At the meeting, on behalf of industry leaders, Deputy General Director Nguyen Duc Hoa expressed sincere thanks to Ms. Aparnaa Somanathan and the WB for supporting the VSS during the past time; at the same time, he highly appreciated the cooperation between the two sides, especially in such fields as reform and modernization of Vietnam's social insurance industry; strengthening fund investment management and reforming health care and universal health insurance. Notably, the WB is also actively supporting the VSS in amending and supplementing the Law on Social Insurance and the Law on Health Insurance.

VSS Deputy General Director Nguyen Duc Hoa delivered a speech at the meeting

According to Hoa, currently, the number of health insurance participants in Vietnam reaches over 88 million people, and the coverage rate accounts for over 89% of the population. In addition to developing participants, the VSS also ensures precise, sufficient and timely payment of benefits for millions of people. Notably, every year, about 190 million people are covered by the health insurance fund, and the health insurance fund is currently the most important source of health financing for the people's health care system.

From the above situation, Hoa hoped that the WB would continue to share experiences and make recommendations for the health system in Vietnam in general and the implementation of the health insurance policy of the VSS in particular. Besides, he hoped the WB will support the VSS to apply artificial intelligence (AI) to health insurance assessment, inspection and examination operations; pilot implementation of an online scheduling system to support people and businesses when interacting with social security agencies; appoint experts to provide technical assistance to VSS' staff on DRG payment methods; develop principles of fund allocation for DRG and contingency funds, develop DRG-based medical care contracts with medical facilities, etc.

Sending congratulations to Deputy General Director Nguyen Duc Hoa, Ms. Somanathan expressed her wish that, in her new position, Hoa will always accompany and work closely with the WB in the fields of cooperation between the two parties. According to Ms. Somanathan, the fields of cooperation between the two sides are diverse, such as IT application, administrative procedure reform, building and perfecting a model for calculating fund balance, training, technology transfer in management financial management, fund investment management, etc. However, in any field, the WB always receives active cooperation from the VSS.

The two sides made a number of cooperation proposals

Sharing the orientation of cooperation in the coming time, Ms. Somanathan affirmed that the WB is always ready to expand cooperation with the VSS in related fields to build a sustainable health system, through which Vietnamese people can use the most modern medicines and medical equipment.

At the meeting, a representative of the Center for Medical Claim Review said that in recent years, the VSS has promoted the application of data mining and artificial intelligence in health insurance assessment. Accordingly, after nearly 6 years of conducting electronic assessment, medical treatment data has grown rapidly with more than 15 billion records collected from nearly 1 billion visits to medical treatment. Moreover, the quality of data has increasingly improved with the addition of mandatory data normalization requirements.

Research into the application of data mining and artificial intelligence that has supported the control of health insurance claims is expected to be specifically implemented. The objective is to build a data mining tool to support the establishment of a protocols treatment plan for each disease group; develop a standard treatment regimen based on evidence and conclusions of experts, and use AI to assist in identifying payment claims and managing risks in health insurance payments.

Deputy General Director Nguyen Duc Hoa presents souvenirs to the WB delegation

According to the Center for Medical Claim Review, the AI application to the assessment work has not been applied by many countries, including Thailand, Korea, and Japan. In Vietnam, at present, the Ministry of Health has only issued 40% of standard treatment procedures. "Therefore, the Center wants the WB to be a bridge for the VSS to provide documents and experience on standard treatment procedures that we currently lack," a representative of the Center shared./.