新冠肺炎疫情对武汉市职工医保统筹基金的影响

The Influence of COVID-19 Epidemic on the Basic Medical Insurance Fund of Urban Employees in Wuhan

通过构建GM(1,1)基金收入预测模型和医疗保险精算模型,可以分析新冠肺炎疫情对武汉市城镇职工基本医疗保险(简称职工医保)统筹基金的影响。研究表明:新冠肺炎疫情可能会导致2020年武汉市职工医保统筹基金出现年度内收不抵支。在既定减征政策下,当2020年经济增长率低于3.58%时,武汉市职工医保统筹基金年度内将收不抵支,且2020年经济增长率越低,统筹基金赤字规模越大,最大可达到2.79亿元。建议武汉市政府加大在新业态领域的投资力度以促进经济增长,同时采取控制医疗费用、打击骗保等措施减少医保基金支出。

By constructing the actuarial model of medical insurance and grey prediction GM(1,1)model of revenue of funds,this paper analyzes the impact of COVID-19 epidemic on the basic medical insurance fund of urban employees in Wuhan.The result indicates that,under the employee medical insurance fee reduction policy,the current funds will go into the red when the annual rate of economic growth is lower than 3.58%in 2020.The lower the economic growth rate in 2020,the larger the scale of the overall fund deficit,and the maximum fund deficit can reach 279 million yuan.To reduce the deficit,the Wuhan government is advised to invest on TMT to promote economic growth,to take measures to control medical expenses,and to combat fraud.