Conduct an Actuarial Assessment of the Current Viability of the Vietnam Social Security Scheme
The Government of Vietnam (GOV) is committed to Social Health Insurance (SHI) as a mechanism for achieving Universal Health Coverage (UHC), including passage of a new amendment to the Law on Health Insurance that mandates SHI for all. Nearly 70 percent of the population is insured through Vietnam’s SHI scheme, but out-of-pocket payments remain high at 47% of Total Health Expenditures and health care costs are escalating. The Viet Nam Social Security agency (VSS) is the central agency responsible for administering the SHI. As part of recently passed law, the MOH and VSS are responsible for defining a health insurance benefits package to address challenges that currently prevent the scale up and viability of the SHI scheme. In defining the benefit package, the VSS shall be addressing the following key questions in relation to the SHI: (1) Which services shall be covered? (2) Who shall be covered? and (3) How much should be covered? Actuarial costing analysis is required to inform how the MOH and VSS address these key questions.
The overarching objective of this activity is to assemble and clean a dataset derived from the VSS’ claims database and other relevant sources of data, and to use this dataset to create an actuarial model that the MOH and VSS may use to model various options for defining their health insurance benefit package.