The Study Of The Business Model Of Commercial Health Insurance In China

From the recovery of commercial health insurance in 1982, the commercial health insurance market has a situation of high-speed development. In contrast to the market in the developed countries, the commercial health insurance market in our country is still backward. Health insurance business model is the channel through which health insurance companies sell the products and services to their customers, so that customers get health coverage while the health insurance companies get the maximum revenue, in a nutshell, it is health insurance operation mode. The introduction of new medical reform of China has pointed out the direction of commercial health insurance in the short term, but in the long run, where will the commercial health insurance go has become a very important issue in front of us. In this paper, based on analyzes of the current business model of commercial health insurance, we will explore the new commercial health insurance business model by learning from the experience of the developed countries.The first chapter is titled as'Introduction'. This chapter first points out the purpose and significance of this research. In order to meet the needs of the people, health insurance business model should be innovated. In this chapter we will also introduce the content of this topic, research methods and ideas, and references in this paper.The second chapter is titled as'the analysis of the current situation of commercial health insurance business model'. This chapter is focused on the development of commercial health insurance in our country, the current situation of commercial health insurance business model and the problem of the health insurance business model. From the recovery of commercial health insurance in 1980s, the commercial health insurance market has a situation of high-speed development. In 2010, the total premium of the health insurance in our country is 67.7billion.In contrast to the market in the developed countries, the commercial health insurance market in our country is still backward. The main reason is the problem the business model. Nowadays the health insurance business model in our country is mainly a "pay" type mode, which emphasizes on the function of compensation after the medical treatment. In this mode, the commercial health insurance companies and medical institutions are different bodes and have different interests, so that the commercial health insurance companies can not control the increasing medical cost, which affect the profitability of the health insurance companies.The third chapter describes the 'analysis of commercial health insurance business model in other countries and the experience for our country', This chapter includes three main parts, the first part is the trends of the commercial health insurance business model in other countries:from comprehensive insurance company to professional health insurance company; from the traditional "pay" mode to managed care model; from a sole body to a variety of business which focus on health insurance; from the business of health insurance to a variety of service related to healthy. The second part describes the current health insurance business model which are successful international, third-party management business model, the cooperation business model of commercial health insurance companies and medical institution; health care model. The last part of the paper is what we can learn from the commercial health insurance business model in the other country. We should improve ourselves and to be professional. Create more new ideas and cooperated with the medical institution.The chapter four discusses the'new business model of the commercial health insurance nowadays'in order to deal the problem of health insurance in our country some insurance company which operated health insurance have created new business model:the model of joining in the basic medical project; the model of cooperation with medical institution by agreement; the model of insurance company buy part of the shares of medical institution; the health care services added model.The last chapter analyze 'the innovation advices of the health insurance business model' At present, the transformation of commercial health insurance business model is not enough, in order to achieve long-term development, commercial health insurance company should learn from the other country and consider the fact of our country, the author gave some advices on the innovation of the third-party management business model, the cooperation business model of commercial health insurance companies and medical institution; health care model.The possible innovations of this article are as followings:1. The author analyzed the commercial health insurance based on not only the experiences form the other country, but also the medical reform and the current situation in our country.2. In the analysis of the commercial health insurance business model, the author had interviewed some experts, their views are support this article which can make the views of the author more authoritative and persuasive.The shortcomings of this article are as followings:1. The analysis of the business model of commercial health insurance is mainly based on theories, lacking of understanding in practice.2. Due to time reasons, the author only analyze the advantages and mechanisms of the commercial health business models, lack the deep analysis of the details of the operating and management, the author will consider it in the future.