The company establishes a service-oriented charging model around the comprehensive management service of the medical insurance fund to ensure the company's long-term sustainable profitability. In the future, the company relies on the good card position at the end of health insurance, and is expected to continue to give play to the advantages of central enterprises in the field of health big data, open TPA services for commercial health insurance, and maintain a "highly recommended-A" rating.
Event: Zhonggong Healthcare, a holding subsidiary of the company, received the transaction notice of Foshan Medical Insurance hospitalization fee DRGs points payment method (point method) for the implementation of the service project, charging a construction fee of 602500 yuan and a service fee of 3.778 million yuan, totaling 4.3805 million yuan. The service period ends on December 31, 2018. At the same time, the company signed a strategic cooperation agreement with Foshan Human Resources and Social Security Bureau to cooperate in four aspects: fine management of health insurance fund and construction of cloud platform, establishment of supplementary insurance mechanism, establishment of supply guarantee supervision and management mechanism such as drugs and consumables, and development of health big data service.
The annual fee model of medical insurance end service falls to the ground, which establishes the company's long-term profitability. The charging model of the company's DRGs points settlement service in Foshan clearly separates the project construction fee from the service fee, which marks the long-term sustainability of this income in the form of service charge. At present, the company's services around the health insurance side include intelligent audit, clinic audit, DRGs, health insurance payment standards, supplementary payment, chronic disease management, etc., this time, DRGs alone can contribute nearly 4 million years of service fees in one region. If the company continues to expand and deepen various services in the future, the company's overall revenue scale will enter a stage of rapid increase.
The company's health big data strategy has taken an important step. The company signed a "Strategic Cooperation Agreement" with Foshan people's and Social Affairs Bureau, focusing on collecting and improving data and information of all parties in Foshan City, building a healthy big data service platform, and using big data technology to carry out data association analysis. to provide demand-oriented application services to medical institutions, participants, pharmaceutical companies, commercial insurance institutions and other main bodies. The imagination of the company's TPA services for commercial insurance is much larger than that of the comprehensive management business of the medical insurance fund. We believe that cooperation with the medical insurance fund management in the field of health big data is an important basis for the company to develop TPA services in the future. Foshan City and the company reached a strategic cooperation agreement on Health big data, which is an important step in the company's strategic territory.
After the establishment of National Healthcare Security Administration, the company is expected to give further play to the advantages of central enterprises. After the establishment of the Medical Insurance Bureau, the health insurance fund will shift from passive payment in the past to active fee control, from ex post supervision to pre-supervision, and from supervising price level to supervising price behavior. At the same time, active and meticulous management of health insurance is expected to promote the rapid development of health big data application, and health insurance control fees with intelligent audit, DRGs, and health insurance payment as the core are expected to be promoted quickly. The services provided by the company around the medical insurance fund are highly consistent with the main functions of the newly established National Healthcare Security Administration, and it is expected to play a key role in promoting the linkage of "medical, medical insurance, and medicine" by the country in the future, and usher in a period of accelerated business development.
Maintain the "highly recommended-A" rating: it is estimated that the net profit in 2018-20 will be RMB 1.132 billion, the company's charging model for various services will continue to expand in 2018, and the health security service business will achieve overall growth. Maintain the "highly recommended-A" rating.
Risk tips: 1, the health security service business charging model falls short of expectations; 2, the promotion speed of commercial insurance business is slow, and the market competition intensifies.
