Meideyi and Qiezi Oral Cloud Launch China's First Dental Insurance Service Platform 'QieziBao', File IPO Prospectus

In recent years, health insurance has increasingly been regarded as one of the most significant future opportunities for both the insurance and healthcare industries, attracting a surge of capital from various sources. According to incomplete statistics, more than 50 companies have applied to the China Insurance Regulatory Commission (CIRC) for health insurance licenses. Meanwhile, the administration of basic medical insurance is expected to be further opened up to commercial insurance companies. The "Opinions of the State Council on Integrating the Basic Medical Insurance Systems for Urban and Rural Residents," released earlier this year, proposes "entrusting qualified commercial insurance institutions and other social forces to participate in the administration of basic medical insurance through government purchase of services, thereby stimulating operational vitality."

However, the industry is still in an exploratory phase regarding how commercial insurers can genuinely engage in and reshape the healthcare system, effectively control medical expenditure, and improve the quality of medical services. The crux of the issue may lie in the severe fragmentation of the public healthcare system and the prevalence of information silos, which hinder the provision of a unified information interface and data standards for commercial insurers. As a result, critical operations such as insurance policy design based on medical data and cost containment in health insurance cannot proceed smoothly.

MedImpact, which entered the Chinese market in 2011, is the largest non-retail Pharmacy Benefit Management (PBM) company in the United States. Its prescription drug reimbursement and review system is networked with more than 65,000 healthcare institutions across the country. Its clients include Fortune 500 companies, eight of the ten largest insurance companies in the U.S., as well as state and federal governments.

Ms. Yang Yijing, General Manager and Head of the Asia-Pacific Region at Medidata, told VCBeat that what China’s healthcare system lacks is precisely a third-party administrator (TPA) for group medical insurance like Medidata, which assumes the functions of pharmacy benefit management. Since entering the Chinese market, Medidata has leveraged its mature experience from the United States and its professional curation of Chinese medical data to build an intelligent clinical knowledge base tailored to the local context. Based on this foundation, the company has developed specialized services for healthcare institutions and insurers, including rational drug use support and real-time claims processing.

In 2016, Meideyi began to enter the dental field. Ms. Yang Yijing introduced that Meideyi has established an exclusive strategic partnership with “Qiezi Dental Cloud,” a well-known domestic dental SaaS platform. It will introduce Dental Benefit Management (DBM), a mature model already established in the United States, into China. On the open ecosystem cooperation platform of “Qiezi Dental Cloud,” it will establish “Qiezi Bao,” the first financial insurance platform in China centered on dental services.

Leveraging the network of over 20,000 dental hospitals and clinics covered by “Qiezi Dental Cloud,” “Qiezi Bao” will enable Chinese consumers to access transparently priced, quality-assured dental healthcare and medical services. It also lays the information and data foundation for commercial health insurance payments, claims processing, and optimization of the dental supply chain.

Oral Care Will Be One of the Fastest-Growing Segments in the Healthcare Industry

Yang Yijing told VCBeat that the decision to enter the dental sector was driven by its rapidly expanding market size and high degree of commercialization. International experience suggests that as a country transitions from lower-middle to upper-middle income status, rising health awareness and improved quality of life make dental care one of the fastest-growing segments within the healthcare industry.

Moreover, according to relevant statistics, the current annual market size of oral healthcare consumption is approximately RMB 60 billion, while commercial insurance accounts for only 0.1% of the total market, which is nearly negligible. If commercial insurance can effectively stimulate the oral healthcare consumption market, coupled with strong macroeconomic and social drivers supporting the industry, commercial insurance may capture a significant share of the oral healthcare market in the coming years. In light of this, as a third-party administrator (TPA) for medical insurance and an oral health benefits management company, now is the optimal time for Meideyi to strategically position itself in the oral healthcare industry.

Compared with public hospitals, dental clinics are predominantly market-oriented private entities that operate on a self-sustaining financial basis, placing greater emphasis on factors such as patient acquisition sources and customer acquisition costs. As a third-party administrator (TPA) for medical insurance, Meideyi leverages its extensive network of insurance company partners. Through “Qiezi Bao,” a product jointly developed with “Qiezi Dental Cloud,” it can provide offline clinics with a steady stream of insured patients.

Leveraging the SaaS model of “Qiezi Dental Cloud” to connect with over 20,000 dental hospitals and clinics across China

After deciding to enter the dental care sector, Medmei has been seeking the most effective way to penetrate the oral health market. Yang Yijing introduced that Medmei has currently established partnerships with over 200 large chain dental clinics in Beijing, Shanghai, Guangzhou, and Shenzhen. Consumers can search for “Medmei” on WeChat to access its consumer-facing platform, where they can view profiles of these partner clinics, standard pricing for dental procedures, and promotional offers. Although the collaboration has progressed well, Yang Yijing believes that this dental network is still far from sufficient for Medmei’s needs, until she discovered “Qiezi Dental Cloud,” a cloud-based information management service provider specializing in hospitals and clinics.

It is reported that “Qiezi Dental Cloud” currently has over 20,000 registered dental hospitals and clinics using its services. Building on this foundation, “Qiezi Dental Cloud” is deepening its coverage of dental clinics, moving from breadth to depth, and actively building an open ecological cooperation platform for the dental industry. It introduces a wide range of upstream suppliers to dental hospitals and clinics, including equipment, consumables, denture processing, as well as various financial and insurance services tailored for both B-end and C-end users.

