MediLink-Global Accelerates the Development of a Chinese-Style 'Insurance + Healthcare' Model Based on a Full-Cycle Health Management Platform

With the development of China's socio-economy and medical technology, people's demand for health protection is increasing.

The proportion of commercial health insurance in the life and health insurance business has been increasing year by year, reaching 25.8% in 2020. As a supplement to basic medical insurance, commercial health insurance products such as Huiminbao (city-specific supplementary medical insurance) and million-yuan medical insurance have flourished across China. Meanwhile, beyond reimbursing medical expenses, and driven by considerations of customer health management and medical cost containment,“The Insurance + Healthcare” Model Is Gaining Momentum: The Triangular Framework Linking Payers, Customers, and Healthcare Providers Emerges as an Advanced Stage in Health Insurance Development。

High-end medical insurance, as an insurance product that closely integrates insurance with medical services, serves as a "medical passport" for high-net-worth individuals. It not only provides financial compensation to supplement traditional health insurance but also drives transformations in people's lifestyles. Beyond offering high reimbursement limits, it delivers comprehensive, premium medical protection services, covering special groups such as children, pregnant women, and the elderly.

Initially, high-end medical insurance in China primarily targeted expatriate executives to meet their healthcare needs while residing in the country. The term “high-end” has elevated this type of insurance to a prestigious status, with “exorbitant” premiums serving as a barrier to customer acquisition. In reality, premiums for high-end medical insurance range from several thousand to tens of thousands of yuan. When compared with the services offered by premium private medical institutions and comprehensive health management programs, these costs are not particularly high. Moreover, such insurance addresses challenges associated with public hospitals, including difficulties in securing appointments and strained medical resources. Consequently, a growing number of high-net-worth individuals in China are opting for high-end medical insurance.

In 2005, Medilink Global was officially established. As a Third-Party Administrator (TPA) for medical insurance, it served multiple insurance companies and partnered with numerous healthcare institutions, accumulating extensive health management experience and vast amounts of data. After being acquired by the Nanyan Group, Medilink Global leveraged its advantages in medical resources, data processing capabilities, and channel networks to transform into a premium healthcare company. It now provides full-lifecycle health management services to customers based on high-end medical insurance plans.

Premium Medical Insurance: Premium in More Than Just Price.

According to Huang Lidan, head of MEDILINK GLOBAL: “An excellent high-end medical insurance product must meet three criteria. First, it should provide services at reasonable prices and design customized insurance products for different segmented groups. Second, service quality must keep pace, offering high-quality medical care, health management, and other services. Third, the product must demonstrate sustained stability; medical insurance is a product purchased today to prepare for the future, and high-end medical insurance aims for high renewal rates.”

High-end medical insurance focuses on front-end market selection. Existing high-end medical insurance products in the market have not yet adequately covered special groups such as children (including newborns), pregnant women, and the elderly; pediatric medical insurance is mostly offered as a rider to adult policies.

ButAs the rise in newborns drives up demand for commercial health insurance, and medical services expand into lower-tier markets, a growing number of emerging consumer segments are opting for self-paid vaccines and private pediatric specialty care. Coupled with the spillover of purchasing power resulting from drugs passing the consistency evaluation, the pure high-end medical market is beginning to penetrate broader segments. This shift has given rise to a new category of health insurance products, distinct from traditional pure high-end health plans, which are gaining widespread popularity.。

Having gained a thorough understanding of market pain points and user needs, MEDILINK GLOBAL has decided to enter the market with children's medical insurance.MEDILINK GLOBAL’s inaugural product, “New Yanbao,” covers insured persons aged 30 days to 17 years, allows children to be insured independently, and features premiums lower than those of comparable products in the market.Clients can enjoy 100% reimbursement for outpatient services at designated private medical institutions. Additionally, direct billing is available for in-person visits via a mobile electronic card, with access to supplementary services such as health management.

Beyond market-oriented design, a product’s successful launch and customer acceptance hinge on robust marketing and operational capabilities. MEDILINK GLOBAL leverages cross-functional collaboration among its Internal Network Department, Medical Department, Customer Service Department, and other teams to manage customer communications, match medical resources, oversee condition management, and track service delivery. By focusing on every detail, the company delivers the most suitable, cost-effective, and efficient solutions tailored to customers’ medical needs.

Huang Lidan stated, “Integrating resources is a prerequisite for meeting demands. In 2021, a key client of the company needed to schedule an appointment with a renowned ophthalmologist in Beijing. MEDILINK GLOBAL’s account managers coordinated through multiple channels to ascertain the expert’s full consultation schedule and successfully facilitated the connection between the client and the specialist. The company has established a database of high-quality specialist physicians across major regions in China, forming a premium medical resource center managed by dedicated personnel, with the aim of providing tangible assistance to clients in specialist referrals and appointment scheduling.”

With “MEDILINK GLOBAL · New Yanbao,” MEDILINK GLOBAL has gradually penetrated the high-end medical insurance market. Building on this foundation, the company has launched “MEDILINK GLOBAL · Xi Yanbao,” providing medical coverage and health management services for both mother and child during pregnancy.

