| After healthy China has risen to the national strategy,coupled with the introduction of a series of national policies,people's health has received more and more attention,and health-related health insurance has also been favored.With the aging of the society,the high incidence of chronic diseases and the excessive burden of medical expenses have become more prominent.Social medical insurance,which is solely for the purpose of disease treatment and with cost reimbursement,cannot fundamentally solve the above problems.In the "Healthy China 2030" planning outline,it is clearly proposed to improve the multi-level medical security system supplemented by basic medical insurance as the main body and other forms of supplementary insurance and commercial health insurance Therefore,as an important part of China's medical security system,commercial health insurance will become one of the fastest growing and most promising areas.However,the risks of commercial health insurance are also ubiquitous.How to resolve risks is of great significance to insurance companies and directly affects their income and development prospectsAt this stage,commercial health insurance risk control is mainly focused on ex ante underwriting and after-the-fact claims.This topic analyzes the status and existing problems of China's commercial health insurance,the risks and risks,the problems of risk control,the methods of health insurance risk control in the United States and the United Kingdom,and proposes the use of health management for risks in health insurance.Control,establish specific control processes,and introduce risk assessment systems,segment risk groups,give specific control methods for different groups of people,and propose recommendations for insurance companies to operate.To a certain extent,reduce the prevalence rate of insured persons,prolong survival time,and reduce medical expenses,thereby reducing the insurance company's claims and increasing profit margins. |
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