Vietnam Social Security - Ministry of Health: Effective coordination, ensuring the best benefits for health insurance participants

Coordinate with the Ministry of Health in developing and amending policies and laws on health insurance.

Provide data on medical examination and treatment, medical examination and treatment costs, summarize the results achieved, analyze the advantages, difficulties, and obstacles in the process of organizing and implementing policies and propose appropriate amendments in legal documents and implementation guidance documents such as the Law on Medical Examination and Treatment, the Law on Bidding (for bidding for drugs and medical equipment and supplies), and the Decree amending Decree 146/2018/ND-CP guiding a number of measures to implement the Law on Health Insurance.

Closely and effectively coordinate with the Ministry of Health and other ministries to advise and propose the National Assembly and the Government to issue many policies to remove difficulties and obstacles in the procurement, bidding, management and use of drugs, medical equipment and supplies in the past time: Resolution No. 80/2023/NQ-QH15 dated January 9, 2023 of the National Assembly allowing the continued extension of drug circulation registration certificates until the end of 2024, Decree No. 07/2023/ND-CP dated March 3, 2023 resolving a number of obstacles in the management of medical equipment, Resolution No. 144/NQ-CP dated November 5, 2022 and Resolution No. 30/NQ-CP dated March 4, 2023 of the Government resolving obstacles in payment of health insurance medical examination and treatment costs, ensuring the supply of drugs, medical equipment and supplies for medical examination and treatment. Health insurance

During the Covid-19 pandemic, Vietnam Social Security coordinated with the Ministry of Health to issue many documents guiding the organization of medical examination and treatment and payment of health insurance examination and treatment costs in accordance with the pandemic period, creating favorable conditions for health insurance participants and medical examination and treatment facilities: Signing contracts with Covid-19 treatment facilities, increasing the time to provide outpatient medicine for chronic diseases to 3 months, resolving difficulties in payment for Covid-19 combined with underlying diseases.

Monitor and supervise the implementation of medical examination and treatment discipline and payment of health insurance medical examination and treatment costs.

With the interconnection of medical examination and treatment data of nearly 13,000 medical examination and treatment facilities, and the application of the electronic appraisal system, the management and monitoring of health insurance examination and treatment costs have achieved many results, and medical examination and treatment facilities are increasingly complying with the regulations of the Ministry of Health. If in 2017 the deducted cost was 2,584 billion VND, in 2021 it was reduced by more than 1,414 billion VND, and in 2022 it was 955 billion VND. Participating in the Drug Procurement Bidding Councils from the central to local levels has contributed to reducing errors in bidding.

In recent years, drug prices have been decreasing and there is no big difference between localities. Closely monitor the registration of practice and practice at medical examination and treatment facilities through the health insurance appraisal information system and direct inspection at the facility. In recent years, Vietnam Social Security has discovered many cases of granting operating licenses of medical examination and treatment facilities, practice certificates not in accordance with regulations (medical staff who do not meet the requirements are still granted practice certificates), practice not in accordance with regulations (wrong scope of professional activities, not registered to practice but still examining and treating patients...).

Contribute to greater transparency in cost paymentsmedical examination and treatment: Medical examination and treatment facilities must connect daily data to the health insurance appraisal information portal to help monitor treatment prescriptions and health insurance abuse by medical staff and patients.

Reforming administrative procedures in health insurance examination and treatment

Implementing the use of citizen identification cards for health insurance examination and treatment, replacing paper health insurance cards for medical examination and treatment, helping to simplify procedures and save time for people when carrying out medical examination and treatment procedures...

The initial application of biometrics at medical examination and treatment facilities not only ensures people's rights, but also saves costs and strengthens management of agencies, preventing waste and profiteering of the health insurance fund.

Enhance interaction between people, medical facilities and social insurance agencies: With the application of VssID, people can know their medical examination and treatment history; a premise for building an electronic health book.

Providing and sharing data on health insurance participants and health insurance examination and treatment to build a national database on people's health.

Overcoming the shortage of drugs and medical supplies

Since mid-2022, there has been a shortage of drugs and medical supplies at many medical facilities nationwide, as well as policy problems affecting the payment of health insurance examination and treatment costs, affecting the rights of health insurance patients. Vietnam Social Security has promptly instructed local social security agencies to uphold the highest sense of responsibility, closely coordinate with the health sector to guide the resolution of difficulties and problems, and ensure adequate supply of drugs and medical supplies for health insurance examination and treatment. Especially after the Government issued Resolution No. 144/NQ-CP dated November 5, 2022 on ensuring drugs, medical equipment and payment of health insurance examination and treatment costs, many difficulties in terms of policies and mechanisms have been removed. By the fourth quarter of 2022, the shortage of drugs and medical supplies has been basically overcome in all localities.

Coordinate to resolve payment issuesmedical examination and treatmentHealth insurance

Vietnam Social Security has coordinated with the Ministry of Health and relevant ministries to propose policy mechanisms to remove difficulties and obstacles. On March 4, 2023, the Government issued Resolution No. 30/NQ-CP amending Clause 4 of Resolution No. 144/NQ-CP dated November 5, 2022 of the Government. The Resolution has basically removed difficulties and obstacles in the use of medical equipment and payment of technical service costs performed from these equipment.

Solve difficulties in payment of expensesmedical examination and treatmentHealth insurance

In December 2022, Vietnam Social Security provided sufficient funds for health insurance examination and treatment exceeding the total payment within the 2021 budget estimate for the provincial Social Security according to the data assessed by the provincial Social Security. The provincial Social Security has made payments to health insurance examination and treatment facilities. The amount exceeding the budget estimate assigned by the Prime Minister in 2021 for the 5 provinces of Ha Tinh; Ninh Binh, Phu Tho, Thai Nguyen, Thanh Hoa, Vietnam Social Security has reported to the Management Board for approval to submit to the Prime Minister for additional approval.

Resolve outstanding expenses that are not eligible for payment in years 2020 and earlier

The total amount of money compiled in the State Audit report for December 2022 is VND 2,128 billion, of which VND 170 billion is under the authority of the Ministry of Health. These are mainly expenses exceeding the budget assigned by the Prime Minister. Up to this point, Vietnam Social Security has basically completed the review and appraisal to report to the Management Board and submit to the Prime Minister for approval to supplement the above-mentioned expenses exceeding the budget.

Thus, with the goal of prioritizing the legitimate rights and interests of health insurance participants, in recent times, the Vietnam Social Security and the Health sector have reached consensus, unity and high determination in the work of building and organizing the implementation of policies and laws on health insurance with the goal of sustainable development of universal health insurance. In the coming time, with the amendment of the Health Insurance Law, it is necessary to continue to have close coordination and consensus between the two sectors in the field of policy building and implementation, to best ensure the rights of health insurance participants and the ability to balance and develop sustainably the health insurance fund./.

By the end of June 2023, the whole country has achievednear the92% withnear 91million people participate in health insurance.In the first 6 months of 2023 alone, the whole country had nearly 83 million people receiving inpatient and outpatient health insurance examination and treatment with an assessment and payment amount of over 57 trillion VND.This is an important premise for our country to continue striving to realize the goal.obtain95% of the population will participate in health insurance by 2025 according toResolution 20-NQ/TWOctober 25, 2017 ofThe 6th Conference of the 12th Central Executive Committee on strengthening the work of protecting, caring for and improving people's health.