Yang Yijing told VCBeat that under the mature medical insurance system in the United States, Meideyi can deliver its services simply by integrating with standardized information interfaces at healthcare institutions. In China, however, the promotion of commercial health insurance faces significant obstacles due to two main factors: the lack of uniform standards for public hospital information interfaces and the weak level of digitalization among small and medium-sized private healthcare providers.

“Qiezi Dental Cloud” and Meideyi have jointly created “Qiezi Bao,” which can immediately connect to over 20,000 dental hospitals and clinics across China. Moreover, as all these institutions are provided with standardized information interfaces by “Qiezi Dental Cloud,” it becomes a natural progression to standardize clinic diagnosis and treatment processes, establish clinical pathways for dentistry, and enable insurance companies to achieve cost control and direct claim payments.

“Qiezi Bao” essentially provides the infrastructure necessary for commercial insurance companies to enter the dental care sector. By leveraging a SaaS platform to establish a comprehensive, end-to-end information monitoring system for offline clinics, it ensures effective oversight of clinical treatment, payment processing, and operational management. This enables commercial insurers to confidently and robustly penetrate the dental care market.

Establishing a Credit System for Dental Clinics: “Qiezi Bao” Helps “Top-Tier Clinics” Stand Out

For private dental institutions, consumers perceive significantly superior service attitudes and experiences compared to public institutions; however, issues such as opaque pricing and non-standardized practices constrain their healthy and rapid development. Yang Yijing stated that by leveraging the mature Dental Benefits Management (DBM) model from the United States, Meideyi and “Qiezi Oral Cloud” have jointly created “Qiezi Bao,” a dental financial insurance service platform. This platform not only helps consumers access transparently priced, quality-assured dental healthcare but also establishes a “Dianping-style” review system for dental clinics, enabling high-quality clinics to stand out and secure greater development opportunities.

According to Yang Yijing, in the United States, Dental Benefit Management (DBM) is a vertical sector of healthcare benefit management that rivals Pharmaceutical Benefit Management (PBM) in importance. It serves as the primary channel connecting dental clinics with insurance payers, playing an irreplaceable role in ensuring medical quality, controlling healthcare costs, and facilitating direct claim payments. Although DBM is relatively simpler than PBM—given that there are only hundreds of dental fee items compared to 170,000 pharmaceutical products on the Chinese market—it still requires specialized expertise to design reasonable insurance products and implement professional claims risk control. For instance, not all patients with missing teeth are suitable for dental implants. Patients with osteoporosis in the alveolar bone at the implant site or insufficient distance between adjacent teeth are not candidates for implants. Leveraging its experience in the U.S. and its accumulated expertise in the Chinese market, Meideyi conducts pre-authorization reviews for high-cost procedures to eliminate fraud, waste, and abuse, thereby protecting patients’ interests and helping insurers avoid unnecessary expenditures.

“Qiezi Bao” is the first to introduce Dental Benefits Management (DBM) to more than 20,000 dental hospitals and clinics in China. In the initial phase, it primarily establishes standardized clinical service protocols for offline clinics, covering multiple aspects including diagnostic and treatment services, pharmaceuticals, and medical consumables, with the aim of providing patients with high-quality, reassuring dental care. In the later stage, leveraging accumulated data and supply chain resources, it will gradually establish dental clinical pathways, laying the foundation for insurance cost containment and optimization of the dental supply chain.

In addition to oral health patients and insurance companies, Dental Benefits Management (DBM) also holds significant importance for a wide range of dental hospitals and clinics. Yang Yijing told VCBeat that establishing standardized dental diagnosis and treatment processes can not only substantially reduce the incidence of medical accidents and medical risks in clinics but also, by leveraging the extensive data accumulated by “Qiezi Oral Cloud,” enable the development of tiered evaluation standards and credit systems for clinics. This effectively distinguishes “good clinics” from “bad ones,” fostering a survival-of-the-fittest mechanism among the more than 20,000 dental hospitals and clinics covered by “Qiezi Oral Cloud.” As a result, clinics with superior medical skills and excellent service attitudes will gain more development opportunities, while those with poor medical competence and irresponsible patient care will gradually be phased out.

Many insurance companies have already expressed strong interest in the “Qiezi Bao” platform, jointly developed by Meideyi and “Qiezi Oral Cloud.” Yang Yijing introduced that currently, common dental insurance products on the market are mainly embedded within larger medical insurance products, and typically involve cooperation between a single insurance company and a single dental chain institution. The problem with this model is that the geographic coverage and service price range of an individual dental chain are limited, failing to meet the dispersed and diverse dental care needs of insurance customers. Moreover, the customer base of a single insurance company is limited, resulting in insignificant effects in driving patient traffic and increasing revenue for the chain institutions.

With over 20,000 dental hospitals and clinics on the “Qiezi Dental Cloud” platform, insurers have substantial room to maneuver in terms of geographic coverage density, price ranges, and data scale, facilitating the development of flexible and diverse dental insurance products. Furthermore, for clinics on the “Qiezi Dental Cloud” platform, as their credit ratings continue to improve and more insurers join “Qiezi Bao,” these insurers are likely to drive increasing patient traffic to clinics with high credit ratings.

Yang Yijing revealed that negotiations with multiple insurance companies are currently underway, with the first dental insurance product expected to be launched on the “Qiezi Bao” platform by the end of this year. As China’s first financial insurance service platform dedicated exclusively to oral health, “Qiezi Bao” will uphold a spirit of open collaboration in the future, working alongside insurance companies focused on the dental sector to capitalize on the rapid growth of China’s oral care market.