Legal analysis: it is an important part of deepening the reform of medical insurance payment method, and it is an original payment method that conforms to the national conditions of China. DIP, supported by big data, combines the point method with the regional total budget to guide the rational allocation of medical and health resources, reflect the labor value of medical personnel, ensure the basic medical needs of insured personnel, and promote the stable and efficient operation of medical insurance funds.
Legal basis: Notice of the Office of the National Health Insurance Bureau on Printing and Distributing the Management Rules for Medical Security Management by Paying by Disease Score (DIP)
The first DIP is an important part of deepening the reform of medical insurance payment methods, and it is an original payment method in line with China's national conditions. DIP, supported by big data, combines the point method with the regional total budget to guide the rational allocation of medical and health resources, reflect the labor value of medical personnel, ensure the basic medical needs of insured personnel, and promote the stable and efficient operation of medical insurance funds.
article 2 the medical insurance agency (hereinafter referred to as the agency) shall, in accordance with the requirements of the national medical insurance policy, actively promote the DIP agency management service, do a good job in agreement management, carry out data collection and informatization construction, establish regional total budget management, set scores and other indicators, carry out audit and settlement, assessment and evaluation, audit and inspection, and do a good job in negotiation and dispute handling. At the same time, establish incentive and restraint and risk sharing mechanism, encourage designated medical institutions to establish and improve the internal management mechanism that is compatible with DIP, reasonably control medical expenses, improve the quality of medical services, and orderly promote the settlement with designated medical institutions according to the score of diseases.