Research On The Evaluation Of Operational Efficiency Of Urban Workers’ Basic Medical Insurance Fund

The medical insurance fund is a fund pool that shares disease risks,and its management is related to the normal operation of the entire system and the key interests of the insured persons.With the obvious economic downturn in the new era,the aging structure of insured personnel,the continuous release of health needs,and the overutilization of medical services,multiple contradictions coexist.The risks of medical insurance funds increase,and it is necessary to strengthen the supervision and management of the use of medical insurance.Therefore,studying the operational efficiency of medical insurance funds and improving the operational efficiency of medical insurance funds have good research value and practical significance.Based on this,this article takes the urban employee medical insurance fund of City Z as the research object,and on the basis of related concepts and theoretical explanations,combs the development process of the urban employee medical insurance of City Z,namely the initial trial stage and the rapid development stage.The basic policy of urban employee medical insurance,and the basic status of the current operation of the urban employee medical insurance fund will be introduced.Based on this,according to the established evaluation index system for the operation efficiency of the urban employee medical insurance fund,the descriptive statistical analysis method is used to analyze its operation efficiency from the three aspects of fund raising,fund reimbursement and fund balance,and combined with the evaluation results of the DEA efficiency evaluation model to summarize the urban Factors affecting the inefficient operation of employee medical insurance funds: First,the risk of medical insurance funds increases;second,the difficulty of medical insurance governance increases;third,the development of institutional fragmentation.Based on the fund efficiency evaluation results,the following relevant countermeasures are proposed to further improve the operational efficiency of the urban employee medical insurance fund,including: strengthening the top-level design by implementing government responsibilities and advancing the construction of related legal systems;accelerating institutional integration by accelerating institutional integration and functional integration;Promote the reform of medical insurance payment methods;strengthen the mutual aid ability of medical insurance funds by including improving the overall level of medical insurance funds,improving diversified financing mechanisms,and establishing medical insurance risk funds;promoting the construction of medical insurance supervision informatization,strengthening the publicity and implementation of medical insurance fund policies and classification The diagnosis and treatment system is used to improve the related supporting measures,thereby boosting the efficiency of the medical insurance fund.