling array of medical examination institutions and hospital physical examination departments.
Is physical examination really a good business?
01 Private Physical Examination Institution "History of Jianghu"
A health check-up is a test that can detect diseases and health risk factors at an early stage.
The rise of physical examination in China has not been long in time.
It is understood that before 1990, health check-up was still a service of hospitals, and it was more used for disease check-up than health prevention. It was not until 1991-2000 that relatively independent medical examination service institutions began to appear in Beijing and other places.
In 2001, with the entry of the Western health service concept and the deepening of the reform of the medical system, the government began to propose to open up the medical market and encourage the development of private medical enterprises, which gave the private medical examination institutions the soil for survival. After the SARS epidemic in 2004, the public's attention to their own health and their willingness to pay for health care increased, not only many tertiary hospitals have set up physical examination centers to attract customers, but also a number of private physical examination giants in the future have also been born under this wave, including Meinian Health, iKang Guobin, Ciming Physical Examination, Ruici Medical, etc.
With the continuous improvement of the number of domestic health service institutions, after 2011, the layout of medical informatization has attracted much attention, and the technical upgrading of domestic health service institutions in terms of service forms and medical facilities has made the entire industry get rapid.
In the process of the development of the private physical examination industry, the major capitals are staking their ground, and the "three-legged" pattern led by Meinian Health, iKang Guobin and Ciming Physical Examination has gradually taken shape, with frequent friction between each other and continuous business wars.
It is understood that in 2017, after many unsuccessful attempts at IPO, Ciming Physical Examination chose to merge into the system of Meinian Health;In 2019, iKang Guobin announced the completion of privatization, and Alibaba entered the bureau through its Yunfeng Fund and became the major shareholder of iKang Guobin;In December of the same year, Meinian Health announced that it would strategically introduce Alibaba and its affiliated teams, and Ali also became the largest shareholder of Meinian Health. The drama of "Three Families Returning to Jin" was also staged. So far, there are only two private physical examination listed companies in the industry, Meinian Health and Ruici Medical.
In recent years, with the structural changes of the population age, the increase in disposable income of residents and the rising number of non-healthy people, the people's concept of health management for the purpose of prevention has gradually increased, and the "early detection, early diagnosis and early treatment" of diseases has gradually become the consensus of the people.
According to the statistics of Zhiyan Consulting, from 2012 to 2021, the scale of the mainland physical examination market increased from 46.8 billion yuan to 189 billion yuan, with a compound annual growth rate of 16.78%, and is expected to reach 390 billion yuan in 2025.
In the past ten years, the boost of capital to the private physical examination industry has played a positive role in promoting its rapid expansion, but it has also buried hidden dangers for its savage growth.
Although the overall market demand for medical checkups continues to grow, the challenges behind it cannot be ignored. For example, the chaos within its own institutions, and the increasing competitiveness of public hospitals that dominate the market.
02 Opportunities and challenges
In recent years, with the deepening of urbanization, the pace of life and work of residents has been accelerating, resulting in a rapid increase in the incidence of various chronic diseases, and the "health culture" with a ridiculous nature has risen among young and middle-aged people.
If the health preservation from the perspective of traditional Chinese medicine is changed to the perspective of industry, it is equivalent to "health management". In fact, it is to move the threshold of dealing with diseases forward, according to the words of traditional Chinese medicine, from treating the disease to preventing the disease, and physical examination is an important means of health management.
According to the China Health Statistical Yearbook (2022), the number of health check-ups nationwide in 2021 was 549 million, compared with 230 million in 2009, with a compound annual growth rate of 7.52%.
Behind the high growth, the relatively low coverage rate of physical examinations still exists. As of 2021, the penetration rate of the physical examination industry in mainland China is still less than 40%, while the coverage rate of physical examination in the United States, Japan, and Germany is 73.40, 74.2, and 96.9%, respectively. Although from the data point of view, the coverage rate of physical examination in mainland China is much lower than that of developed countries, but this also shows that there is still a huge market space for the health examination industry in mainland China, especially under the general trend of improving the national health level, the demand for physical examination services will continue to rise.
