Youjia Health Reconstructs the Health Insurance Ecosystem with a Tech-Driven Value-Based Healthcare Service System
Commercial health insurance is regarded as the next untapped gold mine in the broader healthcare consumption industry. On one hand, its rapid development has accumulated a massive volume of medical spending driven by a large customer base, making it an indispensable new payer for various healthcare service providers, including public hospitals. On the other hand, healthcare institutions are attempting to forge entirely new profit models by innovating payment methods with insurers and extending service scenarios, thereby breaking through the revenue limitations imposed by the traditional fee-for-service settlement model.
Over the past few years, the commercial health insurance market has continued to expand in scale, with its service system constantly improving. In 2018, the gross written premiums for health insurance business reached RMB 544.813 billion, representing a year-on-year increase of 24.12%. From 2013 to 2018, the compound annual growth rate (CAGR) of new annual health insurance premiums stood at 35.95%. Amidst this rapid development, new management demands have emerged regarding the expansion of coverage, service innovation, and risk control on the healthcare provider side.
Professional service organizations specializing in various types of health insurance are key drivers behind the expansion of the commercial health insurance market, the optimization of service systems, and the enhancement of risk control management. They play an indispensable role in fostering the healthy development of the commercial health insurance market by building and operating medical consumption networks, evolving coverage responsibilities and value-added services, organizing service resources, and extending into medical behavior management. Emerging trends and practical demands simultaneously arising from both the healthcare and insurance sectors have enabled UJia Health to keenly identify new market opportunities.
“In recent years, in addition to traditional TPA companies, two other types of institutions providing third-party services for health insurance have drawn attention: one is traffic or customer acquisition platforms, which continue to expand the market size; the other leverages data-driven risk control systems to enhance the efficiency of underwriting and claims adjudication.” In contrast, UJIA Health focuses more on building the core engine of health insurance, namely the “Value-Based Medical Service System.” By establishing this medical service system, UJIA Health catalyzes and drives innovation in health insurance coverage responsibilities, optimizes the medical service experience, realizes the monetization of data value, and enhances cost-control capabilities brought about by changes in payment models. This is how Wang Yanping, founder of Beijing UJIA Health Technology Co., Ltd., positions the health insurance service landscape and enterprises.
Founded in 2017, U-Jia Health Technology is dedicated to building a technology-driven value-based healthcare service system that connects insurance institutions, medical providers, and consumers, thereby establishing a healthcare service ecosystem oriented toward commercial insurance payments. Specifically, its services fall into two categories: payment-side and provider-side solutions. The former offers customized services to insurance institutions, including product design, healthcare service networks, and cost risk control. The latter collaborates with medical institutions to transform insurance customer consumption scenarios into standardized healthcare products, providing insured clients with professional services such as intelligent triage, medical consultations, appointment scheduling, direct billing and advance payment, and post-discharge care.
Wang Yanping told VCBeat that since its establishment over a year ago, Youjia Health has made significant progress in building its medical network, continuously iterating its products, constructing its technology platform, and expanding its team. The development of the medical service network is the most fundamental and core component of Youjia Health’s operations.
The “Research Report on Issues and Policy Recommendations for China’s Commercial Health Insurance” published by the Insurance Association of China pointed out that the greatest challenge facing the development of commercial health insurance in China is the lack of a cooperative mechanism between payers and healthcare providers featuring risk sharing, balanced interests, and information exchange. Youjia Health facilitates the connection between commercial insurance payers and medical institutions, helping them establish an interest-sharing mechanism aligned with commercial logic.
“Previously, commercial insurance companies, as payers, lacked a foundational connection with healthcare institutions, particularly public ones. The primary reason was the misalignment of interests, as commercial insurers failed to bring significant incremental patient volume to these institutions. Against the backdrop of policies such as tiered diagnosis and treatment, reforms in medical insurance payment methods, and drug price reforms, the siphon effect of public tertiary hospitals has been broken. The high-value incremental business and new resource allocation models offered by commercial insurance payers have thus established a basis for synergy between the two parties,” said Wang Yanping.
With connectivity established, U-Jia Health focuses on enhancing the depth and specialization of its services. Initially starting with direct billing and advance payment for medical expenses, it has now extended its offerings to cover the entire healthcare journey, including pre-consultation services, health management, chronic disease management, and post-discharge rehabilitation and nursing care. Meanwhile, addressing customer pain points, it actively promotes innovation in health insurance products.
