5 rounds of hospital fee increases from now until the end of the year

The increase in hospital fees with salary factor added will be divided into 5 adjustment periods, initially applied in localities with health insurance coverage rate of about 95%.

According to the circular regulating the unification of medical examination and treatment service prices covered by health insurance among hospitals of the same rank nationwide issued 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 1. The Ministry of Health is proposing to divide the hospital fee adjustment into several phases.

Speaking at a recent conference on health insurance development, Minister of Health Nguyen Thi Kim Tien said that the implementation of the salary-based price level will not be applied at the same time 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 about 8-10 provinces, cities and central hospitals in the area, with the aim of having the monthly price of medical services impact the consumer price index (CPI) by about 0.4-0.5%, in order to control inflation.

Specifically:

- Phase 1 is expected to be adjusted at the end of August first in localities where the population participating in health insurance is about 95%.

- Phase 2 in October in provinces and cities with health insurance participation rate of about 90% and low impact on consumer price index (CPI).

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

- Phase 4 in December in localities with health insurance coverage rate over 80%.

- Phase 5 in January 2017 in the remaining provinces.

With this price adjustment, technical services with high salary costs such as bed day fees; special and first-class major surgeries with 7-8 doctors participating in 3-4 hours... will have high increases. Services that use less human resources and have low salary costs in the service price such as imaging, diagnosis, and testing services will have lower increases.

For example, the highest bed-day price is for intensive care unit (ICU), organ transplant, bone marrow transplant, stem cell transplant, which will be adjusted when calculating salary, ranging from 568,900-677,100 VND. This type of bed will only increase to 350,000 VND in the March adjustment. Similarly, the price of an internal medicine bed at a special-class hospital will be adjusted to 215,300 VND (the price in March was 99,000 VND).

When salaries have been included in the price according to the roadmap, in 2017, the Ministry of Health proposed that the Government, People's Committees, and People's Councils of provinces and cities transfer the budget for salaries to hospitals to increase spending on preventive medicine and primary health care. In addition, increase the support level for the near-poor, for farmers, forestry workers, fishers, and salt workers with average living standards to participate in health insurance; increase the card value to ensure the balance of the health insurance fund when the price is calculated to cover all costs...

The circular regulating the unification of health insurance examination and treatment service prices among hospitals of the same rank nationwide was issued by the joint ministries, adjusting the prices of 1,898 services according to the roadmap. From March 1, the price will include direct costs and special allowances (24/7 on-call allowance, surgery and procedure allowance). From July 1, the price will include salary. The new price will be applied in health insurance payments, so it will not affect people who have not yet participated in health insurance.

According to Minister Tien, inspections and supervision at a number of units and localities showed that most units and localities have complied with regulations, not collecting additional costs already included in the price, reducing out-of-pocket expenses for people with health insurance cards. Hospitals have used revenue to renovate examination areas, patient rooms, and add equipment to improve service quality.

According to the roadmap for adjusting medical service prices, by 2018, prices will fully include salary costs, direct costs and management costs. By 2020, prices will fully include salary costs, direct costs, management costs and fixed asset depreciation costs. The correct and full calculation of medical service prices includes 7 cost elements: Medicines, direct materials; electricity, water, waste treatment; asset maintenance; salaries, allowances; major repairs of fixed assets; asset depreciation; training and scientific research costs.

According to VNE