Operational risk events have severely impacted the development of third-party payment(TPP)platforms,and have even led to a discussion on the operational risk capital charge settlement by relevant international regulat...Operational risk events have severely impacted the development of third-party payment(TPP)platforms,and have even led to a discussion on the operational risk capital charge settlement by relevant international regulators.However,prior studies have mostly focused on qualitative mechanism analysis,and have rarely examined quantitative risk assessment based on actual operational risk events.Therefore,this study attempts to assess the operational risk on TPP platforms in China by constructing a systematic framework incorporating database construction and risk modeling.First,the operational risk database that covers 202 events between Q1,2014,and Q2,2020 is constructed.Then,specific causes are clarified,and the characteristics are analyzed from both the trend and loss severity perspectives.Finally,the piecewise-defined severity distribution based-Loss Distribution Approach(PSD-LDA)with double truncation is utilized to assess the operational risk.Two main conclusions are drawn from the empirical analysis.First,legal risk and external fraud risk are the two main causes of operational risk.Second,the yearly Value at Risk and Expected Shortfall are 724.46 million yuan and 1081.98 million yuan under the 99.9%significance level,respectively.Our results are beneficial for both TPP platform operators and regulators in managing and controlling operational risk.展开更多
China's Mainland has witnessed remarkable achievements in payment innovations based on internet and financial technologies in recent years,whereas Macao has made little progress in financial technologies,especiall...China's Mainland has witnessed remarkable achievements in payment innovations based on internet and financial technologies in recent years,whereas Macao has made little progress in financial technologies,especially in payment technologies.Based on the concept and types of third-party payment business in China's Mainland and Macao,as well as to investigate the causes for Macao’s lack of innovation in third-party payment,this study compares their differences from two aspects:business licensing authorities and key points of supervision.By comparison,although the classification and methods of third-party payment businesses are different between China's Mainland and Macao,they are all managed and licensed by a unified supervision department.Moreover,the key points of supervision in both places are similar,but unlike China's Mainland,which takes financial risk prevention as the principle and financial technology as the means to encourage innovation,Macao showed obvious deficiencies.In order to further deepen the connection between the financial markets of China's Mainland and Macao as well as boost financial technologies in Macao,this study aims to provide some suggestions and references for the development of cross-border payment systems.展开更多
2024年7月,国家医保局发布《关于印发按病组和病种分值付费2.0版分组方案并深入推进相关工作的通知》,标志着我国疾病诊断相关分组(diagnosis related group,DRG)支付改革正式迈入2.0时代。2.0版分组方案中,DRG增加了6组,核心DRG增加了3...2024年7月,国家医保局发布《关于印发按病组和病种分值付费2.0版分组方案并深入推进相关工作的通知》,标志着我国疾病诊断相关分组(diagnosis related group,DRG)支付改革正式迈入2.0时代。2.0版分组方案中,DRG增加了6组,核心DRG增加了33组,具有分组更科学合理、更契合临床实际情况的特点。国家医保局同步明确了5个配套管理机制,即特例单议机制、基金预付机制、谈判协商机制、意见收集反馈机制和数据公开机制,旨在优化DRG支付改革管理,确保医疗机构、医保部门和患者实现多方共赢。2.0版的发布,为医疗机构提供了更精细化的管理工具和更合理的支付机制。医疗机构应积极拥抱该项改革,通过优化内部管理和提高服务质量,实现成本控制和效率提升,最终达到患者、医保基金和医疗机构三方共赢。展开更多
推动中医药医保支付方式改革,探索符合中医药特点的支付方法和管理机制具有重要意义。基于国家医疗保障局推行的按疾病诊断相关分组(Diagnosis Related Groups,DRG)付费和现行医保支付中按项目支付方式,借助博弈理论分析两种支付方式下...推动中医药医保支付方式改革,探索符合中医药特点的支付方法和管理机制具有重要意义。基于国家医疗保障局推行的按疾病诊断相关分组(Diagnosis Related Groups,DRG)付费和现行医保支付中按项目支付方式,借助博弈理论分析两种支付方式下中医院的诊疗行为策略选择及其影响因素。结果表明,在按项目支付下中医院会选择过度诊疗的行为策略以谋取更多的利润;在DRG支付下,中医院会从过度诊疗的行为向缩减诊疗的行为转化,最终选择缩减诊疗的行为策略以获得更大的利润。这表明,与现行的支付方式相比,DRG支付可以在一定程度上纠正中医医疗机构的过度诊疗行为,遏制医疗资源的浪费,但仍需充分发掘中医药的适宜技术和优势病种,发挥中医药的独特优势,实现中西医之间的优势互补。展开更多
基金supported by grants from the National Natural Science Foundation of China(71425002,72101166)the Capital University of Economics and Business for the Fundamental Research Funds for Universities affiliated to Beijing(XRZ2021066).
