Based on thehe promulgation, implementation of Regulations on the Supervision, Administration of the Use of Healthcare Security Fund, there are some problems seriously threatening the safety of medical insurance funds. Therefore, we need to strengthen the supervision of medical insurance funds, update the supervision information in time, solve a series of problems, effectively manage medical expenses, standardize medical service behavior, ensure that medical insurance funds are used effectively, improve the social security system. Therefore, the paper analyzes the problems existing in the supervision of medical insurance fund by taking a first-class hospital in Guangxi as an example, puts forward optimization strategies for the supervision of medical insurance fund