Reporting at the conference, Mr. Nguyen Thanh Danh, Director of Quang Nam Social Security Office, stated that in 2023, the province achieved quite positive results in implementing its tasks. Particularly noteworthy was the high participation rate in Health Insurance. By the end of 2023, Quang Nam province had 1,477,179 people participating in health insurance, reaching 100.32% of the assigned plan, with a health insurance coverage rate compared to the total population of the province at 96.8%.

Conference Scene

Communication work emerged as a bright spot for the provincial social insurance. Recently, the provincial social insurance collaborated with relevant departments and agencies to carry out propaganda and dissemination of policies and laws on social insurance and health insurance. The communication work was regularly innovated in terms of content, form, and methods to ensure practicality, effectiveness, and alignment with the focus and diversity of cultural traditions and psychological characteristics of each population group. There was a focus on leveraging the advantages of modern and multimedia communication methods, as well as online communication...

Especially notable were the programs in collaboration with the Department of Transport, Quang Nam Youth Union, Women's Union, and the Cultural Center, which organized propaganda and dialogues on social and health insurance policies through various forms. Outstanding examples included the 'Chòi Song about Voluntary Social Insurance' and 'Posters on Public Transportation', etc.

Quang Nam Social Security Office also implemented positive measures to enhance the payment of pensions and social insurance benefits without using cash, achieving encouraging results. By the end of 2023, the number of people receiving monthly pensions and social insurance benefits through ATM accounts in urban areas of the province reached 56%, exceeding the VSS plan of 55%. The number of people receiving one-time social insurance benefits through ATM accounts in urban areas of the province reached 85.66%, surpassing the VSS plan of 82%.

Regarding the health insurance verification work, in 2023, the total number of contracted health facilities for health insurance payment was 65 facilities. The provincial social insurance implemented health insurance verification according to Procedure No. 3618/QD-BHXH, developed plans, and organized electronic data verification. It conducted specialized verifications announced by the Health Insurance Verification and Multichannel Payment Center and those developed by the provincial social security office in 2023. Every quarter, the provincial social security office issued many warning documents to health facilities with abnormally increasing fees. Simultaneously, it reported to and advised the Provincial People's Committee to direct the Department of Health and health insurance contracted facilities to promptly rectify the issues warned by the provincial social insurance during the verification and settlement of health insurance-based healthcare fees. The estimated amount of rejected payments for the entire province in 2023 was VND 10.2 billion.

Despite the achieved results, the Steering Committee for the Implementation of Social and Health Insurance Policies in Quang Nam Province acknowledges that there are still many challenges. The number of mandatory participants in Social Insurance and the unemployment insurance reached and exceeded the plan set by the VSS but did not meet the target set by Directive No. 47/KH-BCĐ of the Steering Committee. The health insurance payment in 2023 exceeded the Government's assigned estimate by 7.2% and increased by approximately 2.95% in terms of the number of medical examinations and 10.35% in terms of costs compared to 2022.

VSS’ Deputy General Director, Tran Dinh Lieu, delivering directives at the conference

In Quang Nam, many health facilities contracted for health insurance have inaccurate information in their payment data, causing automatic rejection by the Health Insurance Verification Information System. The situation of resubmitting data has not been adequately addressed, leading to difficulties and delays in the verification and settlement of health insurance-based healthcare fees...

Additionally, the satisfaction index of the people with the activities of the social security agency, according to the province's survey and that of the provincial social security agency, has decreased compared to the previous year. The coordination of inspection and examination by the two departments of Labor, Invalids, and Social Affairs and Health in the province is not effective. Compliance with labor, social insurance, and health laws in some units employing labor is not good, and the situation of evading participation in Social and Health Insurance for employees or not enrolling a sufficient number of workers still occurs. Legal actions against units indebted to Social Insurance have not been effectively carried out due to jurisdictional and legal procedure issues for court hearings.

Speaking at the conference, VSS’ Deputy General Director, Tran Dinh Lieu, acknowledged that Quang Nam Social Security Office has performed quite well in many indicators related to Social and Health Insurance. He pointed out some limitations in the implementation of Social and Health Insurance in Quang Nam, including limitations related to policy mechanisms. Furthermore, limitations also stem from human factors; some Steering Committees for the implementation of Social and Health Insurance policies have not been fully staffed or appropriately assigned. Therefore, it is recommended that local authorities identify the causes of these limitations to find suitable solutions. In the coming time, Quang Nam Social Security Office will continue to excel in advisory and coordination tasks, enhance communication efforts, especially dialogues with businesses, and ensure the rights of participants, particularly avoiding forcing people to purchase medicine and medical supplies on their own./.