Health insurance medical examination and treatment costs increase

The increase was recorded in both the number of health insurance examinations and treatments as well as the increase in expenses. In the cost structure, the highest difference compared to the same period last year was in bed fees, accounting for 15.8% of the total health insurance examination and treatment expenses. The amount of medicine expenses had the second highest increase in the structure of 7 cost factors, but accounted for the highest proportion with 31.3% of the total health insurance examination and treatment expenses...

Statistics also show that in 2024, the rate of inpatient treatment tends to increase, with the national average rate being 10.2% of patients going for medical examination and treatment.

Regarding the remaining tasks in 2024, based on the aggregated data, Vietnam Social Security will analyze the structure of drug procurement and use; warn about types of medical supplies that are used a lot and have high prices...

Inpatient treatment at Bach Mai Hospital.

At the same time, the Social Insurance continues to promote analysis, providing provincial Social Insurance with warnings about unreasonable increases in health insurance examination and treatment expenditure indexes, especially in-depth analysis, specific to each medical examination and treatment facility, along with continuing to promote support for the implementation of specialized appraisals.

For local social insurance agencies, Vietnam Social Insurance requires identifying issues that need to be implemented in optimizing the use of health insurance funds in the last month of 2024; regularly monitoring warning information and other information on the Health Insurance Appraisal Information System to analyze, evaluate and focus on appraisal, and organize work with health insurance medical examination and treatment facilities.

In addition, local Social Insurance proactively coordinates with the Department of Health; regularly reports to the Provincial People's Committees on the situation of health insurance examination and treatment in the area.

Units strictly implement the provisions of Decree No. 75/2023/ND-CP of the Government, practice thrift, combat waste in the appointment of technical services, paraclinical services, medical supplies; strengthen prevention of abuse and profiteering of the health insurance fund. Units develop plans to work directly with facilities that still have high cost increases, refuse to pay unreasonable and illegal health insurance medical examination and treatment costs.

Deputy General Director of Vietnam Social Security Nguyen Duc Hoa requested local Social Security agencies to strengthen appraisals, focus on completing cost settlement in accordance with regulations, and ensure patient rights.

The issue of particular concern in the implementation of the current health insurance policy is the Law amending and supplementing a number of articles of the Health Insurance Law passed by the National Assembly, which has many new points related to the subjects participating in health insurance, regulations on health insurance examination and treatment, health insurance benefits when implementing health insurance examination and treatment; payment mechanism for drugs and medical equipment transferred between health examination and treatment facilities, etc.

In order to implement the amended and supplemented Law on Health Insurance in a timely and effective manner, Deputy General Director Nguyen Duc Hoa requested that the professional units of Vietnam Social Security proactively plan the implementation, such as: participating in the development of Decrees and Circulars guiding the implementation; training for local Social Security agencies, etc.

Source: https://kinhtedothi.vn/muc-chi-kham-chua-benh-bao-hiem-y-te-tang-cao.html