Breaking Through the Integration of Insurance and Health Management: Insights from the Health Management & Insurance Payment Innovation Forum
To meet the growing demand for health insurance among the public and address issues such as supply-demand mismatch, the concept of “Health Insurance + Health Management” has frequently become a buzzword in the industry.
To promote the integrated development of the insurance industry and the health management industry, the Chinese Health Management Association and the Insurance Association of China have jointly formulated and issued the Guidelines for the Construction of the Standard System for Health Management in the Insurance Industry, as well as four series of standards including the Guidelines for Health Management Services of Insurance Institutions.
On May 7, VCBeat’s VB100 hosted the Health Management and Insurance Payment Forum at the 7th Future Healthcare Top 100 Conference. The following speakers attended and delivered insightful presentations: Yang Bin, Director of the Smart Health Center at the Institute for Precision Medicine, Tsinghua University; Pan Zhigang, Senior Vice President of Lifesense Medical; Liang Yuqin, Head of Innovative Pharmaceutical Business at Shuidi Inc.; Cao Minqi, Vice President of Lejian Health Technology Group and General Manager of its Insurance Division; Xu Bingyu, Founder and CEO of Huamei Haolian; Xing Jing, Founder and CEO of Shanghai Shangyong Technology Co., Ltd.; Wang Ding, CEO of Yidianling; and Zeng Yiwei, Director and Deputy General Manager of Junde Pharmaceuticals. Chen Qiang, Partner at YuanYi Capital, served as the moderator.
The forum brings together representatives from enterprises and capital to build a multi-party platform for exchange, cooperation, and integration, focusing on forward-looking perspectives, technology empowerment, and investment insights.
Yang Bin: Exploration and Practice in Building a Regional Smart Health and Medical Service System
Yang Bin | Director, Center for Smart Health, Institute for Precision Medicine, Tsinghua University
Yang Bin, Director of the Smart Health Center at the Institute for Precision Medicine, Tsinghua University, began his presentation by analyzing national health needs and provided a comprehensive introduction to the Tsinghua Healthcare Intelligent System (THIS). According to Yang, the THIS service framework is grounded in physical institutions and has established an integrated, continuous, regional collaborative healthcare service network. Key development areas include THIS service stations, service support platforms, service organizations and standards, and an intelligent regulatory system. Furthermore, Yang shared operational workflows of the THIS service framework through practical application cases, highlighting its role in constructing new personal electronic health records and enhancing community service capacity and efficiency through remote and intelligent technologies. It is reported that THIS collaborates with specialized hospital departments to conduct research on disease-specific care led by health caregivers, covering areas such as diabetes management, geriatric care, and respiratory disease management. After presenting the regional healthcare service network in Tiantongyuan, Yang stated that THIS aims to provide residents within the region with homogeneous, high-quality, full-lifecycle healthcare services. Additionally, the system facilitates infectious disease surveillance and public health event monitoring, enabling timely warnings and precise decision-making.
Pan Zhigang: The “Digital Kung Fu” of Precision Health Management
Pan Zhigang | Senior Vice President of Lifesense Medical
Pan Zhigang, Senior Vice President of Lifesense Medical, stated that the company has strategically deployed solutions in remote ECG services, intelligent hearing assistance products, digitalization for the health management industry, and sports-based health management for adolescents. Mr. Pan further emphasized that the focus of health management lies outside hospital settings, where the primary challenge is data monitoring. The key attributes of effective “data monitoring” in health management are precision, comprehensiveness, continuity, and timeliness. By integrating an all-in-one digital solution encompassing “hardware + software + services,” Lifesense Medical establishes a closed loop for data collection, analysis, and application. This approach maximizes the value of data, ensuring it originates from users and is applied back into their real-life scenarios.
Liang Yuqin: A Patient-Centric, Full-Lifecycle Digital and Intelligent Management Platform
Liang Yuqin | Head of Innovative Business at Shuidi Medicine
Liang Yuqin, Head of Innovative Business at Shuidi Pharma, began by providing an update on the company’s recent developments. She stated that over the past two years, Shuidi has focused on serving millions of patients with serious illnesses, building a patient-centric innovative service platform anchored by its patient ecosystem. This platform offers comprehensive disease journey management services, clinical trial participant recruitment, and other digital clinical services. Ms. Liang then highlighted the operational platform of the Patient Center, emphasizing that it delivers whole-disease-journey solutions guided by patients’ healthcare needs. She showcased Shuidi Pharma’s distinctive initiatives developed under this concept, including specialized disease patient centers, single-disease operational management, single-disease patient communities, and a media operations matrix. Additionally, Ms. Liang explained the operational logic of Shuidi’s Data Center through specific case studies and underscored the company’s core philosophy: “It is not technology itself that determines the direction of human destiny, but the human warmth embedded within technology.”