In 2022, the company’s new Yanbao product underwent three major upgrades, including coverage for outpatient visits at special needs clinics of top-tier public pediatric hospitals in Beijing and Shanghai, and complimentary influenza vaccinations. This August, MEDILINK GLOBAL will launch a product tailored to the needs of traditional high-end medical insurance users, fully covering both existing and potential high-end medical insurance clients.

Currently, China’s high-end medical insurance market remains dominated by foreign institutions. Although there is no shortage of participants in this sector, the stringent requirements for service quality, underwriting, and claims management mean that few companies have achieved significant business scale. There is a scarcity of enterprises that are truly market-oriented and capable of delivering comprehensive services.

As a domestic enterprise, MEDILINK GLOBAL enjoys inherent advantages in the Chinese market, enabling it to refine service details and efficiency based on feedback from local clients.From the “small bot” that assists in reminding staff of missed customer service calls, to the ECCS system that automatically identifies missing documents in customer claims at the backend; from the earliest deployment of industry-specific SaaS solutions to low-code platforms and agile development,MEDILINK GLOBAL: Gaining a Deeper Understanding of Customers. Previously, foreign clients accounted for 80% of the company’s customer base; currently, their proportion does not exceed 20%.

Services and data are the core of high-end medical insurance.

“The Insurance + Service” model operates on the logic that insurers provide high-quality medical services to safeguard patients’ life and health, thereby controlling premium costs. When a customer is diagnosed with a critical illness, the insurance company will seek the most appropriate medical solution on their behalf. Otherwise, if patients were to navigate medical care independently, it could result in substantial medical expenses, leading to uncontrollable claim payouts.

The optimal solution is to implement health management for clients at an early stage, thereby “nipping” diseases in the bud or controlling their progression through intermittent medical services.

Transitioning from a well-known TPA company to providing high-end medical insurance services, MEDILINK GLOBAL possesses inherent advantages in service and data.Since its establishment in 2005, the company has served a cumulative total of 150,000 members worldwide over the past 17 years. It has built a global network of 1.4 million medical and health service providers across 230 countries and regions, established connections with numerous medical institutions, and accumulated extensive medical data and resources.。

It is precisely based on the accumulation of preliminary data that MEDILINK GLOBAL can now conduct analyses from highly granular dimensions—such as identifying which patient populations, in which regions, require what types of diagnosis and treatment services—thereby enabling proactive assessments of the front-end market.

In terms of medical services, MEDILINK GLOBAL is building a full-lifecycle health management platform. In 2021, Nanyan Group acquired Shanghai Yixing Outpatient Department, aiming to provide family doctor-style, multidisciplinary clinical diagnosis and treatment services for expatriates and high-net-worth individuals in China, addressing health issues at an early stage to reduce medical costs. In November of the same year, the Group further acquired Hekang, a provider of workplace healthcare solutions, to build a comprehensive corporate healthcare solutions platform.

Since then, MEDILINK GLOBAL has evolved from a standalone international medical insurance service platform into a comprehensive health management platform covering the entire life cycle. Its goal is to establish a Chinese-style HMO (Health Maintenance Organization) model.

The HMO model is a form of managed care abroad, referring to a system that provides comprehensive medical services to enrolled individuals in a specific area after collecting fixed prepaid fees. Unlike traditional indemnity-based health insurance, the HMO integrates payers and providers into a closed loop, thereby controlling healthcare costs.

To provide more comprehensive medical services, MEDILINK GLOBAL actively collaborates with high-quality medical institutions both domestically and internationally, including the international departments of public hospitals such as Peking Union Medical College Hospital, Beijing Jishuitan Hospital, and Shanghai Ruijin Hospital, as well as premium private healthcare providers.As of May 2022, the company had established partnerships with over 3,000 medical institutions across 298 cities in China.

Meanwhile, MEDILINK GLOBAL has partnered for many years with UnitedHealthcare (UHC), a leading health insurance provider in the United States. Leveraging UHC’s channel resources, MEDILINK GLOBAL’s high-end medical insurance services are accessible across all 50 U.S. states and at more than 1.4 million healthcare institutions and pharmacies, enabling cashless direct billing services.

The development of high-end medical insurance is inseparable from economic growth and the rising health awareness among the public, with the latter inevitably continuing to advance. As the high-end medical insurance market continues to expand, customers will raise their expectations for insurance products and increase their demand for one-stop solutions. Insurers must further integrate multi-party resources to provide comprehensive services covering the entire process, from disease prevention to treatment and management.

Meanwhile, private and high-end medical institutions will undoubtedly become increasingly standardized, offering high-quality specialized and general practice services, attracting more authoritative experts, and gradually gaining market acceptance. Their development is expected to facilitate the rational “triage” of patients, helping to alleviate the current strain on medical resources in China. AndHigh-end medical insurance serves as the bridge connecting customer needs with private healthcare resources.。

In the future, MEDILINK GLOBAL will further deepen its presence in the high-end medical insurance market, refine its product portfolio, segment customer groups more precisely based on existing offerings, and launch high-end insurance products tailored to specific diseases.

Reference: “Raising Billions in Financing: Is the HMO Model Really That Appealing?” – Bao Guan