Increasing medical examination and treatment prices, who is affected?

The Ministry of Health has approved new medical examination and treatment prices for about 25 special and first-class hospitals with thousands of services. How does the increase in medical examination and treatment prices affect hospitals and health insurance participants?

Thousands of techniques and services have their prices adjusted - Photo: NAM TRAN

Since the beginning of the month, a number of hospitals have announced adjustments to the prices of new medical examination and treatment services according to the basic salary from 1.8 million VND to 2.34 million VND. Of which, thousands of medical services have had their prices adjusted up...

Thousands of price adjustment services

After the increase in the basic salary, many hospitals are waiting for the price of medical examination and treatment services to increase synchronously to balance revenue and expenditure. The Ministry of Health has approved the price according to the salary level of 2.34 million VND for medical examination and treatment facilities in the area. As of November 15, the Ministry of Health has approved new medical examination and treatment prices for about 25 hospitals nationwide.

Specifically, previously, the price of health insurance examination services at special and grade I hospitals was 42,100 VND, at grade II hospitals was 37,500 VND, at grade III hospitals was 33,200 VND, at grade IV hospitals and commune health stations was 30,100 VND.

At Bach Mai, Cho Ray, Agricultural General Hospital, Central Dermatology Hospital..., examination fees are adjusted from 42,100 VND to 50,600 VND/visit.

The consultation fee to determine difficult cases (expert/case, only applicable to cases where experts from other units are invited to consult at the medical examination and treatment facility) remains at 200,000 VND/time.

Emergency resuscitation beds at special-class hospitals increased from VND509,400 to VND599,400/bed/day, and grade 1 beds from VND273,100 to VND327,100/visit/day.

Along with increasing examination and bed prices, hospitals also adjusted thousands of technical services. At Cho Ray Hospital (HCMC), more than 6,000 technical service prices were adjusted, technical services performed using anesthesia methods do not include drug costs.

This number at Bach Mai Hospital is nearly 10,000 services and at Thong Nhat Hospital (HCMC) is more than 7,000 services. Adjusting medical examination and treatment prices according to the new basic salary with an average increase of about 10% - 20% depending on each technical service.

In this price adjustment, the Ministry of Health issued a circular on pricing methods allowing units to follow the prices issued or approved by competent authorities until new regulations are issued.

How are people without health insurance cards affected?

Along with the increase in the health insurance contribution rate based on the basic salary, the maximum payment rate for health insurance examination and treatment services also increases according to regulations. The increase in payment rate ensures the rights of health insurance participants.

Besides, when medical examination and treatment costs increase according to the basic salary, it will help hospitals have a source of revenue.

The Ministry of Health said that health insurance participants are poor households, ethnic minorities, and social policy beneficiaries who are 100% covered by health insurance so they are not affected.

People with health insurance cards have to pay a co-payment of 20% or 5%, so the co-payment does not increase much and is affordable because the income of the subjects is also increased according to the basic salary.

People who do not have health insurance cards (about 8% of the population) only affect the payment part according to the price of medical examination and treatment services.

Sharing with Tuoi Tre, Mr. Bui Van Luong (40 years old, Hanoi) said that increasing the price of medical examination and treatment services according to the basic salary is basically acceptable.

Mr. Luong cited that with a benefit rate of 80% and a co-payment rate of 20%, with a bed price of about 270,000 VND, the patient will pay 54,000 VND; when it increases to 327,000 VND, people will have to pay more than 65,000 VND, an increase of more than 10,000 VND.

"However, it is important to ensure enough medicine and medical supplies for treatment. Recently, when being treated at K Hospital, my relative still had to go out to buy medicine and supplies even though it was included in the services covered by health insurance.

Therefore, I think the important thing when increasing health insurance premiums and hospital fees is to ensure the rights of health insurance participants," Mr. Luong expressed.

Increasing hospital fees is still enough to balance the health insurance fund

Speaking with Tuoi Tre, Mr. Phan Van Men, director of Hanoi Social Insurance, said that the unit is currently conducting statistical assessments of the impact of increased medical examination and treatment costs on the health insurance fund.

He said that the increase in medical examination and treatment costs based on the basic salary this time is basically the same as previous adjustments. It is likely to still impact the health insurance fund, but statistics are needed to have a specific assessment.

The Ministry of Health said that the assessment of the impact of the health insurance fund after increasing medical examination and treatment prices is still able to balance.

Specifically, comparing the annual revenue and expenditure difference of the health insurance fund (cumulative balance in 2023), at the same time, the health insurance fund revenue increases due to the adjustment of the basic salary level, which is often earlier than the adjustment of medical examination and treatment service prices, so the health insurance fund is capable of balancing.

Increased hospital fees have not met the requirements of "correctness and adequacy"

Previously, many hospitals believed that it was necessary to "correctly and fully calculate" the price structure of medical examination and treatment services to help hospitals have resources to invest in improving hospital quality.

Currently, the price of medical examination and treatment services only includes two factors: direct costs (medicines, chemicals, medical supplies, etc.) and salaries, not including management costs (including maintenance of medical equipment, fixed assets, training, scientific research, information technology, etc.) and depreciation of fixed assets.

According to the leader of a general hospital in Hanoi, this increase in medical examination and treatment costs only basically covers the cost of paying salaries to hospital staff.

"In fact, hospital fees only adjust salary factors. Meanwhile, other factors, such as information technology costs, are not included in the price of medical examination and treatment services, causing difficulties for most hospitals, especially for hospitals that are self-sufficient in regular expenses," he said.

Source: https://tuoitre.vn/tang-gia-kham-chua-benh-ai-bi-anh-huong-20241118224337582.htm