Research On Business Process Reengineering Of Medical Insurance In X District Of Hangzhou

The medical insurance agency is an institution established by the local government in accordance with the law to implement the basic medical security system to provide basic medical security public services for insured units and individuals.It is mainly responsible for payment records,insurance registration,fund management,and designated management,fee payment review,medical service supervision and other matters.The basic medical insurance has a wide range of service targets and complicated matters.The original feedback mechanism and the overall system are not perfect,resulting in a single handling channel,low efficiency,and inability to actively understand,analyze and process,and feed back to the needs of the people in time,which wastes administrative resources.Finally the problem appeared which is the imbalance between the supply and demand of medical insurance services.Therefore,proactive and continuous improvement of the basic medical insurance service process is not only an objective reality and the need to meet service needs,but also the best choice under limited resource conditions.The independence of the medical insurance fund and the establishment of the medical insurance bureau are the highlights of the national institutional reform,a fundamental change in the organizational structure,and an opportunity to improve the basic medical insurance service process.The integration of medical insurance functions provides a foundation for the overall collaboration of medical insurance through the integration of administrative procedures and the unification of approval standards.However,with the construction requirements of digital government,the original business process can no longer meet the needs of the new era.Zhejiang Province’s“run once at most” reform takes information flow as the starting point for process reengineering and “Internet +” technology as an essential element of the “run once at most” reform,which runs through government standardization,information sharing,departmental coordination,and public services.The essence of providing third-party cooperation is to give the people the power to evaluate the effectiveness of reforms,and to reverse the previous government-centrism.It is a new application of the concept of service-oriented government in China.But on the other hand,there are still many problems to be solved in Zhejiang Province’s "run at most once" reform,which are concentrated in information islands,insufficient standardization,and internal control that needs to be further strengthened.The complexity,comprehensiveness,particularity,and high relevance of medical insurance services to people’s livelihood make it very typical for Zhejiang to run relevant reforms at most once.For the specific section of medical insurance services,it is also necessary to sort out the vertical,horizontal,and time axis to see the best.Therefore,this article focuses on the aspect of "medical insurance service process reengineering",combined with the relationship between X medical insurance’s current service process and other subjects,deeply analyzes contradictions and problems,implements business process reengineering,and puts forward corresponding suggestions.Why do we need to reform the medical insurance service process ? what problems are found in the reform?what causes these problems,and how to further solve them ?This article analyzes,summarizes,diverges,deduces and summarizes the above issues.By combining the theory of new public services and process reengineering,five issues are summarized: insufficient coordination among departments,isolated islands of information,poor communication channels,digital divide,and weak risk control,and believe that these five issues are mainly provided by public services changes in the overall environment,the inertia of bureaucratic organizations still exist,service thinking is limited to the staff,and the lack of innovation motivation of medical insurance institutions is composed of four factors that cross-influence.Finally,in response to these problems,this article proposes follow-up solutions such as doing a good job in top-level design,doing a good job in the evaluation plan,and strengthening internal control.From the perspective of intelligence,it is proposed that the future needs to provide smart government and smart government that provide more flexible,diverse and personalized public services.