At present, the competition pattern of the health examination industry in mainland China is dominated by public medical institutions and supplemented by private professional medical examination institutions.
In recent years, with a flexible operating mechanism and a high sense of service, private professional physical examination institutions in mainland China have achieved rapid development. According to Frost & Sullivan's research, in 2016, the market share of public institutions was about 86.5%, and the market share of private medical examination institutions was only 13.5%, while in 2020, the market share of private medical examination institutions increased by 4.6pct to 18.1%. It is estimated that the market share of private physical examination institutions will reach 24.9% in 2025.
However, while growing rapidly, private physical examination institutions still cannot avoid some long-standing stubborn diseases in the industry.
For example, the quality of service is questionable. According to media reports, in 2018, private physical examination institutions were exposed to the phenomenon of "non-compliance", such as Meinian Health was revealed by a former employee, and the physical examination report of a store of Meinian Health was signed by a fake doctor, and was investigated by the local Health and Family Planning Bureau to confirm that it was suspected of issuing a physical examination report in violation of regulations. This turmoil caused the market value of Meinian Health to evaporate by 6.8 billion in one day.
An industry insider who used to work in Guangzhou Meinian Fuhai Outpatient Department posted an article titled "Meinian Health: If a person dies, you can only earn money once" on the self-media platform. A number of problems in Meinian's health were exposed, including the failure to detect terminal cancer, the fraudulent use of the names of retired doctors, and the unlicensed employment of employees. Subsequently, Meinian Health issued an apology announcement, saying that it had received the "Notice of Rectification Order" from the Health and Family Planning Bureau of Tianhe District, Guangzhou, and would actively rectify it.
As a large-scale chain enterprise, Meinian Health has also opened a franchise model in the process of expansion, and it is indeed difficult to ensure the consumption quality of each service in the medical and health industry that requires refined operation.
Zhang Ligang, chairman and CEO of iKang Group, also bluntly said at the "2018 China Business Leaders Annual Meeting" that the industry has a "fake physical examination" scandal: some medical examination institutions use nurses to pretend to be doctors to see ultrasound;
Zhang Ligang also explained why this can be fooled: "Because the proportion of people who actually get cancer is only 3 per 1,000, if the physical examination center does not do any blood draw, the highest error rate is 3 per 1,000." Because the error ratio is so low, there are many companies in our industry that do fake medical examinations. ”
Due to the lack of health management methods for domestic residents and the strong dependence on physical examination results, the professionalism of physical examination institutions is particularly important.
On the other hand, with the deepening of medical reform, public hospitals that have neglected the physical examination business for a long time have gradually come back to their senses and begun to pay attention to the physical examination market.
In addition, the current policies such as medical insurance fee control, zero markup of drugs and equipment, and centralized procurement of medical equipment consumables are pressing, and the pressure on hospital operation is very great. However, there are fewer medical examinations, stable and controllable cash flow, and higher profits. Therefore, a large number of tertiary hospitals, and even ordinary municipal and county-level hospitals, have been expanding their physical examination centers in recent years.
Unlike private medical institutions, public hospitals have stronger medical service capabilities and stronger professional skills. For projects that need to be reviewed, public hospitals can also facilitate referral, and the way of front-end examination + back-end diagnosis and treatment linkage is a huge advantage that is difficult for the private system to match.
As a relatively special field, the rapid development of private institutions has indeed met the needs of ordinary people for health concerns. However, the perfunctory process and unreliable results in the development may be the main reasons why a large number of consumers "stay away" from private medical examination institutions.
At this point, the tide can't help but ask: Are private physical examination institutions really ready to undertake the huge market demand?
03 Where is the private physical examination going?
For enterprises, grasping the core and "cash cow" accurate customers is the only way to maintain long-term and stable development.
Grasping the "group inspection", the bulk of the income source of physical examination institutions, may be the first step for the long-term stable development of private physical examination institutions. The data shows that "group inspection" is the bulk of the income source of physical examination institutions. Taking Meinian Health as an example, the 2022 financial report shows that group customers contribute 83% of Meinian Health's revenue, while individual consumers account for only 17% of its revenue.
