A good doctor must spend at least 70% of his time on health insurance patients.

Service pricing

The Ministry of Health has issued Circular No. 21/2024/TT-BYT (hereinafter referred to as Circular 21) stipulating the method for pricing medical examination and treatment services, providing a legal basis for implementing the determination of prices for medical examination and treatment services according to the list of technical services issued by the Ministry of Health, in line with the specific characteristics of medical examination and treatment service provision at medical facilities. The Circular takes effect from October 17, 2024.

The Ministry of Health requires skilled doctors to dedicate at least 70% of their time to patients covered by health insurance and to provide professional support to lower-level healthcare facilities.

According to the Ministry of Health, regarding the adjustment of medical examination and treatment prices based on the basic salary of 2.34 million VND, Circular 21 instructs: maintaining the existing price structure and norms, only adjusting the salary factor from the basic salary of 1.8 million VND to the basic salary of 2.34 million VND.

Currently, the Ministry of Health has approved medical examination and treatment prices for 5 special-grade hospitals and 10 grade 1 hospitals. Local authorities are urgently implementing the approval of prices based on a salary of 2.34 million VND for medical examination and treatment facilities in their areas, ensuring that prices do not exceed the highest prices for services stipulated by the Ministry of Health.

Regarding the impact of adjusting medical examination and treatment service prices upwards in accordance with the basic salary level, the Ministry of Health assesses: For the health insurance fund, there is an annual surplus due to revenue and expenditure; moreover, the increase in health insurance fund revenue due to the adjustment of the basic salary level usually occurs earlier than the adjustment of medical examination and treatment service prices, therefore the health insurance fund is capable of balancing its finances.

Regarding the impact of the price increase on services for those participating in health insurance, the poor, ethnic minorities, and beneficiaries of social policies are not affected because their costs are 100% covered by the health insurance fund.

For those with health insurance cards who have to co-pay at a rate of 20% or 5%, the additional co-payment is not significant and is manageable because their income has also increased in line with the base salary.

For those who do not have health insurance cards (currently about 8% of the population), adjusting service prices will affect the portion of payments made based on the cost of medical examination and treatment services.

Skilled doctors provide support to lower-level healthcare facilities.

Circular 21 also specifies the principles and basis for pricing on-demand medical examination and treatment services. In addition to meeting the requirements for facilities, medical equipment, means, and personnel as stipulated by the law on medical examination and treatment, medical facilities providing on-demand services must also meet the following requirements: ensuring that the number of beds available for on-demand services at any given time does not exceed 20% of the average total number of beds in use in the preceding year; excluding on-demand beds located in separate or independent areas not mixed with regular beds in departments or wards, which are invested in by the unit using borrowed capital, mobilized funds, joint ventures, partnerships, public-private partnerships; or purchased from the career development fund or other legally mobilized capital sources as prescribed.

Hospitals need to ensure that their skilled specialists and doctors dedicate a certain percentage of their time (at least 70%) to providing medical care to patients with health insurance cards; those not using on-demand services; and providing professional support to lower-level facilities.

Hospitals must publicly and transparently disclose the list, prices, and availability of medical examination and treatment services so that people and patients can know and choose to use the services on a voluntary basis; ensuring that patients receive medical examination and treatment according to the treatment protocols issued by competent authorities.

The Ministry of Health also requires hospitals to request the competent authority to adjust the prices of medical examination and treatment services in cases where the factors that determine the price of these services fluctuate, either increasing or decreasing.

Source: https://thanhnien.vn/bac-si-gioi-phai-danh-it-nhat-70-thoi-gian-cho-benh-nhan-bhyt-185241116190219125.htm