Cao Minqi: The “Medical Insurance and Healthcare” Integrated Digital-Intelligent Health Platform Comprehensively Safeguards the Health of Enterprises and Families
Cao Minqi | Vice President of Lejian Health Technology Group and General Manager of the Insurance Business Division
Cao Minqi, Vice President of Lejian Health Technology Group and Head of the Insurance Division, stated that Lejian is a platform-based company whose business comprises multiple segments, including medical and health services, insurance services, public hospital services, and nursing care. During the three-year economic downturn amid the pandemic, demand for Lejian’s “medical-health-insurance” services surged. Over this period, the company saw growth in its number of corporate clients, individual users, annual revenue, and insurance premiums. In the past three years, Lejian launched an integrated digital-intelligent health service platform. By leveraging product and R&D solutions based on digital-intelligent health services, the platform integrates diverse medical service networks across hundreds of cities in China, providing enterprises with comprehensive health management solutions and building an employee health service and protection platform centered on healthy work and lifestyle practices.
Xu Bingyu: Reshaping the Value and Function of Health Insurance, Integrating Services into Coverage
Xu Bingyu | Founder and CEO of Huamei Haolian
Xu Bingyu, Founder and CEO of E-Health Now, began by discussing national policies aimed at promoting the healthcare service system and medical security system. She pointed out that the insurance industry has broad development prospects by drawing on innovative models such as managed care and value-based care. She stated that the construction of national health is transitioning from “medical security” to “health security,” with insurance evolving from “risk transfer and medical payment” toward comprehensive health management. Xu then analyzed the challenges facing the integration of health management services with health insurance, supplementing her analysis with specific practical experiences from E-Health Now to explain methods for effectively merging health insurance with health management services in practice. It was reported that E-Health Now addresses the integration of products and services across four dimensions: sales, service, product, and technology. Additionally, Xu showcased innovative insurance products developed for specific conditions, including dental care and pulmonary nodules.
Xing Jing: Digital Health Management Offers New Solutions to Challenges in Commercial Insurance
Xing Jing | Founder and CEO of Shanghai Shangyong Technology Co., Ltd.
Founder of Shangyong Technology andCEOXing Jing noted that the core of the new future of healthcare security lies in the deep integration of insurance and medical care, and the key to overcoming the challenges of this integration is to coordinate the inherent contradictions among the three parties. Centered on customer value, Shangyong Technology addresses “medical care” through innovative digital health management solutions.-Insurance-Addressing the coordination barriers among stakeholders, we are establishing a pathway from commercial insurance to the healthcare market. Specifically, through comprehensive disease-specific management across the entire care continuum, we leverage technology to identify the most appropriate treatment plans for patients. This approach ensures that costs incurred by insurers are both reasonable and medically necessary, ultimately leading to optimal prognostic outcomes for all parties involved. Currently, Shangyong Technology has successfully managed numerous hematology patients with favorable results. Looking ahead, we aim to ensure that every dollar spent by commercial insurers delivers tangible value to patients, while keeping medical costs within a range that is reasonable, necessary, and clinically meaningful. This will represent a significant transformation.
Insurance and Health Management: Where Lies the Difficulty in Integration, and How to Break Through?
From left to right: Chen Qiang | Partner at Yuanyi Capital; Wang Ding | CEO of Yidianling; Xing Jing | Founder and CEO of Shanghai Shangyong Technology Co., Ltd.; Xu Bingyu | Founder and CEO of Huamei Haolian; Yang Bin | Director of the Smart Health Center, Institute for Precision Medicine, Tsinghua University; Zeng Yiwei | Director and Deputy General Manager of Junde Pharmaceutical
Where Lies the Difficulty in Integrating Insurance with Health Management, and How Can We Break Through?
The integration and co-creation of insurance and health management have become an inevitable trend. Currently, domestic users in China lack sufficient awareness of mental health, while the subjectivity on the supply side and the lack of diagnostic standardization constitute bottlenecks for psychological insurance. Wang Ding emphasized that future health insurance must deliver value and form a closed-loop industrial chain to maximize social benefits. Xing Jing noted that, on one hand, health management services must bring value to customers, and the value of medical services must be digitized. On the other hand, customers must perceive tangible benefits from health management services, utilize them effectively, and thereby improve utilization rates. Xu Bingyu believed that health management services can enhance product differentiation, enabling the launch of truly competitive health insurance products. Mr. Zeng Yiwei pointed out that there are very few medical-grade products that can genuinely assist in the early and middle stages of chronic diseases. Health management services are currently neither deep nor robust enough; integrating in-hospital and out-of-hospital care while maintaining medication and product adherence remains a significant challenge. Yang Bin also argued that the urgent need to achieve truly integrated management across pre-hospital, in-hospital, and post-hospital stages must be addressed.
How about the integration of insurance and health management tomorrow?
The two major themes for the future development of China’s big health sector are physical and mental well-being, and health management. From a long-term perspective, health insurance plays a crucial role in achieving widespread societal adoption and improving overall population health levels. The core focus should be on value delivery, rather than merely marketing and claims processing. When the industry chain forms a closed loop, its value will be maximized and fed back to society. Through multi-party integration, technological advancements, and collaborative innovation, high-quality medical resources can become more accessible to the general public, thereby creating new productive forces and driving innovative development within the industry.
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