Study On Risk Prevention And Control Strategy Of The Medical Insurance Fund For The Workers In Shanghai

Proposed in the Third Plenary Session of the eighteen proposed to deepen the medical and health system reform, and medical insurance costs are difficult to control, there is a risk of the fund crisis, is the crux of the difficult medical insurance reform. To ensure the safety of the medical insurance fund’s fund raising funds and the management of funds, can effectively reduce the risk of medical insurance funds face the possibility and reduce the risk of loss, but also to maintain the medical insurance benefits of the insured. From now on the actual situation of the urban workers’ medical insurance fund, risk all the time threatening the safety of the operation of the medical insurance fund: health insurance fund balance has increased, showing extremely high status; the health insurance fund is not fair use, and even fund waste, affect the sustained and stable development and operation of urban basic medical insurance fund the workers. Basic medical insurance for urban workers how to achieve the balance of the fund’s income and expenditure, fair and efficient use of the people, is the problem to be solved at present.Based on the basic medical insurance policy, the BP neural network method is used to analyze the risk factors of urban workers medical insurance fund, and to evaluate the operating status of the medical insurance fund in Shanghai. According to the existing policies and the combination of the existing policies, the paper will be used to determine the risk level of urban workers medical insurance fund. BP neural network method, exponential smoothing forecasting method and system dynamics, the Shanghai urban workers medical insurance fund’s future revenue and expenditure forecast, according to the forecast results found that the future of urban workers medical insurance fund accumulated balance will increase year by year, the cumulative number of time will be more and more, urban workers medical insurance funds are in a state of excessive, there is a risk, such a high margin will have a negative impact on the fund’s positive balance and medical insurance system. Therefore, the risk prevention and control model of Shanghai urban workers’ medical insurance fund is established, and the system of medical insurance reimbursement is introduced, and the related indexes of the model are adjusted, such as high specific fund rate and medical insurance fund.Based on the above introduction, this study through a variety of methods to predict the health insurance fund in Shanghai in the next few years, the main findings are:(2) the current balance of urban workers’ medical insurance fund is 20% to 53%.(3) according to this study, we find that Shanghai’s next several years of urban workers medical insurance fund are in the police and the police.The innovation points of this research lie in:(1) in the past, it is the standard of the fund gap, which is the standard of the medical insurance fund balance, and the effective use of medical insurance fund.(2) using various methods, such as BP neural network method, exponential smoothing forecasting method and system dynamics to reduce the risk of urban workers medical insurance fund in Shanghai.