通过深入调研惠民保发展模式、产品设计、参保现状、理赔现状,考察各方考量、隐藏风险和潜在价值,本研究报告提出从筹资、支付和数据共享三方面促进惠民保的可持续发展:一是通过完善定价、改进服务、主管部门支持开放职工基本医保个人账户、提升消费者风险保障意识等方面提升健康人群参保率;二是科学划定保障范围,创新支付方式;三是实现数据共享,提升运营效率。
<<Through an in-depth investigation of Huimin Insurance’s development model,product design,the current status of insurance participation and claims settlement,and analysis of various considerations,hidden risks,and potential values,this report proposes to promote the sustainable development of Huimin insurance from three aspects,including financing,payment,and data sharing. First,improve the insurance coverage rate of healthy people by improving pricing,improving services,supporting the opening of employees‘accounts for basic medical insurance,and enhancing consumers’ awareness of risk protection. Second,scientifically delimit the guarantee’s scope scientifically and innovate the payment method. Third,realize data sharing and improve operational efficiency.
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