Research On The Development Dilemma And Improvement Countermeasures Of Intelligent Monitoring Of Medical Insurance

With the deepening reform of medical insurance system and the expanding insurance coverage,medical service supervision gradually becomes more difficult.As the traditional method of medical service supervision based on manual labor and afterwards handling has not been able to meet the needs of the new situation,intelligent monitoring of medical insurance opens up a new situation.It obtains big data on medical insurance by means of modern information technology and carries out the medical insurance supervision from the perspective of medical service behavior and the insured;it conducts data collection,analysis and comparison,review and supervision of medical treatment behaviors so as to regulate medical treatment behaviors,achieve comprehensive real-time supervision of medical insurance,and enhance the supervision ability.However,when intelligent monitoring of medical insurance is being fully promoted,many problems has occurred,which seriously affect the implementation efficiency of intelligent monitoring of medical insurance and even hinder the comprehensive development of medical security.This paper uses literature analysis method,comparative analysis method and case analysis method to further explore several modes of intelligent monitoring of medical insurance.Taking the specific case of intelligent monitoring of medical insurance in City A of Shanxi Province as the starting point,this paper analyzes the development dilemma of intelligent monitoring of medical insurance and puts forward countermeasures and suggestions for improving the intelligent monitoring of medical insurance.It has high value for promoting the upgrading of intelligent monitoring in the new stage and is also of great significance for boosting the sustainable development of medical security system.This paper is divided into five parts.The first part introduces the concept of intelligent monitoring of medical insurance.It explains itsbackground from the aspects of policy,wide application of Internet Plus and big data technology as well as management unit of medical insurance,and also expounds the theoretical basis.The second part introduces the development process of intelligent monitoring of medical insurance,which is divided into pilot exploration stage and full implementation stage.This part analyzes "Hangzhou mode","Ningbo mode","Xuzhou mode" and "Taicang mode" mode,summarizes the experience of intelligent monitoring of medical insurance,and takes City A in Shanxi Province as a case for specific analysis.The third part points out the development dilemma of intelligent monitoring of medical insurance at the present stage: imperfect policies and regulations,limited development of intelligent monitoring caused by inadequate team,incomplete construction of intelligent monitoring system and insufficient promotion of intelligent monitoring of medical insurance.This part also studies relevant problems in detail.The fourth part puts forward countermeasures for improving intelligent monitoring of medical insurance,and offers feasible suggestions accordingly in terms of improving relevant laws and regulations,enhancing the efficiency of intelligent monitoring at multiple levels,completing the construction of intelligent monitoring system and increasing the promotion of intelligent monitoring of medical insurance.