Research on the Prediction of Revenue and Expenditure of Shanghai Employees' Medical Insurance Fund Based on the GM(1,1) Model

Objective: To predict the revenue and expenditure data of Shanghai's Employees' Medical Insurance Fund from 2024 to 2030, providing a reference for policy adjustments. Methods: Data on Shanghai's Employees' Medical Insurance Fund from 2017 to 2023 were collected to analyze its operational status. The GM(1,1) model was employed to forecast and analyze the fund's revenue and expenditure for 2024–2030. Results: Both the revenue and expenditure of Shanghai's Employees' Medical Insurance Fund are projected to grow steadily from 2024 to 2030. The annual surplus (revenue minus expenditure) will exceed 40% each year, while the cumulative surplus is expected to expand continuously from 104.64 billion yuan to 252.93 billion yuan. Conclusion: The excessive surplus of Shanghai's Employees' Medical Insurance Fund may undermine its intended role in healthcare security. Recommendations: Reforms to the fund's individual accounts and pooled financing accounts should be accelerated to mitigate the negative impacts of excessive surpluses.