文摘Operational risk events have severely impacted the development of third-party payment(TPP)platforms,and have even led to a discussion on the operational risk capital charge settlement by relevant international regulators.However,prior studies have mostly focused on qualitative mechanism analysis,and have rarely examined quantitative risk assessment based on actual operational risk events.Therefore,this study attempts to assess the operational risk on TPP platforms in China by constructing a systematic framework incorporating database construction and risk modeling.First,the operational risk database that covers 202 events between Q1,2014,and Q2,2020 is constructed.Then,specific causes are clarified,and the characteristics are analyzed from both the trend and loss severity perspectives.Finally,the piecewise-defined severity distribution based-Loss Distribution Approach(PSD-LDA)with double truncation is utilized to assess the operational risk.Two main conclusions are drawn from the empirical analysis.First,legal risk and external fraud risk are the two main causes of operational risk.Second,the yearly Value at Risk and Expected Shortfall are 724.46 million yuan and 1081.98 million yuan under the 99.9%significance level,respectively.Our results are beneficial for both TPP platform operators and regulators in managing and controlling operational risk.
基金Special Project of Guangdong Provincial Key Discipline Project“Public Management”-Research on Information Literacy of Teachers and Students in Colleges and Universities from the Perspective of Crisis and Emergency Management(Key Construction Discipline of Guangdong Provincial Education Department in 2016)The Second Batch of Teaching Quality and Teaching Reform Project of Guangzhou Xinhua University in 2021-Finance Course Teaching and Research Department(Project Number:2021JYS001)。
文摘China's Mainland has witnessed remarkable achievements in payment innovations based on internet and financial technologies in recent years,whereas Macao has made little progress in financial technologies,especially in payment technologies.Based on the concept and types of third-party payment business in China's Mainland and Macao,as well as to investigate the causes for Macao’s lack of innovation in third-party payment,this study compares their differences from two aspects:business licensing authorities and key points of supervision.By comparison,although the classification and methods of third-party payment businesses are different between China's Mainland and Macao,they are all managed and licensed by a unified supervision department.Moreover,the key points of supervision in both places are similar,but unlike China's Mainland,which takes financial risk prevention as the principle and financial technology as the means to encourage innovation,Macao showed obvious deficiencies.In order to further deepen the connection between the financial markets of China's Mainland and Macao as well as boost financial technologies in Macao,this study aims to provide some suggestions and references for the development of cross-border payment systems.
文摘2024年7月,国家医保局发布《关于印发按病组和病种分值付费2.0版分组方案并深入推进相关工作的通知》,标志着我国疾病诊断相关分组(diagnosis related group,DRG)支付改革正式迈入2.0时代。2.0版分组方案中,DRG增加了6组,核心DRG增加了33组,具有分组更科学合理、更契合临床实际情况的特点。国家医保局同步明确了5个配套管理机制,即特例单议机制、基金预付机制、谈判协商机制、意见收集反馈机制和数据公开机制,旨在优化DRG支付改革管理,确保医疗机构、医保部门和患者实现多方共赢。2.0版的发布,为医疗机构提供了更精细化的管理工具和更合理的支付机制。医疗机构应积极拥抱该项改革,通过优化内部管理和提高服务质量,实现成本控制和效率提升,最终达到患者、医保基金和医疗机构三方共赢。
文摘推动中医药医保支付方式改革,探索符合中医药特点的支付方法和管理机制具有重要意义。基于国家医疗保障局推行的按疾病诊断相关分组(Diagnosis Related Groups,DRG)付费和现行医保支付中按项目支付方式,借助博弈理论分析两种支付方式下中医院的诊疗行为策略选择及其影响因素。结果表明,在按项目支付下中医院会选择过度诊疗的行为策略以谋取更多的利润;在DRG支付下,中医院会从过度诊疗的行为向缩减诊疗的行为转化,最终选择缩减诊疗的行为策略以获得更大的利润。这表明,与现行的支付方式相比,DRG支付可以在一定程度上纠正中医医疗机构的过度诊疗行为,遏制医疗资源的浪费,但仍需充分发掘中医药的适宜技术和优势病种,发挥中医药的独特优势,实现中西医之间的优势互补。
