HCMC tightens health insurance regulations

This year, Ho Chi Minh City is allowed to spend nearly VND10 trillion ($438.7 million), a decrease of nearly VND4 trillion compared to last year.
HCMC tightens health insurance regulations
To ensure the planned spending, the city’s Social Insurance Agency will set up the cost estimate in all hospitals, advance, payment a well as tighten control of medical insurance spending for the year.
For 2017, vice director of Social Insurance Agency Luu Thi Thanh Huyen said that the agency has signed medical insurance treatment contracts with 70 public infirmaries, 73 private facilities, 15 medical institutions of companies, and 145 medical centers in districts and communes.
With nearly 6.6 million of medical insurance cards, HCMC planned to spend VND14,263 billion; however, in reality, it paid VND 16.372 billion.
The cause of over-spending is many inpatients and improper prescription of expensive drug in treatment.
Additionally, many patients go to different hospitals for treatment many times but they did not pay for tests ad medicine charges; according the vice director said that with the estimation of nearly VND10 trillion for the year, medical facilities must tighten prescription and limit patients to undergo unnecessary techniques to fix the estimation.
At the health sector’ online meeting for the first quarter, in first three months, medical facilities provided examination and treatment to nine million patients, a year-on-year increase of 7.9 percent and the rate of inpatient is 71.7 percent, a hike of 7.1 percent compared to same period last year.
Ms. Huyen said that the agency will early announced the estimation of medical insurance treatment to all hospitals so that facilities are able to calculate the spending.
Alongside with this, the agency will keep an eye on implementing regulations of advancing, paying and treatment spending to ensure the set estimation.
Directors of hospitals disagreed with medical insurance regulations because they don’t match with the reality.
Deputy director of the municipal Health Department Tang Chi Thuong said that the department has set up a special team to solve problems in medical insurance mission in infirmaries to provide timely guidance.
First of all, the team in coordination with the agency provide training courses relating to connection between hospitals with the aim to use test results in order to cut down the cost.

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