Magnesium Health Health CMO Wan Xiaolong: Huiminbao's operation has entered the deep water area, and refined management speed up

Picture source: Oriental IC

In recent years, many places have explored the city's customized commercial medical insurance business that allows the elderly and the patients with patients, which is commonly known as the "Huimin Insurance" business. From the perspective of the practice in various places, the benefit of the people's insurance business gives full play to the commercial insurance. The supplementary role in the guarantee system continues to expand the insurance group and upgrade the content of the guarantee. With the continuous relaxation of the threshold of the front end insurance, it has also caused concerns about the long -term claims of Huimin's back -end claims, and its sustainability has attracted much attention.

It is reported that in order to improve the operating efficiency and service level of the benefit of the civil insurance business, the regulatory departments are under research to guide and regulate the research, effectively play the role of insurance security, and ensure that the commercial operation can be continuously operated. This means that the policy foundation of Huiminbao's long -term sustainable development will further consolidate, in -depth supplementary health insurance markets, and also put forward higher capability requirements for operators.

As a third -party agency involved in the development and construction of Huimin Bao, Magnesium Health has a deep understanding of this. Recently, Blue Whale Insurance interviewed Magnesium Health Health CMO (Chief Marketing Officer) Wan Xiaolong. The problem needs to be solved, facing higher difficulty challenges, the more refined management, and there will be business barriers. " In order to increase the project's participation rate and renewal rate as much as possible, to achieve long -term sustainable development, product design, government participation, and insured experience are key influencing factor.

The long -term continuous keywords of the product: "open source" must be "throwing"

In 2015, Shenzhen first promoted the "heavy special disease supplementary medical insurance"; in 2020, the local benefits of civil insurance products in various places ushered in explosive growth; as of the end of 2021, more than 200 provinces in the country have launched more than 200 " Huimin Insurance's "products, the total number of insureds has reached 140 million, and the total premium revenue has exceeded 14 billion yuan.

Taking market mechanisms and capital protection as the operational orientation, Huiminbao mainly uses the operating model of "1+1+1+N", that is, "1 product, 1 price, 1 service standard, N commercial insurance institutions" In addition to the necessary operating costs, the raised premiums are mainly used for the benefits of the insured, and the maximum benefits to the insured persons in major diseases.

Wan Xiaolong introduced that in the establishment of a multi -level medical security system, Huiminbao is playing a more important role year by year, but the participation rates of Huimin insurance products in various places are relatively large. After 2021, the product is concentrated in the interval of lowering the insurance rate (less than 5%) and a higher insurance rate (greater than 30%). In 2021 During the dimension).

It should be alert that on the one hand, the number of insureds is too small, which will make the scale of the insurance capital pool insufficient, the underwriting institution is difficult to control the risks, and the operating cost of the product is difficult to effectively dilute, and it will even introduce the product into the "death spiral". On the other hand, as the government's participation in benefiting the people's insurance has increased, and high requirements for the payment rate, some cities have clearly required the compensation rate to reach a level of 85%-95%, and the payment terminal is under pressure.

The participation rate of some projects is relatively low, and some projects have high compensation rate requirements, and the sustainable development of benefiting people's insurance is an important issue.

"Objectively speaking, the sustainability of Hui Minzhang is indeed challenging, but it is developing in the direction of refined management, improving management service efficiency, enhancing risk control capabilities, and fundraising, payment and service. Master funding can achieve higher renewal rates, pay more efficiently and accurately control the cost, the service has the influence to deepen the insurer's sense of gain and reduce the drop rate, especially the insurer who is not in danger. "Wan Xiaolong introduced the Taoism Tao Essence

How to solve funding? It is necessary to improve the insured rate to "open source" and strengthen operation management to "throw", and then achieve operating balance. The funding efficiency depends on the product design itself, whether it meets the needs of users, whether the pricing is more accurate, and meets the local medical expenditure level and actual medical security needs. The opening of medical insurance accounts under the support of the government will also have a significant promotion effect on the insurance participation rate. Furthermore, the support of Huimin Bao is to shift Huimin Bao from a commercial product to the combination of government and enterprises and covers a wider coverage of medical care. The good way of insurance products is conducive to the long -term sustainable development of the product.

