Ping An's Innovative Healthcare Insurance Model: Bridging Government and Internet for Chronic Disease Management

As a domestic insurance giant, Ping An has extended its reach into every aspect of the healthcare sector. This time, Ping An participated in the inaugural “Summit on Innovative Payment Models for Diabetes Education and Management,” aiming to collaborate with more partners to jointly explore the various possibilities of “innovative payment models for diabetes education and management.”

Two Major Challenges in Chronic Disease Management

Data indicate that chronic disease treatment costs account for approximately 70% of total medical expenditures in China. Zhang Lin, Deputy General Manager of Ping An Pension Insurance & Investment Company, has observed three major challenges in current chronic disease management: first, the awareness rate of chronic diseases among the general population; second, how to control these conditions through medication; and third, how to reduce the incidence of complications. Addressing these three challenges requires the participation of payers. However, many medical expenses related to chronic diseases are currently not covered by basic medical insurance, and the year-on-year increase in insurance expenditures has placed significant pressure on medical insurance funds.

Zhang Lin, who has overall responsibility for the Ping An Medical Insurance Division, has been exploring in recent years the integration of commercial health insurance with public medical insurance to participate in chronic disease management.

Zhang Lin believes that healthcare is a semi-public welfare market. “On the one hand, the government must use administrative measures to ensure that people have access to medical care when they are ill; on the other hand, the healthcare sector needs market-oriented approaches to continuously improve service efficiency.”

“From the perspective of market demand, medical services are actually a relatively personalized need. However, public medical institutions provide relatively standardized medical services,” said Zhang Lin. He noted that demands beyond standardized services cannot be met by basic medical insurance and thus require regulation and supplementation through market mechanisms. Commercial health insurance is one such approach.

So, how does commercial insurance play a role in this? Zhang Lin believes it is primarily through services.

Service is the Core

Zhang Lin told VCBeat that integrating commercial insurance with basic medical insurance for chronic disease management requires in-depth control measures.

On the one hand, solutions must be designed from an economic perspective; on the other hand, it is essential to ensure that services can be effectively implemented. Ping An Pension Insurance has achieved remarkable results in its pilot programs for medical insurance administration services across various regions over the past two years.

Ping An Pension & Insurance has partnered with over 100 cities across China in areas such as critical illness insurance, medical insurance cost containment, and administrative services. It has also established the “Ping An Xiamen Model” for collaboration between basic medical insurance and commercial health insurance. Currently, Ping An is engaging in discussions with medical insurance authorities in certain cities to explore and design chronic disease insurance products that integrate basic medical insurance with commercial coverage. Meanwhile, Ping An collaborates with chronic disease management platforms such as Zhangshang Tangyi (Handheld Diabetes Doctor), where Zhangshang Tangyi provides online services, and Ping An is responsible for organizing the relevant insured populations and institutions.

At the current stage, most chronic disease management platforms remain at the level of health maintenance. To truly achieve effective chronic disease management and cost control, multiple steps are involved. For instance, how to rapidly, effectively, and cost-efficiently collect patients’ vital signs data and disease screening data. Existing internet-based chronic disease management focuses more on online services; however, no medical service can be delivered without offline components.

In addition to providing an online platform for chronic disease management, Ping An also partners with community physicians to deliver integrated online and offline services to users.

B2B2CPattern

Notably, Ping An’s attempt to integrate commercial health insurance with public medical insurance in the design of its chronic disease insurance products represents a bold and innovative endeavor. Given the variations in local public medical insurance policies and demographic structures across different regions, Ping An’s chronic disease insurance products feature regional customization and are distributed through partnerships with medical insurance authorities. This approach essentially adopts a B2B2C business model.

"In fact, Ping An Pension Insurance excels in group insurance business."

Ping An Pension Insurance, established on December 13, 2004, is the first and, to date, the largest professional pension insurance company in China. Its business scope covers enterprise annuities and pension asset management, insurance protection, and critical illness coverage under basic medical insurance, with a core focus on pension asset management and livelihood welfare protection. It provides comprehensive financial services to governments, corporate groups, and individuals.

However, Ping An Pension Insurance is transitioning from a sole focus on annuity operations to pension asset management with annuities as the core; shifting from traditional corporate group insurance to healthcare security services primarily centered on administering government medical insurance programs; and evolving from its current enterprise-centric group client model to comprehensive management of both corporate clients and individual customers under government jurisdictions.

From the Medical Partner Competition to the “Summit on Innovative Payment Models for Diabetes Education and Management,” Ping An aims to identify more potential partners. “We need to collaborate with more professional service providers across the healthcare industry chain to jointly create a larger market,” said Zhang Lin.