A suitable management mechanism is needed for the digital healthcare model.

Integrating health insurance cards into citizen identity cards is expected to be a breakthrough in the digital transformation of healthcare. However, the actual implementation is encountering issues that need to be addressed.

The recent practice of Thai Nguyen Central Hospital temporarily charging 500,000 VND to patients seeking medical examination and treatment highlights the need to quickly finalize management and payment mechanisms that are compatible with the digital healthcare model.

The introduction of a procedure requiring patients to pay advance fees at Thai Nguyen Central Hospital is attracting considerable public attention.

At the Outpatient Department of Thai Nguyen Central Hospital, what many patients have been talking about recently is not the 500,000 VND fee, but the addition of extra steps in the examination and treatment process, which is expected to become increasingly streamlined.

Not only patients seeking emergency care, but even those with health insurance cards who have routine check-ups or outpatient treatment have to go through the additional step of making a provisional payment and reimbursement, making many feel that the medical examination and treatment process is not truly convenient.

Ms. Trieu Thi Hong, resident of neighborhood 64, Phan Dinh Phung ward, who regularly has her blood pressure checked, shared: "If it's for an unscheduled check-up, then charging is correct, but for people like me whose regular check-ups are fully covered by insurance, this regulation shouldn't be implemented."

However, from the healthcare facility's perspective, the story is not simply about an advance payment. According to the hospital representative, the temporary collection of fees is not intended to increase the financial burden on patients, but stems from practical difficulties in the process of transitioning to a new method of managing medical examinations and treatment.

Patient care at Thai Nguyen Central Hospital.

According to Dr. Nguyen Thu Huong, Head of the Outpatient Department at Thai Nguyen Central Hospital: Currently, the hospital accepts patients with health insurance using citizen identification cards integrated with insurance data. However, according to regulations, medical facilities are not allowed to retain patients' citizen identification cards. This leads to a situation where, after examination, testing, and receiving results, some patients leave the hospital but do not return to complete the procedures. This poses a significant challenge in management.

According to hospital statistics, from the beginning of 2025 to the present, there have been 1,050 cases of patients not returning to complete the payment procedures after medical examination and treatment. This is not only an administrative burden but also directly related to the financial, settlement, and operational work of the unit.

Looking at it more broadly, this story illustrates a reality: Technology can change rapidly, but management mechanisms sometimes fail to keep pace with the speed of practical operation. Integrating health insurance into the citizen identity card is a significant step in building a digital healthcare ecosystem. People no longer have to carry multiple documents, and procedures are streamlined.

However, as the new management model came into operation, some "bottlenecks" also emerged. While previously hospitals could manage patients using paper insurance cards, now, without the ability to retain citizen identification cards, the challenge of ensuring patients complete the necessary procedures has become more complex.

Clearly, the solution to this problem cannot be placed solely on the shoulders of individual hospitals. In the context of the country's accelerated digital transformation, cashless payments, and administrative procedure reforms, the Ministry of Health and the Vietnam Social Security need to promptly research and finalize a management mechanism suitable for the digital healthcare model; and simultaneously develop more comprehensive solutions regarding patient authentication, electronic payment settlement, post-examination cost management, and the financial responsibility of healthcare service users.

Source: https://baothainguyen.vn/y-te/202605/can-co-che-quan-ly-phu-hop-mo-hinh-kham-chua-benh-so-0c23b01/