According to the report of the Thanh Hoa Social Security Office, the cost of medical treatment under health insurance in the first four months of 2023 in the province reached nearly VND 1,440 billion, an increase of 32%, equivalent to an increase of over VND 351 billion compared to the same period in 2022. The number of patients receiving health insurance treatment in the entire province was over 1.6 million, an increase of 38%, equivalent to an increase of 444,721 patients compared to the same period in 2022.

Illustration image (source: Internet)

Notably, some medical facilities have increased the number of health insurance patients and the cost of health insurance treatment compared to the same period, such as Quan Hoa district general hospital with a 106% increase, the polyclinic of Ngoc Lac district medical center with a 101% increase, and Lang Chanh district general hospital with a 95% increase. At the same time, some medical facilities have increased the average cost of outpatient treatment in 2023 compared to the same period, such as Nam Son clinic with a 75% increase, Thanh Hoa Rehabilitation Hospital with a 64% increase, Thanh Hoa Eye Hospital with a 41% increase, and Hai Tien district general hospital with a 40% increase.

To control the cost of HI-based healthcare in the last months of 2023 and enhance the effective use of health insurance funds, the Chairman of Thanh Hoa People's Committee has requested the People's Committees of districts, towns, and cities to closely coordinate with the the VSS in inspecting, verifying, and strictly handling organizations and individuals who violate regulations in the field of health insurance according to the provisions of the law, including the exploitation of charitable medical treatment of some medical facilities for personal gain.

At the same time, the Department of Health has instructed healthcare facilities throughout the province to carry out inpatient examination and treatment in accordance with professional regulations and appropriate conditions of equipment and personnel. In cases where healthcare facilities increase the number of registered hospital beds, they must add a corresponding number of staff as directed by the Minister of Health and only register the beds when granted approval.

Illustration image (internet)

The Department shall direct inspections and checks of the operations of private healthcare facilities, proactively monitor and prevent the exploitation of charitable health insurance treatment to collect and transport individuals with health insurance cards to their facilities to provide unnecessary technical services, exceeding indications, and showing signs of exploiting health insurance funds by some private healthcare facilities; Immediate consideration of plans to inspect a number of specialized private healthcare facilities in the province is also recommended.

The provincial Social Security Office shall proactively synthesize monthly and quarterly data, analyze and evaluate the implementation of health insurance payments for healthcare facilities in the province, identifies the causes of unreasonable cost increases, misuse, and exploitation of health insurance funds, and recommends measures to prevent and handle such violations in accordance with the law.

Furthermore, plans and management solutions must be developed to ensure the effective and appropriate use of health insurance funds, based on the allocation from the Prime Minister's approved budget; coordination with the Department of Health to strengthen inspection and examination of health insurance treatment activities in healthcare facilities showing unusual signs and continuously exceeding the allocated budget must be carried out. In addition, measures to prevent and handle violations must be proposed and implemented in accordance with the law./.