Since 2013, Xuzhou has carried out in-depth reform of healthcare security payment mode based on payment by disease type. At the same time, relying on the construction of intelligent monitoring system of big data platform, Xuzhou has assisted the reform of high-quality payment by disease type. This paper summarizes the beneficial experience of intelligent monitoring of healthcare security in typical areas, introduces the practice and effectiveness of Xuzhou's intelligent monitoring system of payment by disease based on big data platform, analyzes the existing problems, and puts forward the next development goals and prospects. This paper provides theoretical basis and practical reference for improving the construction of intelligent monitoring system based on disease collection and payment.