Speaking at the meeting, on behalf of industry leaders, Deputy General Director Nguyen Duc Hoa expressed sincere thanks to Ms. Aparnaa Somanathan and the World Bank for supporting Vietnam Social Security during the past time; at the same time, he highly appreciated the cooperation between the two sides, especially in such fields as: Reform and modernization of Vietnam’s social insurance industry; strengthening fund investment management and reforming health care and universal health insurance. Notably, the WB is also actively supporting Vietnam Social Insurance in amending and supplementing the Law on Social Insurance and the Law on Health Insurance.

According to Deputy General Director Nguyen Duc Hoa, currently, the number of people participating in health insurance in Vietnam reaches over 88 million people, the coverage rate is over 89% of the population. In addition to developing participants, Vietnam Social Insurance also ensures correct, sufficient and timely payment of benefits for millions of people.

Notably, every year, about 190 million people are covered by the health insurance fund by the health insurance fund, and the health insurance fund is currently the most important source of health financing for the people’s health care system.

“However, it can be seen that the health insurance premium for participants is fixed, and benefits are always extended. Therefore, Vietnam Social Insurance urgently needs a suitable payment method to both ensure the interests of the people, at the same time balance the health insurance fund and prevent profiteering in medical care and health insurance “- Deputy General Director Nguyen Duc Hoa stated. .

From the above situation, Deputy General Director Nguyen Duc Hoa hoped that the WB would continue to share experiences and make recommendations for the health system in Vietnam in general and the implementation of the health insurance policy of the Vietnam Social Insurance. private. At the same time, support Vietnam Social Insurance to apply artificial intelligence (AI) to health insurance assessment, inspection and examination operations; pilot implementation of an online scheduling system to support people and businesses when interacting with social insurance agencies; appoint experts to provide technical assistance to staff of the Vietnam Social Security Administration on payment methods under DRG; develop principles of fund allocation for DRG and contingency funds, develop DRG-based medical care contracts with medical facilities…

Sending congratulations to Deputy General Director Nguyen Duc Hoa, Ms. Aparnaa Somanathan expressed her wish that, in her new position, Deputy General Director Nguyen Duc Hoa will always accompany and work closely with the World Bank in the fields of cooperation. between two parties. According to Ms. Aparnaa Somanathan, the fields of cooperation between the Vietnam Social Security Administration and the World Bank are diverse, such as: IT application, administrative procedure reform, building and perfecting a model for calculating fund balance, training and technology transfer in management financial management, fund investment management… However, in any field, the WB always receives active cooperation from Vietnam Social Security.

“Personally, I had the opportunity to participate in amending the Law on Health Insurance in 2014, and at the same time, with the WB delegation to study and write a review report on the social insurance system. From there, understand clearly about Vietnam’s social insurance system. And, I am very excited to continue working in this field,” shared Ms. Aparnaa Somanathan.

In the field of medical cooperation, Ms. Aparnaa Somanathan said that the WB has supported Vietnam Social Security to implement payment by diagnostic group (DRG); improve the quality of medical care services; expand and develop the audience, especially in the informal sector…

Sharing the direction of cooperation in the coming time, Ms. Aparnaa Somanathan affirmed that the WB always wants and is ready to expand cooperation with Vietnam Social Security in related fields to build a sustainable health system, through Vietnamese people can use the most modern medicines and medical equipment.

At the meeting, a representative of the Center for Assessment of Health Insurance and Electronic Information said that in recent years, Vietnam Social Security has promoted the application of data mining and artificial intelligence in health insurance assessment. Accordingly, after nearly 6 years of conducting electronic assessment, medical examination and treatment data has grown rapidly with more than 15 billion records collected from nearly 1 billion visits of medical examination and treatment, the quality of data is increasingly improved with the addition of mandatory data normalization requirements.

Research into the application of data mining and artificial intelligence that has supported the control of health insurance claims is expected to be implemented specifically, such as: Regarding the objective, building a data mining tool to support the establishment of protocols treatment plan for each disease group; develop a standard treatment regimen based on evidence and conclusions of experts; using AI to assist in identifying payment claims and managing risks in health insurance payments.

PV