Mr Le Hung Son, Director General of VSS delivered keynote remarks at the conference

Mr Le Hung Son, Director General of VSS, attended and delivered keynote remarks at the conference. Mr Nguyen Duc Hoa, Deputy Director General of VSS, chaired the conference at the central hub, with the participation of leaders of units under VSS, the Social Security Office of the Ministry of National Defence and Ministry of Public Security. At local hubs, participants included Directors and Deputy Directors in charge of HI medical reviews, heads of relevant divisions, and representatives of grassroots social security offices.

Identifying difficulties, focusing on breakthrough solutions and Improving effectiveness of the implementation

In his opening remarks, Mr Le Hung Son, Director General,  stressed that during the first 06 months of 2026, the VSS system had made significant efforts to implement various coordinated measures and achieved important results in implementing HI policies, thus ensuring meaningful benefits for participants. However, there are considerable challenges in second half of the year, particularly the rapidly increasing in HI healthcare expenditure, which requires continued innovation in management methods, improved quality of HI medical reviews, and strengthened discipline and accountability in task performance.

The Director General requested local social security offices to seriously assess the actual situation, clearly identify shortcomings and limitations, and develop practical and appropriate solutions. In particular, the offices should strengthen supervision, proactively analyze healthcare expenditure data, promptly detect abnormal indicators at healthcare facilities to take early and suitable measures to prevent overspending which could affect the balance of the HI fund and participants’ rights.

According to a report from the Health Insurance Policy Implementation Department and the Electronic SI and HI Payment Review Center, by the end of June 2026, there were 3,672 medical facilities nationwide providing HI medical services, including 2,354 public facilities and 1,318 private facilities, with an increase of 26 facilities compared with 2025. The healthcare delivery system has been relatively reasonably structured, with 94 specialized facilities, 1,498 basic-level facilities, and 2,080 primary-healthcare facilities, meeting the increasingly diverse healthcare needs of the people.

The total number of HI medical visits reached approximately 94.4 million, remaining at the same level as in the corresponding period of the previous year, in which inpatient treatment accounted for 10.3%, slightly higher than in the same period of 2025. The total HI healthcare expenditure in the first 06 months amounted to VND 84,765.8 billion, 11.1%  higher than that of same period of last year, which representing an estimated 54.42% of the annual expenditure.

As many new HI regulations took effect in 2026, VSS proactively issued timely guidance to local offices to resolve difficulties in the implementation. The signing of HI healthcare service contracts was carried out strictly in compliance with legal regulations; the quality of HI review activities was gradually improved; and reimbursement of HI healthcare payments was made in a timely and lawful manner, thus protecting the legitimate rights and interests of participants.

Notably, the application of IT, digital transformation, data analytics, and AI has continued to be strengthened in HI management and review. Early warning systems have helped detect abnormalities in healthcare expenditures, contributing to the timely prevention of abuse and fraud against the HI fund. As a result, the number of provinces with expenditure utilization rates exceeding the national average has decreased significantly, from 28 provinces and cities to 13 localities.

Along with the implementation of activities, VSS has continued to actively participate in the development and improvement of HI policies, ensuring their practicality, promptly addressing difficulties in implementation, and facilitating the access and enjoyment of HI benefits for participants.

Despite these achievements, the conference also identified several shortcomings that require attention. In some local offices, the utilization rate of annual expenditure budget exceeded 50% of the annual target, while the average cost per healthcare visit increased by approximately 11.7% compared with the same period of the previous year. Provinces with particularly high expenditure growth included Hanoi, Ho Chi Minh City, Vinh Long, Ca Mau, and Son La.

In HI review activities, there remained a backlog of reimbursement dossiers that did not fully comply with regulatory requirements; expenditure monitoring and warning activities in some provinces were not conducted regularly or not into depth. Some healthcare facilities had not fully complied with regulations on the use of HI technical services and medical equipments. There were still limited analysis of the factors contributing to the increasement of expenditure, with responsibilities and corrective measures not clearly defined. In addition, difficulties remained in addressing HI healthcare expenditures that exceeded budget estimates and payment ceilings under Government Resolution No. 113/NQ-CP, particularly for healthcare facilities that had been closed down or had ceased to operate, creating obstacles to the final settlement process. These limitations highlight the need to further strengthen management effectiveness, reinforce discipline and administrative order, and enhance the accountability of local authorities and relevant units in implementing HI policy.

Strengthening coordinated solutions and effectively managing of expenditure

At the conference, delegates discussed and proposed a range of practical measures to enhance the effectiveness of HI policy implementation. Discussions focused on strengthening the review, inspection, and management of HI healthcare expenditures; guiding healthcare facilities in developing and implementing treatment protocols and standards appropriate to actual conditions; promoting the rational use of medicines and medical supplies; and minimizing waste. Delegates also emphasized the strict implementation of the guidance issued by the Ministry of Finance and the Ministry of Health on preventing abuse and fraud against the HI fund; along with strengthening further the capacity of the HI review workforce to ensure professionalism, transparency and objectivity.

In his remarks, Deputy Director General Mr Nguyen Duc Hoa affirmed that effective control of HI healthcare expenditure is not only essential to ensuring the sensible use of the HI fund, but also provides a solid foundation for securing financial sustainability and improving benefits for participants, specially for those with severe illnesses, high treatment costs and difficult circumstances. Mr Hoa emphasized that “Our top priority is to ensure that HI participants receive their benefits fully, accurately and in the best possible method”.

To achieve this objective, units need to intensify data analysis and risk assessment in fund management; strengthen inspection, review and auditing of the implementation of HI healthcare service contracts; and strongly prevent abuse, fraud and waste. At the same time, they must continue to tighten discipline and administrative order and enhance the accountability of leaders and public employees in performing their duties.

In addition, accelerating digital transformation and the application of artificial intelligence in the management, assessment, and reimbursement of HI healthcare costs was identified as a key priority, contributing to improved management efficiency, shorter reimbursement processing times, and easier access to healthcare services for Vietnamese citizens.

Intensifying tasks implementation for the 2nd half of the year

In his concluding remarks, Mr Le Hung Son acknowledged and commended the achievements of the VSS system in implementing HI policy during the first 06 months of 2026. He requested all units to continue implementing the agreed solutions in a coordinated manner and to promptly communicate and strictly implement the conference conclusions, ensuring their effective and consistent implementation at all levels, from the central to the grassroots level.

Emphasizing the need to strengthen the review of HI healthcare expenditure, the Director General stressed that all categories of healthcare services should continue to be reviewed comprehensively; shortcomings such as healthcare service contracts that do not comply with the prescribed standard forms, should be promptly rectified; and the quality of inspection and HI review activities should be further improved. Inspection decisions must be based on clear legal grounds, while inspection records should clearly identify violations, cite the relevant legal provisions, and avoid unclear or unsupported conclusions. For difficulties arising during practical implementation, particularly those related to periodic healthcare check-ups, local social security offices should proactively coordinate with provincial Departments of Health to resolve them in a timely manner. Matters beyond their authority should be reported to the provincial People's Committees for consideration and resolution.

Mr Le Hung Son also requested provincial social security offices to enhance their quality of policy advice, clearly define the roles and responsibilities for each level, particularly the role of provincial People's Committees and Departments of Health; and ensure the strict implementation of reporting and performance evaluation mechanisms based on specific, substantive, and results-oriented criterias.

The VSS system will continue to strengthen administrative discipline and order in accordance with the principle of the “6 clarities”: clear responsibilities, clear tasks, clear accountability, clear procedures, clear timelines, and clear outcomes. Every task must be linked to specific deliverables and accompanied by practical, feasible and effective implementation measures.