DIP Smart Cost Control Platform
An intelligent medical insurance cost-control platform for refined fund management.
Project Background
As DIP payment reform advances, medical insurance authorities need more refined management tools. Healthyway developed a DIP smart cost control platform to improve insurance fund efficiency.
Solution
The DIP smart cost control platform includes several core capabilities:
- Intelligent disease-score calculation to support scientific payment standards
- Smart medical expense review to identify abnormal costs
- Provider performance assessment to encourage appropriate care
- Insurance fund operation monitoring to prevent fund risks
- Data analytics and decision support for policy optimization
Project Value
The platform will deliver several forms of value:
- Improve medical insurance fund efficiency
- Control unreasonable growth in medical expenses
- Encourage providers to deliver standardized care
- Protect the rights and interests of insured people
DIP Payment
Payment by disease score
Smart Review
Identifying abnormal expenses
Fund Safety
Preventing operational risks