For corporate customers, private physical examination institutions can provide them with personalized customized services, and launch different packages for them to choose from according to different needs.
However, from the point of view of customer unit price, the customer unit price of individual inspection is higher than that of group inspection. Therefore, individual inspection customers can not miss it, and now in order to obtain C-end customers, private physical examination institutions have also done their best.
For example, in terms of channels, the Ping An Health (Testing) Center for high-end consumers has continuously expanded its customer acquisition channels and launched Ping An Shangyi's flagship store on Tmall and Jingdong platforms; in terms of price, Ruici Physical Examination has launched preferential activities such as "Daily Sale" and "Buy 1 Get 1 Free"; in terms of products, from basic examination to special examination, the projects of physical examination institutions are more subdivided to meet the needs of different groups.
Another key point is the quality of physical examination. As we all know, the purpose of physical examination is to make yourself more aware of your physical condition, so as to know and intervene early.
However, as a private physical examination institution, compared with professional hospitals, there are always some gaps from medical accumulation to public awareness. It is obviously not a wise move to "hit the nail on the head", and the differentiation of technological means may be the way to break the game, for example, by introducing more cutting-edge artificial intelligence technology.
Yu Rong, chairman of Meinian Health, once mentioned that it is necessary to embrace the large model and empower the whole process of physical examination business. At present, Meinian Health has introduced AI productivity tools, such as intelligent guidance, intelligent chief examination, physician assistant, etc., and continues to launch new products, such as AI physical examination report interpretation, AI digital human, mental health companionship, etc.
For key disciplines, Meinian Health has launched AI physical examination products, such as Brain Ruijia, Lung Ningning, Fundus Analysis, etc.
Taking "Brain Ruijia" as an example, it is based on AI segmentation and reconstruction technology of brain regions, which is an intelligent risk assessment package for brain cognition and stroke, covering major diseases such as Alzheimer's disease and stroke, and is used for early warning.
In addition, physical examination institutions can also cooperate with insurance companies to create an integrated service of "inspection and insurance".
For example, Meinian Health, in conjunction with PICC Health, has launched an exclusive medical product for people with pulmonary nodules, including physical examination services and lung nodule imaging course management services, and the "Lung Ning" (AI intelligent assessment of pulmonary nodules) product also packages malignant tumor insurance.
Finally, it is necessary to create real health management. Improving the application value of physical examination and completing the closed loop of health management are not only challenges and opportunities for industry participants, but also a key topic for health regulatory authorities.
In fact, for consumers, getting the physical examination report is only the first step, and it is the most important thing for consumers to have a doctor's explanation and guidance for abnormal indicators.
Physical examination institutions can use artificial intelligence to create a real big health management platform, and through intelligent physical examination services such as "health prevention + precise medical treatment", the health situation can be analyzed by AI and big data to issue health prescriptions. Through the combination of online and offline, the business contact and data connection before, during and after the inspection are opened, and the problems of "how to deal with health problems" and "how to check personalized physical examination" are solved in the physical examination report, and multiple measures are taken to provide full-cycle intelligent health management.
In this regard, the National Health Commission has also taken action, and the most direct is to introduce the results of examinations and tests into the medical system. In 2021, the "Notice on Accelerating the Mutual Recognition of Inspection and Inspection Results" was issued, and in 2022, the Beijing-Tianjin-Hebei and Shandong regions also jointly issued the "Notice on Announcing the Mutual Recognition of Clinical Test Results of Medical Institutions in the Beijing-Tianjin-Hebei-Shandong Region in 2021-2022", and 22 physical examination institutions in these four places have been included in the mutual recognition system.
Joy finally decided to go to a private physical examination institution for a physical examination, "There must be a lot of people in the hospital, and the queue is quite annoying, and to be honest, as a person who is particularly afraid of entering the hospital, the institution still doesn't sound so cold." The point is, you don't have to wait in line to get there at the appointment time."
You see, business is like that.