Study On The Current Situation,Problems And Countermeasures Of The Medical Insurance Fund Management In The Top Three Hospitals

Improving the management system of medical insurance fund in China is an important support for the establishment of "medical insurance system with Chinese characteristics" in the new era.In the current practice of medical insurance fund management,the contradiction between the psychology of "covering the money bag"of medical insurance payers and "Insured patients have higher demand for medical services”is particularly prominent.Medical insurance designated medical institutions,especially the third class hospitals,have become the main targets of various kinds of medical insurance funds,and medical insurance funds have increasingly become an important economic source to ensure the normal operation of the top three hospitals.Based on this fact,it is necessary and urgent to strengthen the construction of medical insurance fund management capacity and effectively improve the use efficiency of medical insurance fund from the actual situation of the third class hospitals.In this paper,taking a third class hospital in Z Province as an example,firstly,the current medical insurance fund management system and the application and refusal of payment of medical insurance fund in the hospital are investigated in detail,so as to fully understand the current situation of medical insurance fund management in the hospital.Secondly,"look beyond appearance for the essence",from the current situation of the hospital’s medical insurance fund management,this paper combs out its existing problems in "the composition of medical insurance fund management system,the formulation of post responsibilities,the construction of talent team,,information construction,promotion the sense of obtaining from policy for both sides of health care,deepen the communication between hospitals and the health care security administration ",etc.Finally,according to the above analysis results,the reasonable countermeasures to improve the management level of the medical insurance fund of the third class hospitals are given,so as to maximize the mutual benefits and assure a win-win situation for them.