Costs far exceed the number of health insurance visits
According to statistics from Vietnam Social Security, in the first 9 months of 2024, the number of medical examination and treatment visits increased by 5.8% compared to the same period in 2023, but the cost increased by 15.5%. This increase in cost is equivalent to an increase of VND 13,686 billion compared to the same period in 2023, bringing the total health insurance medical examination and treatment expenditure to VND 102,057 billion.
Therefore, the effectiveness of controlling health insurance costs is first and foremost reflected in ensuring the rights of health insurance participants, requiring health insurance facilities to provide correct and sufficient medical services for health insurance patients. In addition, effectively using the health insurance fund, making payments and settlements to ensure transparency and compliance with regulations...
Deputy General Director of Vietnam Social Security Nguyen Duc Hoa emphasized that the fluctuation in health insurance medical examination and treatment costs of 26 localities will have a great impact on the overall cost of the whole country. Through the assessment of health insurance medical examination and treatment work in 9 months, the local social security agencies will clearly identify the causes of the increase in costs, because each place has different characteristics.
Based on the analysis of effective solutions, difficulties and obstacles to draw out groups of solutions to ensure optimization of health insurance treatment costs, minimize unreasonable cost increases in the last months of 2024 and the coming time...
It can be seen that one of the positive aspects of the increase in health insurance costs is that many localities have ensured bidding and adequate supply of medical supplies for surgery, especially expensive technical services.
However, there are still cases where medical facilities prescribe technical services and extensive testing beyond what is necessary; or prescribe inpatient treatment for patients with mild illnesses that can be treated as outpatients, prolonging the treatment period...
Total solution in cost control
Regarding the issue of health insurance, Head of the Health Insurance Policy Implementation Department, Vietnam Social Security, Le Van Phuc, said that in the first 9 months of 2024, the budget implementation rate of 63 provinces and cities was 84%. Of which, Son La had the highest implementation rate of 91%, followed by Phu Tho with 89%, Bac Giang, Thai Nguyen, Hai Phong and Thai Binh with 88%; the remaining provinces had a budget utilization rate of 87% or less...
“To ensure effective health insurance spending and optimize resources so that patients can enjoy maximum benefits, local social insurance agencies need to closely follow the professional guidance documents of Vietnam Social Insurance. At the same time, units need to improve efficiency in selecting and working with facilities with high costs; at the same time, link cost control with management and use of health insurance spending estimates assigned to each province…” – Mr. Phuc stated.
Deputy General Director of Vietnam Social Security Nguyen Duc Hoa emphasized that with the goal of focusing on ensuring the legal rights of health insurance participants, the Vietnam Social Security sector has strengthened the appraisal of health insurance treatment costs, optimizing resources to serve the people.
Identifying problems arising in each locality, pointing out the causes of increased costs, the leaders of Vietnam Social Security requested that local Social Security agencies have comprehensive solutions in controlling costs, and strictly follow the instructions of Vietnam Social Security.
The leaders of Vietnam Social Security also mentioned the solution of tightening discipline, promoting the responsibility of each individual and unit; not allowing delays in the process of implementing policies and resolving benefits; effectively coordinating between related units, not affecting the benefits of health insurance participants.
“We absolutely will not pay, even a single penny of wasteful or illegal expenses. This is also the principle to ensure that the health insurance fund is used effectively in practice,” the Deputy General Director of Vietnam Social Security emphasized.
In addition, the leaders of Vietnam Social Security requested the Health Insurance Policy Implementation Board and the Health Insurance Assessment and Multi-line Payment Center to proactively guide and coordinate with local Social Security to ensure the effectiveness of settlement of health insurance medical examination and treatment costs.
Source: https://kinhtedothi.vn/chi-kham-chua-benh-bhyt-hieu-qua-bao-dam-quyen-loi-nguoi-benh.html
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