The National Social Security Fund yesterday said it’s gearing up to sign agreements with about 200 provincial referral hospitals and health centres to provide coverage to a wave of recently insured workers in the country.
Ouk Samvithyea, executive director of the NSSF, said a workshop held yesterday in conjunction with the Labour and Health ministries was intended to prepare health care providers for the upcoming changes.
“We need to make them aware of how we are going to work with them,” he said outside the workshop.
NSSF has already signed 10 contracts with service providers in Phnom Penh, Kandal and Kampong Speu. Roughly 360,000 workers in those three provinces are already registered for health insurance under the NSSF expansion.
Under the new scheme, a worker contribution of 1.3 per cent of their gross monthly salary will be matched by employers.
Health providers will not only need to check if the workers are members of the NSSF when seeking care, Samvithyea said, but will also need to verify the workers’ identity. Agreements are still being worked out as to how much the NSSF will reimburse providers for various medical procedures.
“After providing services, the hospital can make a claim to NSSF, and then NSSF will check whether the claim matches the agreement price,” he said.
The NSSF has also established a medical committee to monitor the quality of care at the contracted hospitals and health centres, Samvithyea said.
If health-care facilities are not in compliance with agreement terms, the providers will be given time to correct their errors. “We will discuss with them and ask them to make reforms,” he said.
Ath Thorn, president of the Coalition of Cambodian Apparel Workers’ Democratic Union, welcomed the news of a medical committee to monitor the delivery of services.
“Currently, services at the hospitals and treatment are not very good,” he said. “There have been a lot of complaints of poor services at the hospitals.”
Ek Bun Than, governor of Kandal’s Loeuk Dek district and a medical doctor himself, said the scheme was a win-win for health providers and workers, as the health facilities will be reimbursed for the services they provide and workers will get the care they need.
However, he said, at least in his district, the capacity to provide health services to an influx of workers is not yet there.
“Currently, our district is lacking human and technical resources,” he said. “We are not sure if we could afford to expand our services.”
Additional reporting by Yesenia Amaro