| In1998, the State Council issued "Decision on Establishing the Basic Medical Insurance System for Urban Employees ", which gradually brings an end to the free medical treatment. With the basic medical insurance system being carried out, expanding coverage, improving the compensation level and strengthening service management are the main working focus for a decade. With comprehensive coverage of basic medical security system, the control of the medical expenses will become more and more important; the control of the buyers (patients) makes it difficult to curb the excessive growth of medical expenses, so the control of the suppliers (hospitals) is the trend of international management. Social management of medical security in China has officially started, and the key to the success of the reform of medical insurance system is to build a scientific and reasonable management mode of cost settlement, to enhance the expenditure management of the basic medical insurance fund for urban employees, to make rational use of medical insurance fund.This paper analyses the current classification and problems of the medical insurance settlement in Jiangxi province and it takes the domestic and foreign management experience and enlightenment on the development of the medical insurance settlement, combine the developing history of basic medical insurance clearing method and evaluation analysis, and use the theories of the public management. From the view of the public management, suggestions and measures of improving the reform of the medical insurance settlement in Jiangxi province are put forward. |