The cost of medical examination and treatment under health insurance is increasing rapidly.

On August 1, Vietnam Social Security held an online conference to deploy tasks to implement the health insurance policy in the last 5 months of 2023. Deputy General Director of Vietnam Social Security Nguyen Duc Hoa chaired the conference at the central bridge, connecting with bridges at social security agencies in localities nationwide...

Scene of the online conference on implementing health insurance policies in the last months of the year.

According to the assessment of the Social Insurance industry, from the beginning of 2023 until now, the whole industry has made many efforts in implementing the health insurance policy, contributing to bringing many benefits to participants and beneficiaries of the policy.

Currently, the Social Insurance of provinces and cities have signed contracts for direct health examination and treatment under health insurance with 2,830 medical facilities, including 46 central-level facilities, 563 provincial-level facilities, 2,088 district-level facilities and 133 agency health facilities (equivalent to commune level). In addition, the country has nearly 10,000 medical stations performing health examination and treatment under health insurance through contracts with district hospitals or health centers or assigned by the Department of Health of provinces and cities. Compared to 2022, the number of facilities signing contracts for health examination and treatment under health insurance increased by 140 facilities, creating maximum convenience for people in medical examination and treatment. Thanks to that, no matter where they are, people can go for health examination and treatment under health insurance at the nearest place.

However, due to many reasons, the cost of health examination and treatment under health insurance is currently increasing at a rapid rate. It is estimated that from the beginning of 2023 until now, the expenditure from the Health Examination and Treatment Fund under health insurance is about 60% of the estimate assigned by the Prime Minister. This reality requires the social insurance sector to have drastic solutions to control the cost of health examination and treatment under health insurance in a reasonable and effective manner, while ensuring the rights of participants.

Specifically, according to Decision No. 877/QD-TTg dated July 20, 2023, the Prime Minister assigned the estimated expenditure for health examination and treatment under health insurance in 2023 to be nearly VND 114,536 billion. The expenditure estimate is calculated based on the total payment in 2022 and takes into account factors of increase and decrease in health examination and treatment costs under health insurance in 2023. However, the estimate of the Health Insurance Policy Implementation Board (Vietnam Social Security) shows that the health insurance amount from the beginning of the year to the end of July is about VND 68,000 billion, equal to 60% of the assigned estimate. With the rate of increase in the use of the Health Insurance Examination and Treatment Fund as in the recent past, the estimated expenditure for health examination and treatment under health insurance in 2023 is VND 120,666 billion, equal to 107% of the estimate assigned by the Prime Minister. The number of localities exceeding the estimate is about 40 provinces and cities.

To effectively use the fund, Deputy General Director of Vietnam Social Security Nguyen Duc Hoa requested that Social Security agencies of provinces and cities coordinate with the Department of Health to advise the People's Committees of provinces and cities to direct the effective use of the Health Insurance Examination and Treatment Fund; clearly define the responsibilities of medical facilities in this work. Along with that, the parties focus on improving the quality of health insurance appraisal.

Regarding the rights of participants, Vietnam Social Security requires all parties to closely monitor the protection of health insurance patients’ rights. Medical examination and treatment facilities are responsible for providing adequate medicines and medical supplies within the scope of health insurance payment for patients…

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