After the company transformed into central enterprise holding, China Guoxin concentrated the resources of central enterprises to actively expand its business in various health insurance planning areas, helping the company to completely get out of the predicament of "difficult charging" for many years, and the company's health security service charging model landed rapidly. establish long-term profitability in the future and maintain a "highly recommended-A" rating.
Event: Zhonggong, a subsidiary of the company, won the bid Quzhou Social Insurance Administration paid for the service items according to the disease grouping point method. The winning transaction price was 10.95 million yuan and the service period was 5 years.
From private enterprises to central enterprises, the company finally broke the dilemma of "difficulty in charging". The "paid purchase service project based on disease grouping point method", which is the fund settlement business of DRGs point method, which won the bid this time, is one of the core businesses of the company's comprehensive medical insurance fund management service. Jinhua, which provides DRGs services, is the only health insurance co-ordinated area in the country that uses DRGs for full-year settlement. The winning bid once again establishes the company's leading position in DRGs. In the past, due to the restrictions on the identity of private enterprises, the charging model of providing services to local social security bureaus has not been landed for a long time. With the change of the identity of central enterprises, the company quickly bid farewell to the situation of free services and won tens of millions of orders. We believe that the landing of the company's charging model marks the advent of the "National New Health" era, and the comprehensive management services of medical insurance funds are expected to fully realize charges this year, laying a good foundation for the long-term development of the company's business.
The medical insurance fund will enter the era of fine management, and the company is expected to benefit from the industry opportunities. National Healthcare Security Administration, newly established by the institutional reform of the State Council, has fully integrated the functions of fund management and supervision of the three major basic medical insurance, pricing of drugs and medical services, and drug recruitment. After the Medical Insurance Bureau has become a strong department of medical reform in China in the future, the medical insurance fund will shift from passive payment in the past to active fee control, from post supervision to pre-supervision, and from supervising price level to supervising price behavior. The company as the central enterprise holding the health insurance control fee "national team", the business is expected to usher in transformational opportunities. At present, the company has upgraded the original basic audit service to comprehensive medical insurance fund management service (including intelligent audit, clinic audit, DRGs, medical insurance payment price standard, supplementary payment, chronic disease management, etc.). In the future, the company will use the medical insurance fund fine management cloud platform to charge annual service fees and individual services for project charges, and medical insurance payment standard services by drug type. At the same time, the pilot of the company's commercial insurance TPA service and health care big data service is progressing smoothly, and the TPA service is expected to achieve a profit-sharing model based on the proportion of commercial insurance pipelining.
Maintain the "highly recommended-A" rating: it is estimated that the net profit in 2017-19 will be 1491,850 million yuan, 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.
