This paper discusses the main challenges and limitations faced by the current cash basis medical insurance fund accounting system and proposes optimization strategies to improve the quality of accounting information and management efficiency of medical insurance funds. Combining cases of medical insurance fund accounting, the paper analyzes problems in accounting information quality, control link, and analysis and evaluation. It points out the deficiencies of the cash basis in reflecting the true operational status of medical insurance funds and preventing fund risks, as well as the management shortcomings caused by low collaboration between finance and business. The paper recommends exploring the accounting foundation that combines the cash basis and accrual basis, strengthening the integration of accounting informatization and business system, and constructing a scientific financial analysis system for medical insurance funds.

Objective: Taking a sample hospital as an example, this study explores the effect of establishing a business-finance integration system and optimizing supporting management systems to promote cost reduction and efficiency improvement in hospitals, in order to provide optimization solutions and implementation pathways for business-finance integrated management in other public hospitals. Methods: A business-finance integration system was developed through data center, accounting center, and control center, and supporting application and management systems were designed accordingly. The thyroid surgery department of the sample hospital was selected as the research subject. Differences in DRG capability, DRG efficiency, and CMI before and after implementing business-finance integration measures were analyzed using Excel 2010 and SPSS 26.0. Results: A total of 2247 hospitalized patients from the thyroid surgery department were included. The results showed that after implementing business-finance integration measures, the number of disease groups increased, while medical treatment days, total hospitalization costs, surgical fees, material costs, western medicine fees, and laboratory fees decreased, with statistical significance (P < 0.05). The overall CMI value remained stable. Conclusion: Currently, business-finance integration has achieved preliminary success in cost management and service expansion. However, the system shows limited effectiveness in promoting technological innovation or improving CMI. Achieving high-quality development while reducing costs and improving efficiency is to be explored .

Objective: The paper explores the accounting system of medical insurance fund suitable for China's national conditions, to promote the reform of medical insurance management system. Methods: From the perspective of accounting theory, the theoretical basis of the accounting entity assumption of medical insurance fund and the fundamental role of the accounting entity assumption were discussed, and the conflict between the current single fund accounting entity and the administrative management system in China was analyzed from the perspective of accounting practice. This paper analyzes the feasibility of the dual accounting entity model of "fund plus units" in a way that combines theory and practice. Conclusion: A fund accounting system suitable for the management of medical insurance funds in China should be established to provide institutional guarantee for promoting the reform of medical insurance management system and improving the efficiency of medical insurance fund use. Suggestion: The dual accounting entity model of "fund plus unit" should be adopted to establish the accounting entity of the medical insurance fund, so as to achieve the accounting objectives of improving the decision-making quality of the management entity, relieving the public fiduciary responsibility, improving the efficiency of fund use, and reducing the risk of fund misappropriation.

Objective: The paper attempts to resolve the core contradiction between accounting and financial management of medical insurance funds, and enhance the efficiency of fund management. Methods: The paper analyzes the lag of the "Social Insurance Fund Accounting System" in dealing with new businesses such as remote medical settlement and DRG payments, and proposes targeted optimization paths. Results: The current system has problems such as incomplete coverage and insufficient adaptability of subjects. The optimization path includes revising the system, unifying operating procedures, and constructing a dual mechanism accounting framework of "cash basis plus accrual basis". Conclusion: We need to strengthen personnel capabilities and information technology support, improve accounting standards, and ensure the safe and efficient operation of funds.

Objective: The paper attempts to promote the optimization of medical insurance business process and improve the efficiency of medical insurance management by realizing the integration of administration and finance. Methods: This paper analyzes the reasons for the separation of administration and finance in medical insurance, and discusses the implementation path of the integration of administration and finance. Conclusion: The establishment of China's healthcare security management system and national healthcare security information platform provides favorable conditions for the integration of medical insurance administration and finance. Suggestions: The medical insurance departments should give full play to the advantages of the management system, strengthen the construction of business regularization and standardization, and promote the integration of medical insurance management administration and finance on the basis of optimizing the internal management organization, improving the basic management system, and standardizing the medical insurance management behavior. Also, they should standardize the basic management business of medical insurance in batches, accelerate the improvement of the basic management system, promote the construction of medical insurance informatization in stages, and gradually realize the integration of administration and finance.

Efficient fund financial management is a fundamental condition for ensuring the safety of medical insurance funds and the foundation for the sustainable development of the healthcare security system. Affected by traditional administrative management thinking, the internal control environment of China's healthcare security department is weak, with functional departments acting independently, medical insurance business being detached from fund finance, which limits the performance of fund financial management functions. This article analyzes the current situation of financial management environment and financial business construction in the practice of medical insurance management, explores the relationship between management behavior and fulfillment of responsibilities by functional departments, and proposes a path for the synchronous development of medical insurance business and fund finance. It is recommended establishing and implementing a standardized internal control system, strengthening daily business guidance, cultivating high-quality medical insurance professional and technical talents, and improving the level of medical insurance management.

The current rules, regulations of the hospital financial accounting system are not perfect, resulting in non-standard medical financial accounting behavior, so related medical insurance problems cannot be processed in a short time. Hospital financial management has a direct impact on the running benefits of hospitals. Under the background of medical insurance reform, the hospital financial accounting system should be constantly improved. The professional skills, comprehensive quality of hospital financial accounting personnel need to be improved. It is necessary to cultivate financial accounting personnel who are politically, morally, professionally competent to meet the need of medical insurance, its development. Based on the requirements of the reform, development of the medical security system, this paper studies the current situation of hospital financial accounting, puts forward relevant suggestions