The Ministry of Health has been tasked with coordinating with relevant agencies to draft a Decree that raises health insurance contribution rates from 2027 in a manner aligned with expanding the scope of benefits and levels of health insurance coverage. The Prime Minister requires that, in addition to routine duties, ministries and agencies strengthen direction by revising, supplementing, and improving the health insurance policy framework to meet universal coverage goals. The Ministry of Health, in collaboration with the Ministry of
Finance and other involved ministries, shall prepare documents such as: a resolution on piloting diversified health insurance packages and supplementary health insurance to meet public demand, strengthening linkages between health insurance and corporate health insurance to avoid duplicate medical payments, to be completed in Q2 2028. A Decree on increasing health insurance contribution rates from 2027 in line with expanding benefit scope and coverage. The plan also calls for continuing to increase subsidy support for health insurance contributions for policy beneficiaries, near-poor households, people with disabilities, and vulnerable groups, ensuring sustainability and raising the share of the population participating in health insurance, to be completed by March 2027. A resolution on piloting diversified and expanded funding sources to ensure the sustainability and growth of the Health Insurance Fund, including a mechanism to allocate a portion of tax revenue from tobacco products, alcohol, and sugar-sweetened beverages to cover preventive services, chronic disease management, periodic health checkups, screening, and early detection of certain diseases, particularly non-communicable diseases, to be completed in Q4 2028. The Health Insurance Law amendment to be completed in Q1 2029. The plan also notes that from May 2026, eligible healthcare facilities will implement new service pricing with cost-management components. From Q1 2027, facilities will study conditions to enable patient discharge on Saturdays, Sundays, and holidays. From Q2 2027, there will be a phased patient flow by clinical specialty to reduce treatment of mild illnesses at highly specialized facilities. Regarding resource diversification and sustainable development of the Health Insurance Fund to expand the scope of benefits, the government aims to increase health insurance participation through household-based coverage to reach over 95.5% of the population by 2026 and universal health insurance by 2030. From 2026, gradually increasing payments for prevention, diagnosis, and early treatment of certain diseases in line with the contribution increases and the Fund balance. The plan also expands the scope of Fund payments to cover preventive care, nutrition, chronic disease management, periodic health examinations, and demand-driven screening. It also includes direct support for health insurance participants when using healthcare services and pilots to reduce the out-of-pocket costs, prioritizing beneficiaries who are poor or near-poor and other social policy groups. At the same time, it calls for reviewing and revising rules on the lists, rates, and payment levels for medicines, medical devices, and medical services covered by health insurance to align with the Fund’s balance. In addition, it outlines the method of paying health insurance by diagnosis-related groups.
Xây dựng phương thức thanh toán bảo hiểm y tế theo nhóm chẩn đoán
