Shandong Promotes the 'Tai'an Model' of Chronic Disease Management at Provincial Medical Insurance Field Meeting

Registration, follow-up visits, prescription issuance, medical insurance review, payment, and medication pickup—this entire series of steps that previously took two to three hours for a single medical visit in Tai’an was completed by Ms. Zhang in just over 20 minutes at the Chronic Disease Service Center. This improved experience is attributable to Tai’an City’s innovative explorations in chronic disease management services over the past two years, through which 236,000 outpatients with major chronic diseases in the city (reimbursable at designated hospitals) now enjoy one-stop convenient services.

On June 18, the on-site meeting for innovative chronic disease management services under Shandong Province’s “Internet + Medical Insurance + Healthcare + Pharmaceuticals” initiative was held in Tai’an. As a model example of the practical application of Shandong’s Internet-based Medical Insurance and Health Service Platform, Tai’an has established an integrated online-offline chronic disease management system, developed smart traditional Chinese medicine (TCM) pharmacies, and vigorously promoted intelligent monitoring of medical insurance and innovation in payment methods, thereby creating the “Tai’an Model” for innovative chronic disease management. With the province-wide promotion of this model, residents of Shandong, particularly patients with chronic diseases, will enjoy higher-quality, more efficient, and more convenient healthcare services in the future.

The insidious nature of chronic diseases, the irreversibility of their damage, and the prolonged treatment cycles pose significant challenges to chronic disease prevention and control, making it a key task in the Healthy China Initiative. Tai’an City also faces substantial pressure on the operation of its medical insurance fund, characterized by a high proportion and rapid growth of expenditures for major chronic conditions, as well as cumbersome procedures for follow-up visits and medication refills for patients with chronic diseases.

In September 2019, the Tai’an Municipal People’s Government signed a strategic cooperation agreement with WeDoctor Group, initiating an exploration of innovative service models for chronic disease management. Leveraging the construction of a Digital Health Community and using the Taishan Internet Hospital for Chronic Diseases as its platform, Tai’an City has made comprehensive efforts to promote digital synergy among medical care, pharmaceuticals, and health insurance. On one hand, it has reengineered the processes for outpatient management of chronic and major diseases in hospitals while creating an integrated online-offline chronic disease service workflow. On the other hand, it has explored a digital chronic disease management system to enhance the citywide level of chronic disease management.

Zhang Ningbo, Secretary of the Party Committee and Director of the Shandong Provincial Healthcare Security Administration; Zhang Tao, Deputy Secretary of the Tai’an Municipal Party Committee and Mayor of Tai’an; Guo Jishui, Deputy Director of the Shandong Provincial Healthcare Security Administration; principal officials from various departments and affiliated units of the Provincial Healthcare Security Administration; and key leaders from municipal healthcare security administrations across the province attended the on-site meeting held that day. Accompanied by Xiao Heyuan, Director of the Tai’an Municipal Healthcare Security Administration, and Liao Jieyuan, Chairman of Shandong Internet Medical & Health Group Co., Ltd. and Chairman and CEO of WeDoctor Group, the participants visited the Taishan Internet Hospital for Chronic Diseases and observed the innovative practices and achievements in medical care, pharmaceutical services, and health insurance coverage surrounding chronic disease management in Tai’an.

Located on Leigushi Avenue, the Taishan Internet Hospital for Chronic Diseases serves as the regional operations center and digital medical center of the Tai’an Health Community, as well as the citywide chronic disease management center and intelligent health insurance monitoring center. The real-time data dashboard of the Taishan Internet Hospital for Chronic Diseases shows that, to date, Tai’an has established 17 chronic disease service centers (with three under construction), achieving full coverage across its six districts and counties. Nearly 7,000 local physicians practice online on the internet hospital platform, having cumulatively served over 320,000 patient visits. During the pandemic, the internet hospital rapidly launched online health insurance payment services, providing online health insurance settlement for 30 chronic conditions, including hypertension and diabetes.

Leveraging the extensive connectivity and comprehensive empowerment of internet hospitals, broader information interoperability and sharing have been achieved among medical insurance agencies, physical hospitals, internet hospitals, pharmacies, and patients. Building on this foundation, Tai’an has established a three-tier coordinated chronic disease management service mechanism centered on “prevention, diagnosis, treatment, management, and health promotion.” By utilizing the WeDoctor Chronic Disease Full-Process Decision Support System (WCDSS) and adopting the “three-specialist collaborative management” model, the city addresses the practical challenges in implementing health management initiatives.

On the day of the on-site meeting, Zhang Ningbo and his delegation visited the Tai’an Medical Insurance Intelligent Monitoring Center. Currently, Tai’an City implements full-process intelligent supervision of medical insurance, featuring “pre-event alerts, in-process controls, and post-event audits.” Data show that compared with the period before system integration, the average prescription cost per visit for outpatients with chronic major diseases at Tai’an Central Hospital decreased from RMB 550 to RMB 480, a decline of 12.7%, effectively reducing medical insurance expenditures.

In response to widespread feedback from patients with chronic diseases that while traditional Chinese medicine (TCM) is effective, home decoction is inconvenient, Tai’an City has established “Smart TCM Pharmacies.” These facilities integrate services including centralized herbal storage, prescription circulation, intelligent decoction, and internet-based delivery, providing the public with a one-stop solution for dispensing, decocting, and delivering TCM.

Focusing on resolving the challenges of chronic disease management, Tai’an City has advanced major reforms through targeted interventions, refined chronic disease diagnosis and treatment services, optimized whole-process chronic disease management, strengthened medical security capabilities, and solidified the coordinated platform for healthcare, health insurance, and pharmaceuticals. In doing so, it has pioneered the “Tai’an Model” for chronic disease management under the “Internet + Health Insurance + Healthcare + Pharmaceuticals” framework.

At the on-site conference, Zhang Ningbo stated that the province would further summarize and promote Taian City’s innovative experiences in chronic disease management, comprehensively advance the construction of an integrated support system encompassing “Internet + health insurance + healthcare + pharmaceuticals,” and accelerate the development of Shandong’s flagship platform for Internet-based health insurance and big health. These efforts aim to drive the growth of the provincial Internet economy, digital economy, traditional Chinese medicine, and digital elderly care industries, thereby providing the public with multi-level, multi-sector, and diversified services.