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Researching On The Path Innovation Of China's Medical Insurance Fund Supervision Under The Background Of Big Data

Posted on:2020-11-02Degree:MasterType:Thesis
Country:ChinaCandidate:Q YangFull Text:PDF
GTID:2404330572994435Subject:Public management MPA
Abstract/Summary:PDF Full Text Request
The medical insurance fund is a fund accumulated by the insured personnel or units and the financial subsidies accumulated by the governments at all levels.It is an indispensable component of the social security system and is organized and managed by the medical insurance management department.And pay the medical expenses of the insured personnel according to the relevant payment methods.The medical insurance fund is about the fundamental interests of every insured person,and it is also related to social stability and long-term stability.With the rapid development of China's medical insurance industry,the coverage of medical insurance,the scale of insured personnel,the number of fixed-point institutions,and the amount of payment for treatment have increased sharply.Those criminals are paying more attention to the medical insurance fund,and the ways of committing crimes have been continuously refurbished.The means of committing crimes are becoming more and more concealed.Even there emerges the phenomenon that the fixed-point agreement agencies and the insured personnel jointly defraud and obtain medical insurance funds,which poses a serious threat to the safety of the medical insurance fund.The serious shortage of service capacity,the poor accessibility of artificial supervision and the unsmooth situation of departmental cooperation mechanisms have brought more serious challenges to the supervision of medical insurance funds by medical insurance agencies.In the new era,how to strengthen the supervision of medical insurance agencies through the innovative medical insurance fund supervision model is worthy of further discussion.This paper firstly summarizes the research status of existing medical insurance fund supervision models at home and abroad and the research ideas of this paper.It goes into the core concepts of medical insurance funds,big data,medical insurance fund supervision,innovation path,and medical insurance related laws,regulations and policies.After the research,based on the public goods theory and government regulation theory,the paper uses literature review,comparative analysis and case analysis to study the case of C's recent practice in the application of medical insurance supervision big data,then points out the problems in medical insurance supervision one by one,such as the application challenge of medical insurance supervision big data,the lack of service capacity,the shortage of supervision method and means.And the paper comprehensively analyzes its causes,analyzes the necessity of applying the big data to supervise medical insurance fund,and the practical path of big data intelligent monitoring and the feasibility of the innovative medical insurance fund supervision path,and puts forward targeted countermeasures or suggestions for effectively solving the problems encountered in the supervision of medical insurance funds,and hope to play a reference role in the supervision of China's medical insurance funds.At present,domestic and international research on the supervision of medical insurance funds mainly focuses on the supervision mechanism and system.In the same kind of research,more studies on medical insurance are based on theory,and there is a lack of how to use big data in the new era."Informatization means,research on the innovation of medical insurance fund supervision path." At the same time,the C city medical insurance fund supervision case selected in this paper is relatively new,and it is conducted in-depth research based on its own work.The data is real,the case analysis is more in-depth,and it has reference value.It has certain enlightening significance on how to improve the innovation of medical insurance fund supervision path.
Keywords/Search Tags:big data, medical insurance fund, medical insurance fund supervision, path
PDF Full Text Request
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