"When there were many budgets in the past, the operation would be relatively extensive. Now many cities have controlled operating costs, or have requirements for compensation, and they must meet a relatively high insurance rate. To solve the problem of fundraising promotion, the production is higher than the demand, and it is bound to be more fine. "Wan Xiaolong pointed out.

On the payment side, Hui Minzhong needs to realize effective control in fund management, solving what the fund should pay (delineate payment scope), how much (control payment price), and how to pay (control payment behavior).

On the server, we need to do a better service around medical medicine, strengthen connection and interaction with users, enhance customer stickiness, and design some high -frequency and truly valuable health management services for the public, such as Family doctors, three high co -pipes, etc., enable protection to cover greater insured people.

"In a city, I think there will be only one so -called official benefit of the people's protection in the end, and it is bound to be an insured project by the composition of the joint body. It is predictable that under the form of guarantee of payable and compensation, Huimin's insurance participation rate is 20%-30%, and the compensation rate is 80%-90%. A state that feels more comfortable, will not raise too little funding, and the insured will have a good sense of gain. Taking the opportunity of Huimin Bao as an opportunity to break the development of the "island" for the development of commercial health insurance

One of the trends of Huiminbao's upgrading is to expand the expenses of medical insurance. This is not only the main demand for customers, but also one of the main motivations for the government. In the long run, "Huimin Insurance" urgently needs a clear and complete list of insidered benefits of medical insurance directory.

The basic framework of Huiminbao's products includes internal/external responsibilities of medical insurance, the responsibility for the special expenses of the out -of -hospital self -funded, and partial differentiated responsibilities set in some areas. At present, there are products that only guarantee foreign expenses for medical insurance. For example, Shanghai Huhui Insurance and Ningbo Ningning Insurance. The common characteristics of the two places are that the level of medical insurance guarantee is higher than the national average.

Wan Xiaolong believes that the scope of medical service projects in medical insurance and foreign medical services has a wide range of high -cost consumables and medicines. From the perspective of product design, the fund's expenditure should be regulated in the form of a directory. Drugs, equipment consumables, treatment technology and other medical expenses, rather than medical expenses that improve the quality of life of patients.

For example, in order to efficiently improve the accessibility of drugs and expand the scope of special medicine protection, service providers represented by magnesium faith health rely on their own medical fields to ensure the scope of special drug guarantee through reasonable use of drugs, and help danger in danger. Enterprise control fee.

Whether Huiminbao will cause squeezing and impact on the health insurance market is also the focus of the industry's attention. Wan Xiaolong bluntly stated that in the short term, Huimin Bao diverted a small part of the health insurance market to a certain extent, but it also strengthened the public's insurance awareness. In the long run, with the Huimin insurance business and medical insurance system and health service system, it is more closely closer. The integration of the ground will bring better development prospects for health insurance.

"The fusion of medicine and insurance is a long -term process. Cross -domain integration is not a simple matter, but the participants are actively moved closer, and they can also see the progress of each stage. The integration of insurance to support development, Huimin insurance provides a good opportunity. "Wan Xiaolong said.

In its opinion, the benefits of the benefits of local governments, insurance companies, pharmaceuticals, hospitals, hospitals, and people are the opportunities and starting points of the high -quality development of China's health insurance. The product form attracts government and pharmaceutical industry enterprises to enter the bureau, break the "island" situation of commercial health insurance development, and connect medical insurance systems with commercial insurance systems to realize one -stop settlement in public hospitals. The ability to refine and professional operations makes commercial insurance an important payment party outside medical insurance and create a continuous and competitive health service ecosystem.

Based on the long -term development and construction of Huiminbao, recently, the role of Magnesium Health in the "Huifan Bao" urban insurance project is upgraded from special medicine services to comprehensive service operators. In addition to providing special medicine claims service services , Also in -depth participation in many links including the design of the drug security catalog, medical security claims service, value -added services and operation promotion, further give full play to the core advantages of the dual platform of "medical and insurance", link to frontier medical resources, provide better medical and health Serve.

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