Health sector meets to discuss strengthening management and effective use of health insurance examination and treatment funds

On the afternoon of August 9, Nghe An Department of Health held an online conference to strengthen management and effective use of health insurance examination and treatment funds. The conference was attended by representatives of Nghe An Provincial Social Insurance; heads of health departments of districts, towns, and Vinh city; and medical examination and treatment facilities in the province.

At the conference, the Department of Health evaluated the results of using the medical examination and treatment fund in the first 6 months of the year, and set out directions and tasks for the last 6 months of 2023. Accordingly, from the beginning of the year until now, the total number of medical examinations and treatments covered by health insurance inNghe Anwas 2,744,344 times, up 24.6% over the same period; total insurance payment was 2,210.66 billion VND, up 15.05% (equal to 289.140 billion VND), accounting for 53% of the assigned estimate (2,210.66/4,191.25 billion VND).

The province's rate of using the medical examination and treatment fund is 62.54% (the national average is 60%). Ranked 11th nationwide, after Thanh Hoa (64.92%), Dong Nai (62.66% and Hanoi (62.01%)... In this situation, if there are no effective solutions from the heads of medical examination and treatment facilities, in 2023, Nghe An is at risk of exceeding the budget estimate by 15% - 17% (estimated at about 700 billion VND).

Also at the conference, delegates listened to presentations on the issue of managing and effectively using the health insurance examination and treatment fund, such as: Some solutions to reduce the average treatment days; implementing daytime inpatient treatment; solutions to reduce hospital overload; applying information technology in medical examination and treatment management; solutions to strengthen control over the use of generic drugs; solutions to improve the quality of medical examination and treatment to better manage the cost of medical examination and treatment under health insurance; solutions to manage, direct and organize medical examination and treatment under health insurance at medical stations to prevent the use of health insurance funds for improper purposes and against regulations.

Speaking at the conclusion of the conference, Dr. Nguyen Huu Le - Deputy Director of Nghe An Department of Health thoroughly grasped the directions of the Steering Committee for implementing the Social Insurance and Health Insurance policies of Nghe An province; clearly stated the direction for implementing the tasks of medical examination and treatment, medical examination and treatment under health insurance and solutions for effective use of the medical examination and treatment fund under health insurance in the last 6 months of 2023.

At the same time, it is required that medical examination and treatment facilities in the province strengthen communication, education, and dissemination of legal regulations on medical examination and treatment, health insurance medical examination and treatment, and violations of the law to cadres, civil servants, and employees in the unit; enhance the responsibility of the management of the head in controlling the cost of medical examination and treatment under health insurance; develop a plan to implement economical and effective use of the estimated budget for medical examination and treatment under health insurance at medical examination and treatment facilities as notified by inter-sectoral agencies; strengthen self-inspection and supervision to prevent and detect early errors in the process of medical examination and treatment and health insurance medical examination and treatment... Strictly prohibit acts such as abuse,profiteeringhealth insurance fund in any form.

Medical facilities need to ensure proper implementation of professional regulations in examination and treatment; strictly control and manage the appointment of paraclinical tests, appointment of technical services and prescription of drugs appropriate to the disease condition; admit patients for inpatient treatment appropriate to the disease condition; improve the quality of direction at the grassroots level, transfer of technical services to lower levels; improve the quality of medical examination and treatment at grassroots health facilities, especially at the commune level./.