General Director of Vietnam Social Security (VSS) Nguyen The Manh and Deputy Minister of Health Tran Van Thuan co-chaired the conference.

VSS has always accompanied the health sector and medical facilities in detecting difficulties and implementing solutions for medical facilities, especially over the past two years amid the COVID-19 pandemic in Vietnam.

Many difficulties and problems in medical treatment and examination and payment of medical expenses under the jurisdiction of the VSS have been gradually solved, creating favourable conditions for medical facilities and ensuring maximum benefits for people who participate in health insurance.

General Director of VSS Nguyen The Manh speaks at the conference

Accordingly, the social insurance agency has actively strengthened coordination with medical facilities to handle issues, ensuring payment and settlement is on schedule and in accordance with the law.

Expenses that are not eligible for settlement before 2020 have basically been resolved, thus removing many financial difficulties for medical facilities. In order to ensure funding for the operation of medical facilities, VSS directed the social insurance agencies of the provinces to make quarterly settlements to transfer payment and advance funding for the next quarter's activities. During the COVID- 19 pandemic, many medical facilities faced difficulties in funding, thus VSS directed localities to make full advances. Any difficulties would be reported to the VSS for timely settlement.

On the other hand, the VSS also actively cooperated with medical facilities to improve or handle problems in medical examination and treatment procedures, and standardised data submitted to the assessment portal. Currently, VSS is working with Hanoi Social Security to support Bach Mai Hospital in standardising the data of over 100,000 medical records in the first six months of this year to ensure accuracy between the data on the medical records and on the health insurance assessment portal.

 Deputy Minister of Health Tran Van Thuan addresses the conference

In July and August 2022, VSS sent working delegations to grasp the situation at a number of medical facilities in Hanoi, Ho Chi Minh City, Dong Nai Province, and Binh Duong Province, regarding problems in the payment and settlement of medical costs covered by health insurance in the years before 2021.

Directors of social insurance agencies in many localities have directly worked with each medical facility to remove obstacles in the implementation of medical examination and treatment with health insurance.

Flexible solutions

Speaking at the conference, Assoc. Prof. Dr. Dao Xuan Co, Director of Bach Mai Hospital, said that in the two years of the COVID-19 pandemic, Bach Mai Hospital - a pilot unit with full autonomy, faced many difficulties, especially financial ones.

The payment of health insurance was one of the long-standing problems.

Assoc. Prof.Dr. Dao Xuan Co, Director of Bach Mai Hospital speaking at the conference

According to Assoc. Prof. Dr. Nguyen Lan Hieu, Director of Binh Duong General Hospital, the participation and good co-ordination between VSS and the Ministry of Health promptly removed issues in the organisation and implementation of health insurance policies.

In particular, the two agencies need to study and discuss more closely the current policies and legal frameworks, Hieu said.

Representatives of the hospitals suggested that the Ministry of Health and VSS propose a payment solution suitable to the actual use of medical facilities, and suggested amending regulations to be closer to reality so as not to waste equipment and medical materials.

The hospitals also acknowledged that the use of drugs and medical supplies exceeded the bids, which was due to many reasons beyond their control.

The hospitals want the VSS to assess and soon decide on the expenses to be paid, reducing difficulties for medical facilities.

 Assoc. Prof. Dr. Nguyen Lan Hieu, Director of Binh Duong General Hospital

Le Thanh Cong, Deputy Director of the Financial Planning Department under the Ministry of Health, said that the ministry was submitting to the Government for permission to continue paying costs that relate to the borrowing of medical machines/equipment by hospitals.

The Ministry of Finance is expected to consider amending regulations on the participation of private sectors in supplying/lending hospitals medical equipment according to current practice in the process of amending Decree 151.

Agreeing with the recommendations of medical facilities on the correct calculation of the cost of medical services, Cong said that the department was also discussing a roadmap for early calculation of the correct and adequate cost of medical services.

The Ministry of Health has drafted a Circular on medical treatment prices, asking the authorities for consideration. If it does not have much impact on the national Consumer Prices Index, it would be issued soon, Cong said.

 The representative of the Ministry of Health mentioned problems in the payment of health insurance for medical examination and treatment

Le Van Phuc, Head of the Health Insurance Policy Implementation Department under VSS, said difficulties and problems related to mechanisms and policies fall within the competence of ministries and the Government. Some costs of drugs and medical supplies have not been paid to hospitals, such as determining the legality of drug procurement in the form of contractor appointment at Cho Ray Hospital; procurement of medical equipment in the form of shortened appointment of contractors at Thong Nhat Hospital in Ho Chi Minh City, and medical facilities in Hai Phong City. While the payment of technical service costs from borrowed, ordered and installed machines has not yet changed the form of ownership as prescribed in Decree 151.

In addition, there are shortcomings in the provisions on advance payment and settlement according to Article 32 of the Law on Health Insurance and Decree 146.

The Law on Health Insurance stipulates quarterly settlement according to the provisions of Article 32, but the total payment amount specified in Decree 146 is determined by year and there is no guidance on determining the quarterly settlement.

Le Van Phuc, Head of Health Insurance Policy Implementation Committee (Vietnam Social Security) answer concerns regarding payment and settlement of medical and health insurance costs

Addressing the conference, Deputy Minister of Health Tran Van Thuan emphasised that the two sectors had reached a consensus and coordinated to take care of people's health.

He asked departments and units under the ministry to quickly determine a list of tasks according to their competence and responsibilities, set a specific time limit for handling each issue, and quickly remove difficulties for health facilities, ensuring the interests of patients.

Deputy Minister Tran Van Thuan also suggested that the two sides continue to research and find the optimal solutions, all for the benefit of the patients.

An overview of the conference

Speaking at the conclusion of the conference, VSS General Director Nguyen The Manh highly appreciated the close cooperation between the two sectors of VSS and the health agencies over the years.

He also pointed out that the conference was organised to exchange and provide information in order to solve difficulties and problems related to the implementation of legal policies on health insurance.

Manh asked relevant units under VSS to guide and direct the social insurance agencies of provinces to coordinate with medical facilities to continue reviewing the costs of medical treatment and medical insurance that have not been paid in advance last year.

He suggested that the two sectors focus more on amending and promulgating legal documents to solve problems and better ensure benefits for health insurance card holders./.