Medical services are expensive.
In 2018, China’s social health insurance (SHI) funds, which cover more than 95% of the population, recorded an expenditure of RMB1.76 trillion. Looking for ways to make savings and combat fraud and inflated insurance claims has become a top priority of the nation.
Ping An HealthKonnect (Ping An Medical and Healthcare Management Co. Ltd) is pioneering innovative solutions to help governments keep costs at bay.
A catalyst in Ping An Group’s pan health care strategy, HealthKonnect is also a core member of the Group’s Smart City ecosystem. Its services cover all participants of the health care ecosystem, including SHI, private insurers, medical service providers and the insured.
Centering on its smart SHI integrative platform, Ping An HealthKonnect has deployed industry-leading technologies including AI, blockchain and cloud computing, and developed a powerful medical knowledge bank. It is also a certified technology provider for China’s strategic digital initiative for public services – a national network supporting central and local administrative units in providing labor protection, social welfare and other services.
HealthKonnect utilizes advanced algorithms and technologies to build anti-fraud and health care resources optimization models based on huge volume of medical data, helping SHI funds better evaluate and manage claims across the country.
Tailored to fit cities of all sizes along with their unique scenarios, Ping An HealthKonnect’s services proved to be versatile as well as sophisticated.
For instance, in 2014, HealthKonnect joined hands with the SHI supervisory authority in Xiamen to develop a ‘social health insurance and medical service supervision information platform’ to monitor the whole process of medical service provision.
Currently, smart SHI services cover more than 200 cities and 800 million people across China,. The amount of audited SHI claims per year is over RMB300 billion.
In addition to its role in the government social health insurance sector, Ping An HealthKonnect also offers small-to-medium sized insurers smart risk management services.
HealthKonnect has developed a series of products covering all operational aspects of private insurance, building on its integrated expertise in medical services, data, technology and insurance.
Diagnostic and treatment data from medical institutions are analysed to build models to estimate reasonable cost ranges for different treatment plans. These models not only lower the risk of over claim but also allow for more standardization in the auditing of claims thus significantly increase the efficiency of insurers.
As to the insured, they are also benefiting from this cloud-based platform: a fully digital, hassle-free, paperless claim experience.