Research On Business Health Insurance Business Model Based On Managed Care

In 2016,the State Council promulgated the "Healthy China 2030" Planning Outline,which pointed out that by 2030,the proportion of the payment of commercial health insurance will increase significantly in the total cost of health,and strive to give full play to the protection function of commercial health insurance to alleviate the aging belt.Social problems coming.However,at present,China's health insurance business model has a large gap compared with the mature foreign managed medical commercial health insurance business model.Taking Fosun United Health Insurance as an example,this paper analyzes the successful cases of foreign managed medical commercial health insurance business model,and integrates health insurance with the big health industry for Fosun United Health Insurance to jointly build health with health insurance as the core.The industry closed-loop,the management model of “health insurance + health management + medical services” management medical business health insurance provides experience for reference.The paper focuses on how commercial health insurance companies use industrial resources to provide health management services to consumers under the managed medical model,and build a medical information platform to solve the problem of “information silos” in the traditional buy-to-pay health insurance business model,and to control medical expenses.The purpose of reducing the payment and operating costs,and providing reference for the business health insurance company's innovative health insurance business model.