MANILA, Philippines — Five local government units and two private healthcare providers agreed Monday to form a primary care provider network to make access to services to the state health insurer’s benefit package more efficient.
The provinces of Bataan, Guimaras, Quezon and South Cotabato, and Baguio City were identified by the Philippine Health Insurance Corporation as the pilot areas or sandbox sites for the implementation of its Konsultasyong Sulit at Tama (Konsulta) primary care benefit package, the Department of Health and the state health insurer said in a joint release.
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Around two million Filipinos from these areas and another 300,000 Filipinos under the care of the LiFE and QualiMed are expected to benefit from the system.
“PhilHealth should give more support to public-owned and underfunded hospitals and clinics as well as the doctors, nurses, midwives and other health workers in them. PhilHealth should also engage more with private clinics and doctors,” Health Secretary Ted Herbosa said following the signing of the Konsulta primary care network service level agreement.
The current Konsulta primary care benefit package covers patient consultations, laboratory and diagnostic tests, and 21 common medications that can be prescribed according to medical needs.
PhilHealth pays its Konsulta package providers predetermined amounts of P500 per person for public providers and P750 per person for private providers.
“The Konsulta primary care provider network innovates this arrangement on a ‘sandbox’ or testing basis in pre-selected areas, by allowing advanced payments or frontloading of funds even before services have been rendered,” the joint release read. — Gaea Katreena Cabico