Shandong Internet Healthcare & Medical Insurance Platform Files IPO Prospectus, Pioneering Smart Regulation to Safeguard Public Healthcare Funds

Recently, Liang Weinian, Deputy Secretary of the Party Leadership Group and Vice Director of the Standing Committee of the Hubei Provincial People’s Congress, led an inspection team to Shandong Province to conduct research on medical insurance work. Wang Suilian, Vice Director of the Standing Committee of the Shandong Provincial People’s Congress, attended a symposium held in Jinan. Zhang Guangfeng, Member of the Standing Committee of the Shandong Provincial People’s Congress and Director of its Social Affairs Committee, accompanied the delegation during their field visits in Qingdao.

During their visit to Shandong, Liang Weinian and his delegation made a special trip to the Health Building in Jinan High-Tech Zone to conduct research on the Shandong Internet Medical Insurance and Big Health Service Platform (hereinafter referred to as the “Shandong Medical Insurance Big Health Platform”). They were accompanied by Wang Zhaoyu, Member of the Standing Committee of the Shandong Provincial People’s Congress and Deputy Director of its Social Affairs Committee; Zhang Ningbo, Party Secretary and Director of the Shandong Provincial Healthcare Security Administration; Guo Jishui, Deputy Director of the Shandong Provincial Healthcare Security Administration; Li Wenxiu, Party Secretary and Director of the Jinan Municipal Healthcare Security Administration; and other relevant leaders from the Shandong Provincial People’s Congress and the provincial and municipal healthcare security administrations. Jing Weiguo, General Manager of Shandong Internet Medical Insurance and Big Health Group and Executive Vice President of WeDoctor Group, along with other relevant executives from the group, also participated in the visit. Liang Weinian and his delegation conducted a detailed inspection of the platform’s development and gained insights into Shandong’s innovative practices in leveraging digital technologies to achieve intelligent supervision across all dimensions, processes, and links.

Hubei Provincial People's Congress Inspection Team Conducts Research on Shandong Medical Insurance Big Health Platform

Since last year, the State Council has successively issued documents requiring the strengthening of intelligent monitoring and management of medical insurance to safeguard the public’s funds for medical treatment and life-saving care. On May 1 this year, the Regulations on the Supervision and Administration of the Use of Medical Security Funds officially came into effect, providing clear and explicit provisions on the use, supervision, administration, and legal liabilities associated with medical security funds. The National Healthcare Security Administration is vigorously promoting a shift in medical insurance regulation from ex-post oversight to comprehensive whole-process supervision covering pre-event, during-event, and post-event stages, further enhancing regulatory capabilities to ensure the safety, efficiency, and rational use of medical security funds.

According to reports, Shandong Province launched the Shandong Medical Insurance Big Health Platform last year, establishing a comprehensive service system across the province that integrates “Internet + medical insurance + healthcare + pharmaceuticals.” By leveraging digital empowerment and advancing process reengineering reforms, the initiative has effectively facilitated coordinated reforms among healthcare providers, medical insurance schemes, and the pharmaceutical industry. In terms of intelligent supervision of medical insurance, efforts have been focused on building a regulatory framework covering the entire patient care journey. This system enables multi-dimensional intelligent cost control through real-time monitoring, intelligent analysis, dual-layer audits, and smart management, all powered by big data applications.

Director Zhang Ningbo Introduces the Construction Progress of Shandong’s Medical Insurance and Big Health Platform to the Hubei Provincial People’s Congress Inspection Team

The Hubei Provincial People’s Congress Inspection Team reviewed the operational status of Shandong Province’s Intelligent Monitoring and Big Data Analytics Platform for Medical Insurance. Staff members explained that, built upon a medical insurance knowledge base and integrated with artificial intelligence and big data analytics tools, the platform achieves end-to-end oversight of physicians’ prescription writing and diagnostic test ordering through the implementation of systems for pre- and intra-service monitoring, post-service audit, monitoring analysis, and big data-based risk control.

Hubei Provincial People's Congress Inspection Team Reviews Shandong Province’s Intelligent Monitoring and Big Data Analytics Platform for Medical Insurance

The establishment of a real-time monitoring system for pre- and intra-event oversight has shifted healthcare insurance supervision proactively upstream. This approach effectively reduces the incidence of excessive prescriptions and unnecessary examinations, significantly lowering the risk of non-compliance in post-service settlements of healthcare insurance funds. Furthermore, it helps standardize clinical practices, facilitating a transition from pure regulation to an integrated model combining supervision, management, and services. Consequently, the focus of regulatory efforts has shifted from merely controlling medical costs to dual control over both medical expenses and quality of care.

Jing Weiguo introduced the attempts and explorations made by the Shandong Medical Insurance Big Health Platform in areas such as medical insurance payment reform, intelligent supervision of medical insurance, and facilitating public access to medical insurance benefits. Driven by medical insurance payment mechanisms, the platform has promoted innovative services including online consultations, online follow-up visits with prescription issuance, chronic disease management, assistance and agency services, and inclusive commercial health insurance. Over the past year, it has served nearly 7 million insured individuals in Shandong Province, earning media acclaim for “pioneering ‘people’s well-being and happiness’ through digital technology.” Jing Weiguo stated that the Shandong Medical Insurance Big Health Platform will leverage intelligent supervision as an effective means to integrate high-quality resources from various parties, thereby providing the public with more efficient and convenient healthcare services.

Jing Weiguo Introduces the Convenient and People-Benefiting Innovative Services of the Shandong Medical Insurance Big Health Platform to Liang Weinian and Others

As healthcare reform deepens and the “Internet + Healthcare” model rapidly develops, new requirements have been imposed on medical insurance supervision. It is reported that Shandong Province was the first in China to provide one-stop services encompassing online consultations, e-prescribing, medical insurance review, and online settlement. The nation’s first electronic medical insurance settlement statement was issued on the Shandong Medical Insurance Health Platform. Leveraging this platform, Shandong has achieved end-to-end supervision of medical insurance processes for internet hospitals. With ongoing efforts, the province will soon realize comprehensive online and offline supervision of medical insurance across its entire jurisdiction.

The Hubei Provincial People's Congress inspection team expressed strong approval of Shandong’s innovative models and people-centric practices, stating on the spot that they would draw valuable lessons from Shandong’s explorations and implement them in Hubei in light of local conditions.

During the new period of the 14th Five-Year Plan, China’s economy has shifted from a stage of high-speed growth to one of high-quality development, with the public’s demand for health services continuing to rise. With the application of digitalization and intelligence technologies, the coordinated reform of healthcare, medical insurance, and pharmaceuticals (“Three-Medical Linkage”) is deepening. Health insurance supervision based on this coordinated reform, along with comprehensive innovative service models, will enhance the public’s sense of gain.