Objective: The paper is to explore effective methods and measures for managing URBMI expenses. Methods: Based on the analysis of policy literature, the medical insurance reimbursement database is used to analyze the trends in total and per-visit URBMI outpatient and inpatient expenses and the composition of inpatient expenses in 2008-2020. Results: The average annual growth rate of total URBMI outpatient and inpatient expenses in Putuo District of Shanghai is higher than that of per-capita disposable income of Shanghai residents over the same period. Total URBMI inpatient expenses grew faster than total URBMI outpatient expenses. Private hospitals saw URBMI expenses growing faster than public hospitals. Of inpatient expenses, surgical supply costs and treatment expenses grew faster. Conclusion: The total medical expenses of URBMI beneficiaries in Putuo District of Shanghai are increasing rapidly, posing great pressure to expense control. It is necessary to strengthen expense controls and supervision in terms of payment methods to ensure the rational use of medical insurance funds.