Research On Risk Prevention And Resolution Of Medical Insurance Fund In S City

The report to the 19th National Congress of the Communist Party of China pointed out that the people’s health is about the cause of socialism in China to promote events,party and the country did a lot of efforts to improve people’s health,including basic medical insurance(hereinafter referred to as "insurance")cause outstanding achievements,in solving the difficulty and high cost of the people to see the doctor aspects such as question,in the realization of the goal of health of China plays a particularly important role in the process.After exploration and development,the medical insurance work in S city has achieved certain stage results,but some problems and deficiencies have also been exposed.How to continuously improve the management level of medical insurance fund,so that the limited fund to bring a higher level of medical services for the insured personnel has become a major issue facing the municipal medical insurance department.First of all,the relevant literature on risk prevention and control of medical insurance fund at home and abroad is reviewed,the concept of medical insurance fund and risk prevention and control is clearly defined,and the process of risk prevention and control is described.Secondly,through detailed data analysis,the practical problems existing in the operation of the medical insurance fund in S city are deeply analyzed,and it is pointed out that the operation of the medical insurance fund in S city has problems such as too fast growth of expenditure,aging of population,and loopholes in total amount pre-control.Once again,Starting from the implementation risk and environmental risk of the medical insurance fund in S city,from different perspectives of raising,institutional framework,payment operation,as well as the influence of political environment,economic environment and social environment on the medical insurance fund in S city,the current various risks are effectively identified and evaluated.Finally,aiming at the existing problem of S city,in the operation of the medical insurance fund puts forward the corresponding countermeasures and suggestions,including establishing large data analysis system,we will improve the mechanism of the appraisal of medical insurance fixed-point medical institutions,the implementation of the credit evaluation system,enrich the fund regulatory power,improve the mode of payment and internal control mechanism,build system of municipal medical insurance fund as a whole,intensify information disclosure,establish branch association Consultation system.