Five local government units (lgus) and two private sector groups of clinics and doctors signed on Monday, June 19, an agreement with the Philippine Health Insurance Corporation (PhilHealth) to establish the country's first seven primary care networks.
DOH Sec. Teodoro Herbosa and PhilHealth Acting President and CEO Emmanuel R. Ledesma, Jr., together with officials from five government and two private health care sectors, signed an agreement on Monday, June 19, for the creation of the country's first seven primary care networks. (Photo courtesy of DOH)
"Primary care and essential public health services, integrated with a broader health care network of hospitals and other facilities, is a key element needed for universal health care to happen. Dapat ramdam ng bawat Pilipino ang UHC (Each Filipino should feel the UHC)," said Department of Health (DOH) Secretary and PhilHealth Chairperson of the Board Dr. Teodoro "Ted" Herbosa.
Under Republic Act No. 11223 or the Universal Health Care Act, "primary care" is defined as the person's first contact and most accessible source of healthcare.
This mandates the DOH and lgus to ensure the prompt delivery of primary care assistance to Filipinos.
(Photo courtesy of DOH)
The newly formed Primary Care Provider Network (PCPN) will conduct its "sandbox" or initial testing in Bataan, Guimaras, Quezon, South Cotabato, and Baguio City where about two million individuals are expected to benefit.
Another 300,000 under LiFE group and QualiMed will also be included in the improvements in primary care financing.
These locations will pilot the program to assess outcomes and identify areas for improvement in the system.
How is this different from the current PhilHealth Konsulta primary care benefit package?
The current PhilHealth Konsulta primary care package covers consultation, 13 laboratory and diagnostic tests, and 21 common medications.
This package follows the usual reimbursement method, where healthcare providers receive P500–750 per patient per year after providing services.
The new Konsulta primary care network, on the other hand, will enable PhilHealth and lgus to allocate funds to partner health institutions even before services are rendered ensuring Filipinos' access to select health services without spending a dime.
Konsulta PCPN will only pay networks of primary care doctors and clinics, in contrast with the regular Konsulta benefit, where individual clinics are paid
"These innovations are enabled by new Commission on Audit (COA) accounting guidelines. The seven Konsulta PCPNs caring for 2.3 million Filipinos are projected to be paid a total of P1.2 billion, which may be used to improve infrastructure, equipment, and staff compensation even before the first patient starts using services," explained the DOH.