In the process of hospital operation，economic contract plays the role of carrier to reach various transactions. Economic contract management is not only an important part of standardized hospital management，but also a common and important means of hospital risk prevention and control. Based on COSO-ERM (2017)，it establishes an economic contract risk analysis framework for public hospitals，analyzes the risk of hospital economic contract management，and puts forward countermeasures and suggestions for economic contract management. Through the practice test of Beijing Friendship Hospital，Capital Medical University，the hospital economic contract risk management based on COSO-ERM (2017) framework can effectively enhance the awareness of hospital risk management，effectively improve the quality and efficiency of economic contract management by identifying and controlling risks，standardize the economic contract management process，and promote the high-quality development of the hospital.