Five rounds of hospital fee increases from now until the end of the year.

The increase in hospital fees, which will include salary adjustments, will be divided into five phases, initially applied in localities with a health insurance coverage rate of approximately 95%.

According to the circular regulating the unified pricing of medical examination and treatment services covered by health insurance among hospitals of the same category nationwide, issued jointly by the Ministry of Health and the Ministry of Finance, the prices of nearly 2,000 medical services, including salaries, are expected to be applied from July 1st. The Ministry of Health is proposing to divide the adjustment of hospital fees into several phases.

Speaking at a recent conference on health insurance development, Minister of Health Nguyen Thi Kim Tien stated that the implementation of the price level including salaries will not be applied all at once, but will be divided into several phases from now until the end of 2016 and the beginning of 2017. Each phase will be implemented in approximately 8-10 provinces and cities and central hospitals in the area, with the aim of having each month's medical service price impact the Consumer Price Index (CPI) by about 0.4-0.5%, in order to curb inflation.

Specifically:

- The first phase, scheduled for the end of August, will adjust hospital fees first in localities where the health insurance coverage rate is around 95%.

- The second phase will take place in October in provinces and cities with a health insurance participation rate of approximately 90% and a low impact on the consumer price index (CPI).

- Phase 3 was implemented in November in areas with a health insurance coverage rate of 85%.

- Phase 4 in December in localities with health insurance coverage rates above 80%.

- Phase 5 in January 2017 in the remaining provinces.

With this price adjustment, technical services with high labor costs, such as daily hospital bed fees; and major surgeries classified as special or category one, requiring 7-8 doctors working for 3-4 hours, will see significant increases. Services that require less manpower and have low labor costs included in the service price, such as imaging, diagnosis, and testing, will experience smaller increases.

For example, the highest daily bed rates, for intensive care unit (ICU) beds, organ transplants, bone marrow transplants, and stem cell transplants, will be adjusted to reflect salary changes, ranging from 568,900 to 677,100 VND. This type of bed only increased by 350,000 VND in the March adjustment. Similarly, the price of internal medicine beds in specialized hospitals will be adjusted to 215,300 VND (the price in March was 99,000 VND).

With salaries already included in the price according to the roadmap, in 2017, the Ministry of Health proposed to the Government, People's Committees, and People's Councils of provinces and cities to transfer the budget allocated for hospital salaries to increase spending on preventive medicine and primary healthcare. In addition, they proposed increasing the support level for the near-poor, and for those working in agriculture, forestry, fisheries, and salt production with average living standards to participate in health insurance; and increasing the face value of health insurance cards to ensure the balance of the health insurance fund when prices fully cover costs...

A circular stipulating the unified pricing of health insurance-covered medical examination and treatment services across hospitals of the same category nationwide, issued by the inter-ministerial committee, adjusts the prices of 1,898 services according to a roadmap. From March 1st, the prices will include direct costs and specific allowances (24/7 on-call allowance, surgical and procedural allowance). From July 1st, the prices will include salaries. The new prices are implemented in health insurance payments and therefore do not yet affect those who are not covered by health insurance.

According to Minister Tien, inspections and monitoring at several units and localities showed that most units and localities had complied with regulations, not collecting additional fees already included in the price, and reducing out-of-pocket expenses for those with health insurance cards. Hospitals used the revenue to renovate examination areas and wards, and add equipment to improve service quality.

According to the roadmap for adjusting medical service prices, by 2018, prices will fully cover salary costs, direct costs, and management costs. By 2020, prices will fully cover salary costs, direct costs, management costs, and depreciation of fixed assets. Accurately calculated medical service prices include seven cost components: medicines and direct supplies; electricity, water, and waste treatment; asset maintenance and repair; salaries and allowances; major repairs of fixed assets; asset depreciation; and training and scientific research costs.

According to VNE