Prices for medical examination and treatment services in Nghe An will increase according to the new salary.

Adjusted to new basic salary

On October 17, 2024, the Ministry of Health issued Circular No. 21/2024/TT-BYT regulating the method of pricing medical examination and treatment services. The Circular was issued to serve as a legal basis for determining the price of medical examination and treatment services according to the list of technical medical examination and treatment services issued by the Ministry of Health, in accordance with the characteristics of providing medical examination and treatment services at medical facilities.

Circular 21/2024/TT-BYT specifically stipulates the principles and bases for pricing medical examination and treatment services; stipulates conditions and guides the selection and application of medical examination and treatment pricing methods according to two methods: the comparison method and the cost method.

The Ministry of Health said that, based on Decree 73/2024/ND-CP, Circular 21/2024/TT-BYT, the Ministry of Health has approved the prices of medical examination and treatment for a number of hospitals, including 05 special-class hospitals and about 10 class 1 hospitals. The new prices of medical examination and treatment maintain the price structure and issued norms, only adjusting the salary factor from the basic salary of 1.8 million VND to the basic salary of 2.34 million VND.

Accordingly, medical examination pricehealth insuranceThe current price for a bed in a special-class hospital is 42,100 VND, the adjusted price is 50,600 VND. The price for a bed in intensive care, organ transplant, bone marrow transplant, and stem cell transplant at a special-class hospital was previously 867,500 VND/day, but after the adjustment it will be 1,017,300 VND. Similarly, the price for a bed in a class 1 internal medicine treatment at a special-class hospital has also been adjusted from 273,100 VND to 327,100 VND.

The Ministry of Health assessed that the adjustment of medical examination and treatment prices based on salary factors from the basic salary of 1.8 million to 2.34 million VND does not have much impact on the people. Specifically, the poor, ethnic minorities, and social policy groups are covered 100% by health insurance so they are not affected.

The group with health insurance card has to pay co-payment at 20% or 5%, so the co-payment does not increase much. In addition, this group can afford to pay because their income is also increased according to the basic salary. The group without health insurance card (about 8% of the population) is only affected in the payment part according to the price of medical examination and treatment services.

Regarding the impact of the Health Insurance Fund, the Ministry of Health said: Comparing the annual difference in revenue and expenditure of the Health Insurance Fund (cumulative balance in 2023), at the same time, the Health Insurance Fund's revenue increases due to the adjustment of the basic salary level, which is often earlier than the adjustment of medical examination and treatment service prices, so the Health Insurance Fund is capable of balancing.

Also according to the Ministry of Health: Decree 96/2023/ND-CP allows units to implement according to the price levels issued or approved by competent authorities until new regulations are issued but no later than December 31, 2024... That means from now until December 31, 2024, medical examination and treatment facilities nationwide must have their medical examination and treatment prices regulated by competent authorities in accordance with the Law on Medical Examination and Treatment 2023.

Localities need to urgently implement the approval of prices according to the salary level of 2.34 million VND for medical examination and treatment facilities in the area, not higher than the highest price of the corresponding service as prescribed by the Ministry of Health. The competent authority approves the price on which day, the unit can collect the new price from that day.

Building new price levels

According to information fromNghe An Department of Health, The People's Council of Nghe An province is the agency that issues the Resolution on regulating prices of medical examination and treatment services for state-owned medical examination and treatment facilities under the management of Nghe An province.

Pursuant to Circular No. 21/2024/TT-BYT, Official Dispatch No. 9414/UBND-VX dated October 25, 2024 of the Provincial People's Committee, Nghe An Department of Health has based on the provisions of law to establish a Consulting Team to develop a dossier of price plan for medical examination and treatment services; develop a dossier of price plan to transfer to the Appraisal Council to appraise the price plan. The Appraisal Council was established by the Department of Health with the participation of representatives of the Price Management and Public Assets Department of the Department of Finance and public medical examination and treatment facilities.

On November 14, 2024, the Department of Health issued Document No. 3890/TTr-SYT on the proposal to issue a Resolution on regulating prices of medical examination and treatment services for state-owned medical examination and treatment facilities under the management of Nghe An province to the People's Committee of Nghe An province.

Accordingly, in Nghe An, currently, state-owned medical examination and treatment facilities under the management of Nghe An province are implementing medical examination and treatment prices according to the provisions of: Circular No. 22/2023/TT-BYT of the Ministry of Health (price includes direct costs, allowances and salary of 1.8 million VND) for medical examination and treatment services on the list paid by the Health Insurance Fund; Circular No. 21/2023/TT-BYT of the Ministry of Health and Resolution No. 01/2024/NQ-HDND of the People's Council of Nghe An province (price includes direct costs, allowances and salary of 1.8 million VND) for medical examination and treatment services not on the list paid by the Health Insurance Fund but not on-demand medical examination and treatment services.

Implementing the above medical examination and treatment prices, medical facilities, especially autonomous units, are facing many difficulties. Specifically, autonomous units must pay salaries to medical staff and employees according to the salary levels prescribed in Decree No. 73/2024/ND-CP (basic salary of 2.34 million VND).

Meanwhile, the price structure for medical examination and treatment services is still based on the old salary level (1.8 million VND). The difference in increased labor costs is one of the reasons why units are in a state of imbalance in financial autonomy. This puts many hospitals at risk of having to return to the old level of autonomy (group 3).

Nghe An Department of Health believes that: Developing a Plan to adjust the price of medical examination and treatment to match the basic salary of 2.34 million VND (according to Official Dispatch No. 6417/BYT-KHTC dated October 18, 2024 of the Ministry of Health on implementing the Circular guiding the method of pricing medical examination and treatment services) is urgent, in accordance with regulations and extremely necessary, in order to create conditions for medical examination and treatment facilities to reduce the burden of financial deficit; at the same time, help reduce the need for funding support from the State budget for medical examination and treatment facilities that have not achieved autonomy in regular spending.

Draft Resolution on Regulation of prices of medical examination and treatment services for State-owned medical examination and treatment facilities under the management of Nghe An province, developed by Nghe An Department of Health. The new price of medical examination and treatment services includes direct costs and salaries, wages, allowances and contributions as prescribed (in which salary costs are based on the basic salary of 2.34 million VND); not higher than the highest price of the corresponding service as prescribed by the Ministry of Health.

It is expected that in the regular meeting of the Provincial People's Committee in November 2024, the issue of new prices for medical examination and treatment services will be raised. Members of the Provincial People's Committee will give their opinions so that the Department of Health can complete the draft Resolution, submit it to the Provincial People's Committee, and submit it to the Provincial People's Council. Committees of the Provincial People's Council will review the content of the draft Resolution, submit it to the Standing Committee of the Provincial People's Council for consideration, before submitting it to the Provincial People's Council meeting in December 2024. If approved by the Provincial People's Council, the new prices for medical examination and treatment services will be applied in early 2025.