Among the participants were VSS Deputy General Director Nguyen Duc Hoa, leaders of a number of VSS units and representatives of social security offices of Hanoi, Ho Chi Minh City, Phu Tho, Thai Binh, Ninh Binh, Thanh Hoa, Nghe An, Quang Binh, Da Nang, Binh Dinh, Dak Lak, and Can Tho.

 VSS General Director Nguyen The Manh chairs the meeting

In his opening speech, Manh said the 12 provinces and cities present at the session bear a significant share of national health insurance costs. Localities must be made fully aware of their importance and responsibility in managing the health insurance fund.

Localities with high spending levels are even more accountable. They need to constantly improve management efficiency and fulfill their responsibilities to the people in medical examination and treatment under health insurance, he said.

He requested that the offices manage the expenses of medical exams and treatments paid for by health insurance in order to optimise the funds, avoid and minimise needless spending, and create resources to treat sick patients, particularly those with severe and chronic illnesses.

Social security offices have been asked to regularly work, meet and discuss with nurses and doctors about the wastefulness for the common goal of protecting the rights of health insurance participants and optimising health insurance funds given the context of limited funds.

In light of the limited financial resources, social security offices have been instructed to collaborate and have regular discussions regarding wastefulness with nurses and doctors in order to safeguard the rights of health insurance participants and maximise health insurance funds.

The General Director asked the offices to analyse how medical examination and treatment costs covered by health insurance have been managed since the beginning of the year, with an emphasis on leadership evaluation, testing, inspection, and outcome outcomes.

VSS Deputy General Director Nguyen Duc Hoa delivers a speech

Le Van Phuc, head of the VSS Department of Health Insurance Implementation, said the 12 participating provinces and cities' combined medical examination and treatment costs for health insurance make up more than half of the entire nation.

By the end of May 2024, some provinces in this group have reported a high rate of healthcare insurance spending, potentially exceeding the estimate assigned by the Government. Compared to the national average, many regions have far higher rates of both inpatient and outpatient medical examinations that are covered by health insurance, as well as more treatment days on average.

Thanks to bold leadership from leaders and the involvement of local social security offices, there have been significant developments recently observed nationwide in the management of medical examination and treatment costs paid by health insurance, he said.

Duong Tuan Duc, director of the Centre for Medical Claim Review, said the centre has developed several tools to support the sector’s leaders in managing costs at local social security offices. It has scheduled training sessions on risk identification, management tools, and evaluating unjustified cost rises for local offices.

These tools and solutions have proven effective in managing health insurance-covered medical examination and treatment expenses in compliance with legal requirements.

At the meeting, leaders of 12 local social security offices reported on the expenses of their medical exams and treatments since the beginning of the year, evaluated the reasons for the unreasonable increases, and then mentioned solutions they have taken.

Local offices pledged to keep closely adhering to the sector's and local government's directives in order to pinpoint aspects that are excessive and wasteful.

VSS director general Nguyen The Manh speaks at the working session

VSS General Director Nguyen The Manh concluded that VSS professional units must strengthen the system of statistics, synthesis, and evaluation nationwide and in each locality.

According to the Health Insurance Law and Decree 75/2023/ND-CP, local social security offices are required to notify health insurance medical facilities on a regular basis of rising variables and improper expenditures. Numbers and charts are used to demonstrate the unreasonableness, allowing medical facilities to make the necessary adjustments.

In managing health insurance and social insurance medical treatment costs, localities need to start from general to details, he said.

Local offices can issue warnings, check and test to detect and establish inappropriate variables, and refuse payment based on the statistics and warning systems provided by VSS.

He noted that in order to guarantee patients' rights, all information must be transparent.