What does DIP mean? Total budget based on regional point method and payment based on disease score

dip payment expansion

dip payment is a fuzzy mathematical method to solve the problem of medical insurance payment, including payment based on disease and total budget management. This payment method binds the interests of all medical institutions in the overall planning area, so that medical institutions can be combined into "fate * * *". Because the income of medical insurance fund is limited; The use of medical insurance fund should adhere to the principle of "fixed expenditure by income, balance of payments and slight balance"; The medical insurance fund is not only used for DRG/DIP payment, but also for outpatient chronic diseases and hospitalization in different places.

therefore, in order to ensure the normal development of various medical insurance businesses and the practical use of medical insurance funds, the total budget (commonly known as "total plate" and "total control") will be formulated for each medical insurance business type. On the basis of formulating the total budget, in order to prevent emergencies, "risk money" is often reserved for adjustment.

what needs to be said here is that medical insurance will refer to the expenditure of historical medical insurance fund when making the total budget. Therefore, if a large number of medical institutions pass on the expenses to the outpatient department or out-of-hospital at their own expense and shuffle patients to other places, it will easily lead to a decline in the total DRG/DIP budget in the coming year.

this kind of behavior also belongs to the focus of audit and supervision under DRG/DIP payment-"shifting expenses" and "shirking patients", which is not desirable.

The ways to increase the DIp charge are as follows:

1. Charge: DIP charge refers to a way to charge the service fee when using DIP service.

2. charging mode: the charging mode of DIP can be determined according to different service contents, and generally it can be charged on a per-service basis, monthly basis, quarterly basis, annual basis, etc.

3. charging standard: the charging standard of DIP can be determined according to different service contents, and generally it can be priced according to standards such as the duration, frequency and quality of each service.

4. charging form: the forms of DIP charging can be cash payment, credit card payment and electronic money payment.