A professional and diverse team is the driving force enabling UJIA Health to gain deep insights into the evolving health insurance ecosystem. With over a decade of experience in the health insurance industry, Wang Yanping was an early founding team member and part of the preparatory group at iKang Guobin, Ping An Health, and Taikang Health. She has personally witnessed the first ten years of development of the two emerging industries—health insurance and health management—in China. She has previously served as General Manager of the Medical Network Department and Key Accounts Department at Ping An Health, as well as General Manager of the Medical Management Department at Taikang Health.
At the beginning of last year, Ding Haochuan, former President of Wish China, joined UPlus Health as a co-founder. Previously, Mr. Ding served as Vice President of Operations at eLong.com, where he oversaw operations for product and service platforms, as well as international hotel and insurance businesses. He brings extensive experience in building internet platforms, implementing data-driven operations, and designing and managing supply chain platforms. During his tenure as President of Wish China, the brand significantly improved its reputation among Chinese merchants and increased its overall market share, earning widespread acclaim and recognition from both the industry and the investment community.
Ding Haochuan told VCBeat that since last year, Youjia Health has expanded from the breadth to the depth of medical resource coverage, collaborating with healthcare institutions to optimize health insurance products and service systems. This has enabled a strategic shift from mere connectivity to empowerment. The next step involves upgrading Youjia into a “new species” of health insurance services by developing and applying intelligent medical products and integrating online and offline basic diagnosis and treatment entry points. Youjia Health has built an S2B2C platform to integrate medical resources, providing dozens of insurance companies with comprehensive solutions ranging from needs assessment and product design to medical services. This helps insurers rapidly launch and implement their products and services while offering insurance customers more diversified and innovative services.
Earlier this year, UJia Health recruited another senior executive from the health insurance industry, Yuan Ye, who will be fully responsible for formulating and implementing the company’s new product strategy, as well as building and operating its new service capabilities. Yuan Ye has extensive experience in health management, managed care, and establishing medical consumption systems with commercial insurance as the payer. He served for many years at New China Life Insurance and Kunlun Health Insurance, holding positions such as Head of Underwriting at the Health Insurance Management Center, General Manager of the Information Technology Department, and General Manager of the Medical Health Department. He also held senior roles, including Vice President and Chairman, at health service organizations.
Youjia Health’s Core Executive Team: From left to right, Yuan Ye, Wang Yanping, and Ding Haochuan.
Yuan Ye told VCBeat that the health insurance market is continuously expanding, particularly with the development of products such as “Million Medical Insurance” and single-disease insurance, which are bringing more people into the health insurance service system. Alongside this rapid growth, insurance institutions have an increasingly strong demand for refined risk control management. Professional services aimed at improving the health quality of insured populations, as well as innovative medical service products under transfer payment models, represent the key product directions for UPlus Health in its next phase. UPlus Health has jointly established a product R&D platform with authoritative clinical research institutions and medical universities. By organizing horizontal research projects, the company aims to enhance its own R&D capabilities and has already signed cooperation agreements with these institutions.
“In addition to expanding its core management team, Youjia Health has also established a diversified and professionalized middle-management team, with most members hailing from large life insurers, health insurers, healthcare institutions, and internet companies,” said Wang Yanping.
In terms of business progress, Youjia Health has established partnerships with more than 30 insurance institutions of various types—including life, property, pension, health, mutual, brokerage, and reinsurance insurers—as well as with renowned internet platforms and enterprises. It has developed and launched several health insurance products, serving nearly one million customers to date. The company’s business model has been fully validated, continuously uncovering new growth drivers and achieving revenue in the millions.
Moving forward, Youjia Health will upgrade and refine its products along three key dimensions. First, it will deepen the understanding of customer needs across different service scenarios throughout the insurance coverage period. Second, it will continuously integrate emerging technologies such as medical artificial intelligence, healthcare big data, and 5G-enabled telemedicine to optimize resource allocation and service efficiency within its value-based healthcare system, thereby providing insurance customers with more cost-effective medical service products. Third, it will shift from merely integrating healthcare resources to a model combining “integration + self-built capabilities,” and transition from passive to proactive services, focusing on capturing online and offline traffic entry points in primary care and basic diagnosis and treatment.
In terms of financing, UJIA Health secured millions of RMB in angel investment from Legend Star immediately upon its establishment in July 2017. In November 2018, the company announced the completion of a multi-million USD Series A financing round led by Joy Capital. Following these two rounds of funding, UJIA Health actively deployed resources in talent acquisition, technological upgrades, product iteration, and market expansion. Currently, UJIA Health is initiating a new round of financing, seeking to partner with high-quality investors who possess industry resources and can provide long-term support.