Driven by the dual opportunities of the "Healthy China" strategy and an aging population, China's commercial health insurance market has steadily expanded, with premium income reaching 759.9 billion yuan in the first eight months of 2025, a year-on-year increase of 2.38%, edging closer to the trillion-yuan threshold.

However, behind this rapid growth, persistent pain points such as "easy enrollment but difficult service access" and data silos remain unresolved. The traditional economic compensation model increasingly fails to meet residents' whole-life-cycle health needs, intensifying pressure for industry transformation.

Against this backdrop, the sector is undergoing a profound shift from "risk compensation" to "health management-driven" models, with policy support and market innovation jointly addressing these challenges.

On the policy front, the 15th Five-Year Plan outlines health security system development, while the National Financial Regulatory Administration issued guidelines promoting a new "prevention-management-compensation" health service framework, charting the course for industry transformation.

Market leaders like PA GOODDOCTOR are pioneering breakthroughs by integrating health services into product design, sales, and claims processes through innovative mechanisms like "healthy behavior-rewards-coverage enhancement" cycles.

From technological empowerment to ecosystem collaboration, and from product innovation to service upgrades, the commercial health insurance industry is overcoming transformation bottlenecks, playing an increasingly vital role in China's multi-tier medical security system.

**Core Transformation: Health Management as the Driving Force** "Previously, health insurance was about hoping not to use it. Now, policies come with dedicated health management services," reflects changing consumer perceptions.

Over the past two years, PA GOODDOCTOR has led this paradigm shift, transitioning insurance from pure risk coverage to comprehensive health service ecosystems spanning entire lifecycles.

The company's upgraded "PA LeHealth" service brand addresses key pain points through four core services: proactive health management, professional medical assistance, wellness programs, and lifecycle insurance products.

"Health services are no longer add-ons but central to our entire operational chain," noted Yu Ning, Assistant General Manager at PA GOODDOCTOR. The new model quantifies healthy behaviors through reward mechanisms, creating virtuous cycles where positive habits translate into enhanced coverage.

**Policy Momentum: Strategic Direction Setting** The 15th Five-Year Plan's healthcare provisions position commercial health insurance as central to elderly care solutions. Regulatory guidelines further specify development priorities across four insurance categories, emphasizing integrated prevention-management-compensation systems.

These policies are reshaping market dynamics, with major insurers leveraging full ecosystem advantages while specialized firms differentiate in niche segments.

"Insurance capital naturally aligns with long-term healthcare investments," stated Lin Sheng of PA GOODDOCTOR, highlighting the sector's role in financing medical innovation and elderly care services.

**Breaking Barriers: Multi-dimensional Solutions** Despite approaching trillion-yuan scale, the industry faces challenges including homogeneous products, inadequate medical-insurance coordination, and superficial health management services.

Solutions require both policy support and insurer-led digital transformation to build end-to-end data capabilities spanning health management to claims processing.

At the 2025 Financial Street Forum, regulators emphasized leveraging wearable tech and AI for proactive health management. PA GOODDOCTOR advocates integrating innovative therapies, monitoring devices, and pharmaceutical collaborations into insurance solutions.

As China enters the 15th Five-Year Plan period, commercial health insurance stands at a critical juncture. With advancing policies, technologies, and ecosystem development, the sector is poised to strengthen its foundational role in implementing the "Healthy China" strategy.