Research On Risk Control Of Z Insurance Company’s Commercial Health Insurance Based On Health Management Perspective

With the deepening reform of China’s medical security system,the increasing aging of the population and the rapid growth of disease incidence,commercial health insurance has received more and more attention,and the demand for commercial health insurance is increasing.In recent years,China’s commercial health insurance premiums have grown rapidly,far higher than the total premium growth rate,but the proportion is less than 15%of China’s total premiums,compared with 30% in developed countries.At the same time,China’s commercial health insurance claims rate is far greater than the premium growth rate,which makes the insurance company’s lack of operational incentives,poor performance,and even losses,which hinders the development of commercial health insurance as well.Therefore,it is very necessary to research the risk of commercial health insurance and its control for the healthy development of China’s commercial health insurance.Firstly,this paper analyzes the development status of Z insurance company’s commercial health insurance business from two aspects of development scale and efficiency.Secondly,this paper discusses the risks Z insurance company faces in commercial health insurance from the aspects of moral hazard,adverse selection,market competition risks and pure risks in the business process.It is found that Z insurance company faces relatively large risks in commercial health insurance.And the company’s internal risk control measures have certain defects in the risk control of commercial health insurance.Thirdly,the profitability of commercial health insurance products integrated with health management services was studied by referring to the measures of managed medical treatment and health management and combining the commercial health insurance products of Z insurance company.It is found that adding health management services increased the profits of insurance products.It is concluded that health management can promote the risk control of commercial health insurance.Finally,from the perspective of health management,the risk control optimization measures of Z insurance company are proposed.