Adjusting the price of health insurance services: Hospitals have less difficulty, patients have more worries

SGGP 12/02/2023 06:16

The Ministry of Health has just issued Circular 22/2023/TT-BYT (Circular 22) regulating the unification of prices for health insurance (HI) medical examination and treatment services among hospitals of the same rank nationwide and providing guidance on the application of prices and payment of medical examination and treatment costs in some cases. Many medical services have been adjusted to increase prices, helping hospitals increase their revenue from HI, contributing to improving the quality of patient care, but patients also have more worries.

Adjusting prices of many medical services

In her hand are dozens of receipts of nearly a hundred million VND in hospital fees that Ms. Truong Dung Hanh (living in Thu Duc City, Ho Chi Minh City) had to pay for her husband's surgery for a broken leg due to a work accident at Cho Ray Hospital. Ms. Dung Hanh said that she had saved this money after many years of working as a worker, but it was only enough to cover the first payment. Every time the price of medical services increases, her worries pile up. The previous time the price of medicine increased, now the hospital fees have increased, each treatment costs tens of millions of VND, so she can only try her best.

According to Deputy Minister of Health Nguyen Duc Luan, Circular 22 took effect from November 17, and the prices of many medical services at hospitals of the same rank were adjusted upward. Specifically, the price of medical examination at special-rank hospitals such as Cho Ray, Bach Mai, Viet Duc, Hue Central... increased from 38,700 VND/time to 42,100 VND/time. Not only central-level hospitals, but also the price of medical examination at commune health stations was raised from 27,500 VND/time to 30,100 VND/time.

Meanwhile, for class I hospitals, the price of medical examination per visit increased from 38,700 VND to 42,100 VND; class II hospitals from 34,500 VND to 37,500 VND and class III hospitals from 27,500 VND to 30,100 VND. Along with the adjustment of medical examination prices, the price of a day of treatment at medical examination and treatment facilities also increased according to the provisions of Circular 22. Accordingly, the price of an emergency resuscitation bed at a special class hospital is 509,400 VND/day (an increase of 51,400 VND); class I is 474,700 VND/day (an increase of 47,700 VND); class II is 359,200 VND/day (an increase of 34,200 VND)...; the lowest price is the price of a hospital bed at a commune health station at 64,100 VND/day. For some specialized specialties such as organ transplant, bone marrow transplant, stem cell transplant, the new price for a hospital bed in these specialties at a special-class hospital is 867,500 VND/day (an increase of 85,500 VND).

According to the Ministry of Health, the price of health insurance services in Circular 22 is based on direct costs and salaries. In which, direct costs include: clothes, hats, masks, sheets, pillows and mattresses; electricity, water, cleaning costs; costs of maintenance and repair of houses and equipment... Salary costs include: salary according to the salary scale, allowances prescribed by the State; regular allowances, surgery and procedure allowances according to the Prime Minister's decision. Therefore, with the adjustment of health insurance hospital fees (increased by about 10%) according to Circular 22, hospitals will have additional revenue from health insurance to improve the quality of medical services for patients.

Must improve service quality

Although many medical services have been adjusted to increase prices, according to the representative of the Ministry of Health, Circular 22 does not affect or impact the group of subjects participating in health insurance, which are the poor, ethnic minorities, and social policy subjects because this is the group of subjects whose medical examination and treatment costs are 100% covered by the health insurance fund. For subjects who have to co-pay 5% - 20% of the cost of health examination and treatment under health insurance, the impact is not much, but the increase is not much, they can afford to pay because their income increases according to the basic salary.

CT scan at Ho Chi Minh City Oncology Hospital

According to records at medical facilities, immediately after Circular 22 took effect, many hospitals immediately applied new medical service prices and implemented measures to improve the quality of medical services, reform administrative procedures, reduce overload and inconvenience for patients. Leaders of Cho Ray, Thong Nhat, and 115 hospitals said that Circular 22 was issued on the basis of the basic salary adjusted from VND 1,490,000 to VND 1,800,000 from July 1, 2023, and this is also a step-by-step adjustment of medical service prices in the direction of correct and sufficient calculation.

With Circular 22, from commune health stations to hospitals at all levels, there will be additional revenue from health insurance, which means more funding and resources to invest in equipment, infrastructure and expertise. People will have access to many high-tech services right in their localities, contributing to reducing the burden on higher levels. Associate Professor, Dr. Dao Xuan Co, Director of Bach Mai Hospital, said that although the prices of many health insurance services have increased, in essence, patients benefit because the prices of health services are adjusted in the direction of correct and sufficient calculation, which will gradually reduce people's "out-of-pocket" spending, ensuring the rights of health insurance participants; sick people who have to go to the hospital are respected, placed in the right position as the ones paying for the services, and the hospital is the one serving.

Circular 22 also adjusts the prices of about 2,000 medical services, such as: the price of a simple ultrasound according to the new regulations is 49,300 VND/time (old price is 43,900 VND), the highest is intravascular ultrasound or coronary artery flow reserve measurement FFR with the price of 2,023,000 VND/time (old price is 1,998,000 VND); the price of a regular X-ray is 53,200 VND/time (old price is 50,200 VND); the price of a 64-row to 128-row CT Scanner with contrast is 1,712,000 VND/time (old price is 1,701,000 VND).

Source: https://www.sggp.org.vn/dieu-chinh-tang-gia-dich-vu-bao-hiem-y-te-benh-vien-bot-kho-nguoi-benh-them-lo-post716577.html