PhilHealth, partners modify ‘Konsulta’health package

THE Philippine Health Insurance Corp. (PhilHealth) has partnered with five local government units (LGUs) and two private firms for the provision of its primary health care networks under its Konsultasyong Sulit at Tama or Konsulta primary health care package.

In a media briefing on Monday at the PhilHealth head office in Pasig City, Health Secretary Teodoro Herbosa said that the signing of the agreements is a “game changer” in the Universal Health Care Act, which recognizes primary health care as part of the health care delivery system in the country.

“We will make sure that the health care delivery system will mean a primary care doctor, assisted by health care workers, available to each and every Filipino. These primary health care doctors and clinics must link up with each other,” Herbosa said.

He also added that primary care and essential public health services, integrated with a broader network of hospitals and facilities, are key elements for Universal Health Care to happen.

The local government units that have signed on to the initial program are the provinces of Bataan, Guimaras, Quezon, South Cotabato and Baguio City, as well as patients of private health care providers Qualimed and LabX Corp.

Under the Konsulta package, PhilHealth will cover the primary health care package such as patient consultations, 13 laboratory and diagnostic tests, and 21 common medications that can be prescribed according to medical needs.

PhilHealth will pay public health care providers P500 per person per year for the availability of the package, while private hospitals will receive P750 per year, and this would be on top of the per-capita spend of local government units.

The new arrangement will allow advanced payments or frontloading of funds even before services had been rendered, called close-ended prepaid capitation, as well as paying the networks of primary care doctors and clinics, instead of individual clinics like the regular Konsulta benefit.

PhilHealth Senior Vice President Renato Limsiaco said that the state health insurer has allotted P8 billion for the Konsulta package to facilitate the implementation of primary health care services and has contracted network arrangements to different primary care providers.

Quezon Gov. Angelina “Helen” Tan said that the province signed on to be an implementer even if the policies are not perfect and the implementation can be tedious for them.

“I will join because I want to see the flaws and the wrongs. What is important is the support of the local chief executives,” Tan said.