THE Philippine Health Insurance Corporation (PhilHealth) is set to pilot test its primary care benefit package using the “prepaid” system in five local government units and two private sector groups of clinics.
In a press conference, PhilHealth Board of Directors chairman Teodoro Herbosa announced they launch the primary care networks (PCNs), in Bataan, Guimaras, Quezon, South Cotabato, and Baguio City, as well as with LiFE telemedicine group and QualiMed Health Network.
“It is the goal of PhilHealth to register all Filipinos, and that each member is protected and are ensured medically,” said Herbosa.
“This groundbreaking approach to primary care financing, through network contracting and close-ended, prepaid capitation, is a gamechanger,” he added.
PhilHealth said PCNs are expected to benefit about 2 million Filipinos in the five local government units, and another 300,000 from the private clinics.
The benefits are projected to amount to a total of P1.2 billion during the pilot test, according to PhilHealth.
During the “sandbox” pilot testing, PhilHealth said there will be pre-selected areas, where advanced payments or frontloading of funds even before primary care services have been rendered will be allowed.
The primary care benefit package covers patient consultations, any of the 13 laboratory and diagnostic tests as ordered by the doctor, and 21 common medications that can be prescribed according to medical needs.
